Rant: Addison's is complicated (said with a tremendous amount of sarcasm)

It's not.

Here is the real translation:

Addison's is complicated=my doctor is too lazy to research adrenal insufficiency management and I'm too lazy or sick to teach him.

Did I make you mad?

If you say, "Yes!" or even, "Maybe..." this means you know what I'm saying is true.

Addison's is NOT complicated.  You need to be tested to determine if you have it.  Once that occurs, you need to know if you need Florinef.  Next test for thyroid disorders and correct them.  Lastly, test for the deficient sex hormones and replace them.  This is spelled out in the literature over and over.  If your doctor would read anything written about adrenal insufficiency written in the last decade, he would find the same thing.  Read anything by Arlt, Allilio, Quinkler and Crapo.  Read Medscape.  Read an old endocrinology text book.

He won't read.  He won't manage you properly. He only wants your $250 and for you to feel awful.  He doesn't give a shit.

Here is a link to the newest guidelines as put forth by the Endocrine Society:

Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline

Stefan R. Bornstein(chair), Bruno Allolio, Wiebke Arlt, Andreas Barthel, Andrew Don-Wauchope, Gary D. Hammer, Eystein S. Husebye, Deborah P. Merke, M. Hassan Murad, Constantine A. Stratakis, and David J. Torpy

- See more at: http://press.endocrine.org/doi/10.1210/jc.2015-1710#sthash.Z8UuD2Wa.dpuf

I have not made the time to read the whole paper but what I have read lays out management in a way that a six year old could manage one of us.

Read it.

Print it out.

Highlight the things your doctor needs to learn.

Take a highlighted copy to your doctor visit and give it to the doctor while you hold a copy in your hand with the same highlighting.

Ask to have an 8 am, fasting BMP drawn, DHEA-S, yadda, yadda, yadda.  If the doctor says, "No".  Ask why.  My response would be, "But is says here in section 3.7 that..."  I would then walk out and never go back.

What the hell does it matter if a doctor draws routine labs outlined by every medical publication to be printed about adrenal insufficiency for the last decade and a half?  How is he negatively affected?  I'll tell you how.  He will get information that he doesn't know how to interpret.  He will feel dumb or obligated to understand.  He will have to care and work a little bit.  If he refuses to test the basics of adrenal insufficiency, he is a TERRIBLE DOCTOR.   Because he's a terrible doctor, he will then blame YOU for being "complicated".  

For hell's sake, not much has to be tested for adrenal insufficiency.  Managing HC is a matter of taking enough at the right times and having a prescription that will allow for you to have enough HC in hand.  Managing Florinef is largely based on symptoms as well.  Other hormones need to be tested and other diseases ruled out or in.  It's NOT complicated.

Doctors are complicated.  They are overworked, overpaid, largely uncaring and very intimidated when a patient comes to them who knows her shit and is, unexplainably, 100% healthier than the doctor himself.  Doctors, by and large, refuse to take responsibility for themselves.  You, the patient, suffer because the doctor would prefer to blame you for being complicated than himself for being unwilling to learn how to manage you or refer you to someone would could.

You know what's uncomplicated about adrenal insufficiency.  Learning and understanding the basics.  DO IT.  If you need help, go to my forum or any forum where the whining is minimal (mine's the best :).  I know, I'm biased. ), hire me to help you understand adrenal insufficiency, seek answers if you don't want to get help from people who know their stuff, get answers, stay away from Endos (they tend to be the biggest morons) and go with an NP, PA, GP or DO for managing your adrenal insufficiency.


Addison's is NOT complicated