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The Pro-Active Addisonian and the $120M Diet

February 21, 2008

It occurs to me that I should update my Adrenalog for those coming from the Addison’s Disease tag. I have now been on hydrocortisone for four months, an oral dose of 20 mg in the morning, and 5 mg in the evening.

Fatigue remains a limiting factor of life, but it certainly is not the profound fatigue that leveled me last summer before my diagnosis in October. I am able to withstand normal and even extraordinary stress without increased symptoms. But the scope of my routine keeps my life within the same bounds as any other chronic fatigue illness. In addition to autoimmune Addison’s, I have fibromyalgia and four forms of arthritis, none of which are autoimmune. So far, I have developed no other autoimmune complications.

People with Addison’s need to be pro-active. My endocrinologist was insistent that I acquire a medical ID bracelet. I call it my “steel tattoo,” and hope it is never necessary that an EMT notice it. But the reason anyone with Addison’s should wear one is simple. If you are in an accident, and have bleeding and a head injury, normal triage is belayed. The first priority, unlike normal protocols for anyone else, is to be stabilized with hydrocortisone. Death by shock is so unnecessary.

So far, even in the nanny-state jurisdiction in which I live, people are not going door to door inquiring as to whether anyone with Addison’s Disease lives there. I was diagnosed by an endocrinologist who is not part of the corporate health network that supplies my routine medical care. My routine physical was months off. This meant there would be no record in my regular health care provider’s profile that I have Addison’s for several months. They would rely on me to update them with this information at the time of my next physical.

I called my regular health care provider when I was diagnosed and requested that they update my profile in accordance with the records my endocrinologist forwarded to them. They said they would do this at the time of my next visit. I requested that they please do it immediately. The local hospital relies on their information, which they access through their shared computer network, if I am admitted.

Addison’s is simply too rare to expect to be rediagnosed should we be admitted to a hospital in an emergency. Reasonable pro-active measures are advisable so that ER physicians are not confounded as their patient’s blood pressure plummets for no apparent reason.

The other area in which I think it is important to be pro-active is diet. We never know whether our immune systems will settle for adrenal destruction, or keep triggering further endocrine complications. With hydrocortisone’s effect of elevating blood sugar, mine has become fairly high, and the specter of diabetes hovers. I have high cholesterol. My endocrinologist gave me a variant of the Mediterranean Diet to follow. He indicated that the diet will not necessarily reduce cholesterol numbers, but will, over time, reduce the risk of heart attack and stroke as effectively as statin drugs.

My endocrinologist dubs the diet “The $120M Diet,” the amount WHO and other agencies spent researching it in Europe and the United States. I don’t like fish at all, so I eat lean beef and take fish oil capsules, which he said are likely about as good. Everything else on the diet I find delicious and satisfying.  I eat almost nothing that is not on this diet.  Here it is:

Increase the intake of the following foods:

Fish, 2-3x a week

Chicken and turkey (remove skin & fat)

Fruits, at least 2 portions a day


100% whole bran cereal fiber 3-4x a week

100% whole grain wheat

Beans, 2-3x a week

Use olive oil or canola oil (NO shortening, trans-fat or partially hydrogenated fat)

Broil, grill, or bake fish and meats. NO FRIED FOODS.

Snacks: almonds, walnuts, pistachios

One Comment
  1. Milt permalink
    April 3, 2008 6:01 am

    My addisons was discovered 50 years ago. I am taking hydrocortisone & fludrocortisone (to keep Potassium in your body) . I live a very active life (four children & 7 grandchildren). I commuted to work (almost 2 hours each way-fropm suburbs) . I am 77 years old, married over 50 years. I never let the Addisons interfere with my living. If under severe pressure or health problem, I up the Hydro for a few days.. Live a normal life & don’t let it hold you back. Milt

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