The adrenal glands produce hormones that affect the body differently. Cortisol, aldosterone and androgens such as testosterone are hormones produced by these glands. Adrenal insufficiency is a condition where the adrenal glands produce low amounts of these hormones. This condition is also called Addison's disease and is treated by replacement of the deficient hormones with synthetic ones.
Hormones and Their Replacements
Cortisol is an adrenal hormone that regulates blood pressure, the amount of glucose in the body and the inflammatory response of the body. The National Endocrine and Metabolic Diseases Information Service explains that hydrocortisone is used to treat cortisol deficiency in adrenal insufficiency.
Aldosterone helps the body maintain sodium and potassium balance. It is replaced with a medication called fludrocortisone when it is low or deficient--such as in adrenal insufficiency.
Drugs
Hydrocortisone is a medication that is similar to cortisol made by the adrenal glands. In adrenal insufficiency, it can be given orally as tablets or by injections. The Merck Manuals Online Medical Library explains that in severe cases of adrenal insufficiency, this medication can be given intravenously.
Fludrocortisone tablets help the body resume the functions of aldosterone--secretion of potassium and sodium retention. It works by reducing the amount of sodium excreted by the body.
Time Frame
Medications for adrenal insufficiency are taken throughout a patient's lifetime. Hydrocortisone is given in divided doses due to normal fluctuation in cortisol levels in the body. Normally, the body produces high levels of cortisone in the morning. Due to this, the morning dose of hydrocortisone is usually larger than doses taken at other times during the day. Fludrocortisone is taken every day in adrenal insufficiency.
Side Effects
Fludrocortisone and hydrocortisone can cause undesired effects such as an upset stomach, sleepiness, vomiting, headaches, restlessness and skin that is easily bruised. They may also cause serious side effects that should be reported to a physician once they are recognized. A skin rash, bleeding in the digestive tract seen as black-colored stool, problems seeing, an infection that does not clear up quickly and swelling in the ankles or face are serious side effects of these medicines.
Considerations
Patients taking fludrocortisone or hydrocortisone should not stop taking them abruptly. doing this could lead to effects such as confusion and skin peeling. Medline Plus--a website of the U.S National Library of Medicine--recommends that patients on these drugs talk to their physicians before they stop taking these medicines. Additionally, the Merck Manuals Online Medical Library reports that testosterone--a hormone that regulates development of male sex characteristics--replacement is typically not needed in adrenal insufficiency. However, it can be replaced with dehydroepiandrosterone.
