Fine-tuning the management of Addison's disease/steroid replacement therapy

Assessing the potential for fine-tuning the management of Addison's disease/steroid replacement therapy - by Sarah J.K. Baker

The 2007 study by Sarah J.K. Baker was an early survey of ADSHG members' experiences (n=150). It addressed the potential for fine-tuning the management of Addison's disease/steroid replacement therapy, drawn from the experience of ADSHG members.

Study objectives

1. To assess the nature and degree of post-diagnosis symptoms.
2. If significant patterns should emerge, to have these symptoms acknowledged and validated by medical professionals, raising awareness of them amongst both specialists and GP's.
3. To prompt a clinical study of why these symptoms occur and to request a set of comprehensive guidelines on what, if any, preventive or ameliorative measures can be practicably taken.

Conclusions

1. There is considerable evidence from the data collected that certain post-diagnosis symptoms exist amongst patients with Addison's disease and in some cases are widespread.
2. The question arises as to cause and effect and the degree to which this can be established in relation to each. If any links can be clinically established, are they due to inaccurate baselines, less than optimal dosage times, the disease per se or the treatment per se?
3. In any case there seems to be a clear opportunity to fine-tune hydrocortisone levels through greater use of day curve analyses. There also seems to be considerable potential to bridge a gap perpetrated on both sides between patient and doctor via exchange of more rather than less information.
4. Additionally, more professional advice on diet, nutrition and lifestyle may do much to improve the effectiveness of self-help strategies and reduce the trial and error basis on which these tend to be adopted.