Title : Challenges faced in addisons disease with comorbidities: a long term follow up (>2years) lifestyle modification
Abstract:
Modify Lifestyle as medicine with the right combination of nutrients to reduce many medications and drug nutrient interaction,improve quality of life.A challenging nutrition therapy for Addison disease. In 2004, 34 years old male patient was admitted and on ventilator for three months, causing DVT and pulmonary embolism thus leading him to total parental nutrition. In 2009, operated for appendix, again developed incisional hernia, 2015 gallbladder removal, 2017 developed chronic constipation and high uric acid. After 20 years at 54 years current age BMI 23.87/hypothyroidism , developed Steroid induced myopathy, dyspnea on exertion, unable to do routine work was hospitalized again in 2022. On and off having acidity , chronic constipation, potassium fluctuations, hyperlipidemia. A strict dietary management as doctor advised to take high protein diet inspite of high creatinine level. MNT steroids and many other medication was going on. Disease specific high calorie high protein immunemodifier formula used. High sodium with MCT and soluble insoluble fibre added as had hard stool.A doctor advised Renal diet Patient unable to eat planned calorie and protein, added scientific oral nutritional supplement with curds, custard, blend khichadi and soft pureed rice. Weight was constant with right diet. Added nutritional formula to increase calorie and protein intake and better nutritional compliance. Recent advances suggest that lifestyle modifications with yoga , physiotherapy, gym, right nutrition is the key to reduce many medicine. Along with medical diagnosis nutritional diagnosis very important when the body is under stress (e.g. fighting an infection), this deficiency of cortisol can result in a life threatening Addisonian crisis characterized by low blood pressure. This patient who is taking more than 15 tablets a day prior 2004 no medicine, no steroid.
Today now bring it down to 4-5 medication with customized diet and NLP session as patients was suffering with anxiety too. Advised Nutrition high iron foods to get normal iron level. Since 2022 under my observation ,taking right Diet, & Nutrition for Adrenal Insufficiency & High doses of corticosteroids are linked to a higher risk of osteoporosis—so dietary calcium and vitamin D rich diet advised by me. Diuretics were replaced by high potassium foods drinks.
Keywords: Addisons Disease ; Hypothyroidisnm, Uric acid Osteoporosis; Nutritional diagnosis, TPN
