Case study ( 1936 views as of September 21, 2017 )
Mary is a 44-year-old journalist who presents to her physician with symptoms of poor appetite, nausea, lightheadedness and abdominal pains. These symptoms have been going on for the past year, and she has also noticed a 20-pound weight loss during this time period. Mary does not spend much time in the sun, however she has noticed some changes in the pigmentation of her skin.
After review with her family physician, routine blood work shows that Mary has low sodium and high potassium levels and she is referred to an endocrinologist. Further investigations lead to a diagnosis of Addison's Disease (primary adrenal insufficiency), and Mary is treated with glucocorticoid and mineralocorticoid hormonal therapy which completely resolve her symptoms. She is also given instructions on how to adjust her medication when she is acutely ill and how to maintain proper salt and fluid intake to avoid dehydration.
Mary would benefit from continuing to work with her family physician and endocrinologist to manage her Addison's Disease. She may wish to work with a dietitian to understand the impact of her nutritional intake on her hydration levels as well as her vitamin and mineral intake. A pharmacist could help her manage her medications and supplements and avoid any adverse interactions with her prescribed medications. Finally, keeping stress levels down is important for patients with adrenal insufficiency. Taking yoga or getting a massage may help Mary in her day-to-day life.Author: Dr. Ronald Goldenberg