Addison's disease

The idea that cortisol is a bad E needs to be dispelled.

If you don't produce enough cortisol in a condition called Addison's disease, you are very, very sick.

So this idea, you know, do this regime.

And some said, what,

John F. Kennedy had this?

John F. Kennedy had Addison's disease.

So this is a very integral part of American history.

So one of the signs of Addison's disease is a person becomes very tanned.

When I would show up and say I had my adrenals removed, I'd still have to wait hours at times while in crisis, in shock, on a gurney.

Whereas if I use different language when I show up and say I'm Addisonian...

they immediately like something triggers in their brain and everything becomes a rush with me, which prevents going deeper into crisis, which is excellent.

And I'm likely to not have to be an inpatient and I can just be discharged after some fluids.

So like while I'm not classic Addisonian because I have it or I don't have adrenal glands, I've been full on removed.

Using that different language triggers an entirely different response.

I think vocabulary is so important in medicine.

I believe that that doesn't really work for me because of my lack of pancreatic hormones and my adrenal insufficiency too.

You know, there's a kind of an excess of steroid hormones kind of physiology that we will see or our physical appearance will change.

When we're looking at suspected deficiency or adrenal deficiency Addison's, we're looking at early morning around 8 a.m. serum cortisol as the starting point.

I'm looking at specific levels and then anything... that looks abnormal warrants an ACTH, which is stimulation test with a peak below 18 micrograms per deciliter considered diagnostic for Addison's.

Again, this is what President Kenney suffered from.

On the other side of that, which is much more common to see.

So timing the draw correctly isn't a minor detail.

It's the difference between a useful test and a wasted one.

So if you are being evaluated by an endocrinologist or ruling out Cushing's or Addison's, they're going to have very specific instructions.

Yeah.

Because with, I think Cushing's, whatever it's called, is opposite to Addison's, which Victor's got Addison's.

So I think one's like, is it an overstimulated something? And the other one, like Victor doesn't have the hormone to deal with stress, whereas I think Cushing's is the opposite.

Yeah, okay.