Question 1

What is Addison's disease?

Accepted Answer

Addison's disease is primary adrenal insufficiency in which the adrenal glands do not produce enough cortisol and commonly do not produce enough aldosterone. It requires medical diagnosis and lifelong hormone-replacement management [8].

Question 2

What symptoms can occur with Addison's disease?

Accepted Answer

Symptoms may include chronic fatigue, muscle weakness, reduced appetite, weight loss, abdominal discomfort, nausea, salt craving, low blood pressure, postural dizziness and increased skin or mucosal pigmentation [8].

Question 3

What is an adrenal crisis?

Accepted Answer

An adrenal crisis is an acute, potentially fatal shortage of cortisol that can cause severe weakness, vomiting, abdominal pain, hypotension, confusion, hypoglycaemia, electrolyte disturbance, shock or unconsciousness [8].

Question 4

How is suspected adrenal crisis treated?

Accepted Answer

It requires immediate emergency treatment. Specialist guidance recommends prompt parenteral hydrocortisone and rapid intravenous saline rather than waiting for diagnostic confirmation [8].

Question 5

Can acupuncture replace hydrocortisone or fludrocortisone?

Accepted Answer

No. Acupuncture cannot replace glucocorticoid or mineralocorticoid replacement and must never delay sick-day dosing or emergency hydrocortisone [8].

Question 6

Can Chinese herbs cure Addison's disease?

Accepted Answer

There is no established evidence that Chinese herbs restore destroyed adrenal tissue or remove the need for hormone replacement. Herbal treatment may only be considered adjunctively after interaction and safety review [8].

Question 7

What TCM patterns may be considered?

Accepted Answer

Traditional patterns may include Spleen-Kidney Yang deficiency, Kidney Qi deficiency, Spleen Qi deficiency, Qi-Blood deficiency, Yin-fluid deficiency or Liver-Spleen disharmony. These patterns do not diagnose adrenal insufficiency [8].

Question 8

Which acupuncture points may be considered in stable patients?

Accepted Answer

Pattern-dependent points may include ST36, SP6, REN6, REN4, BL20, BL23, KI3, PC6 and HT7. Treatment should be gentle, particularly when hypotension or fatigue is present [8].

Question 9

Why is liquorice important in Addison's disease herbal safety?

Accepted Answer

Liquorice and concentrated Gān Cǎo can affect sodium, potassium, blood pressure and steroid metabolism. They must not be used as substitutes for fludrocortisone and require clinician and pharmacist review [8].

Question 10

What should a patient with adrenal insufficiency carry?

Accepted Answer

Patients are generally advised to carry medical identification, prescribed steroid medication and an emergency hydrocortisone kit, with training for themselves and close contacts [8].

Question 11

Is adrenal fatigue the same as Addison's disease?

Accepted Answer

No. Addison's disease is a medically recognised hormone-deficiency disorder confirmed through appropriate testing. Adrenal fatigue is not a recognised medical diagnosis [8].

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