Another important aspect to consider is how your current medications might be affecting your adrenals in a negative way. It’s possible that adrenal insufficiency can develop when a person taking glucocorticoid hormones (like prednisone) for a long time, which act similarly to cortisol, suddenly stops taking those medications. If you’re on any prescriptions for treating inflammatory illnesses like rheumatoid arthritis, asthma or ulcerative colitis , talk to your doctor about how to adjust your dosage appropriately before changing them yourself since these can lower ACTH and cortisol.
During an illness, a person taking corticosteroids orally may take an adjusted dose to mimic the normal response of the adrenal glands to this stress on the body. Significant fever or injury may require a triple dose. Once the person recovers from the illness, dosing is then returned to regular, pre-illness levels. People with adrenal insufficiency should know how to increase medication during such periods of stress, as advised by their health care provider. Immediate medical attention is needed if severe infections, vomiting, or diarrhea occur. These conditions can lead to an adrenal crisis.
Untreated, adrenal insufficiency is fatal, and indeed this was invariably the case until the advent of synthetic cortisone in 1949. Treatment of Addison's disease is lifelong. The prognosis for any patient with adrenal insufficiency will depend on the underlying cause. In those patients in whom the prognosis is not affected by the underlying pathology, replacement therapy should result in a return to health. However, a Norwegian study found an excess of mortality in patients diagnosed with Addison's disease at a young age, associated with acute adrenal failure, infection and sudden death. [ 16 ]