Endocrine Abstracts

I have now lived with my Addison’s (adrenal failure) for 7 years. I have achieved a lot during that time and am grateful for the medical care I have received. I was in my 30s when diagnosed, whilst living and working in Germany, after having felt ill for a few months. I was diagnosed with hypothyroidism at the same time, and started on 50 mcg thyroxine and 20 mg hydrocortisone, with doses of 10 mg - 5 mg - 5 mg. When I was given my first dose of hydrocortisone, it was amazing how much better I immediately felt. However, after about 12 months, I became rather unwell again, until I started on 50 mcg fludrocortisone several months later. Three years after diagnosis, I became pregnant with my first child and relocated to the UK at 35 weeks pregnant. I was then under the care of a combined antenatal/endocrine team, who adjusted my medication slightly during pregnancy and followed the Addison’s Group’s (ADSHG) surgical guidelines during a difficult childbirth. I became pregnant again two years later; again, little medication adjustment was required during the pregnancy. As my second baby needed to be born by caesarean, the ADSHG surgical guidelines were followed carefully for the operation. In between pregnancies, and since my second baby was born, I have been under the care of two different hospital endocrine teams. Over the 7 years since diagnosis, my endocrine teams have adjusted the amount and timing of my replacement hormone medication numerous times, sometimes due to blood results, but often in response to how I feel. I currently take 10 mg hydrocortisone at 8 am, 5 mg at 12 noon and 5 mg at tea-time, and 100 mcg fludrocortisone at 8 am. It was only after the birth of my second child that my hypothyroid diagnosis was revisited, concluding that my initial diagnosis of concurrent Addison’s and hypothyroidism - on the basis of elevated TSH - had been mistaken. I have since stopped taking thyroxine, and have felt calmer if a little more tired. Life with a young family is busy, and I am glad that my overall health and stamina remain good. I have experienced two adrenal crises, both involving vomiting bugs, and requiring the use of my injection kit that my family and friends have been trained to use, thanks to my supportive GP and practice nurse. The ADSHG has been a valuable source of information and support, especially during my time in Germany when I felt more isolated. Their medical guidance is available at www.addisons.org.uk

Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.