People require adrenal remedies when adrenal insufficiency exists. Adrenal insufficiency occurs when the adrenal glands, two small organs located on top of each kidney, fail to produce adequate amounts of the hormones cortisol and aldosterone. Cortisol is known as the stress hormone and regulates carbohydrate, protein and glucose metabolism, the body's inflammatory response and blood pressure. Aldosterone controls fluid and electrolyte balance. Remedies center on hormone replacement therapy and patient education and preparedness.
Hormone Replacement
Adrenal insufficiency causes low levels of cortisol and aldosterone incompatible to life. Necessary for survival, cortisol and aldosterone must be replaced by hormone replacement therapy. Patti Radovich, a certified nursing specialist and author of Primary Adrenal Insufficiency: Elusive and Potentially Life-threatening published in the March, 2010 "American Nurse Today" journal, states that cortisol is replaced by oral steroids such as hydrocortisone. Other suitable glucocorticoid steroids include prednisone or dexamethasone. Most people with adrenal insufficiency require aldosterone replacement with a mineralacorticoid called fludrocortisones acetate. Dosages are individualized, weight based and usually taken three times per day.
Increase Dietary Salt
The National Institute of Diabetes and Digestive and Kidney Diseases recommends that people with adrenal insufficiency increase dietary salt intake. Low blood levels of sodium occur because loss of aldosterone causes increased excretion of sodium. Low sodium causes muscle weakness, confusion and can be fatal if not treated. In addition to low sodium, adrenal insufficiency causes high levels of potassium which causes irregular heart rhythms. When adding salt to the diet, people with adrenal insufficiency must not use salt substitutes which contain high levels of potassium.
Manage Stress
Cortisol converts the hormone norepinephrine to epinephrine, a vital hormone necessary for the body to respond to stress. NIDDK explains that patients with adrenal insufficiency require increased dosages of hormone replacement medications to mimic the normal response of the adrenal glands, which allows the body to appropriately respond to stressful situations. For example, during stressful times such as injury, illness or emotional stress, replacement hormone dosages may need to be doubled or more. People with adrenal insufficiency must notify health care providers of stressful situations so that care can be adjusted accordingly. In addition to adjusting medication dosages, another adrenal remedy involves lifestyle changes to minimize daily stress and foster effective coping mechanisms to deal with stress.
Emergency Care
Scott and White Hospital advises people with adrenal insufficiency to carry emergency doses of glucocorticoid at all times. This adrenal remedy can save a person's life in the event of adrenal crisis. Adrenal crisis occurs when hormone levels drop too low to maintain life. Emergent self-injection of hydrocortisone into the thigh muscle can save a patient's life. NIDDK recommends that all people with adrenal insufficiency wear a medical alert bracelet as well to alert caregivers of the patient's health condition in order to initiate correct medical treatment.
References
- "American Nurse Today"; Primary Adrenal Insufficiency: Elusive and Potentially Life-threatening; Patti Radovich; March 2010
- The National Institute of Diabetes and Digestive and Kidney Diseases: Adrenal Insufficiency and Addison's Disease
- Scott and White Hospital: Addison's Disease
