Case Study: Managing Hormonal Disruption in Addison's Disease with Calcitriol Supplementation

Case Study: Managing Hormonal Disruption in Addison’s Disease with Calcitriol Supplementation

Patient Profile: Sarah, a 38-year-old female, was diagnosed with Addison’s disease six years ago following a prolonged period of fatigue, weight loss, and muscle weakness. Despite adhering to glucocorticoid and mineralocorticoid replacement therapy, Sarah continued to experience symptoms suggestive of hormonal disruption, including intermittent muscle cramps and bone pain. Laboratory investigations revealed low serum calcium levels and reduced calcitriol concentrations, indicating impaired calcium metabolism.

Treatment Plan: Given Sarah’s persistent symptoms and biochemical abnormalities, her endocrinologist initiated calcitriol supplementation alongside her existing medication regimen. The goal was to restore calcium balance and potentially alleviate her symptoms of muscular and skeletal discomfort. Sarah was prescribed oral calcitriol at a starting dose of 0.25 mcg daily, with instructions for regular monitoring of serum calcium and calcitriol levels.

Outcome: Over the course of three months, Sarah reported a noticeable improvement in her symptoms, with reduced frequency and severity of muscle cramps and bone pain. Follow-up laboratory tests revealed normalization of serum calcium levels and a modest increase in calcitriol concentrations within the target range. Sarah’s bone mineral density scan showed stable bone density, suggesting a favorable response to calcitriol supplementation.

Discussion: Sarah’s case highlights the importance of recognizing and addressing hormonal disruption in Addison’s disease, particularly disturbances in calcium metabolism. By incorporating calcitriol supplementation into her treatment regimen, Sarah experienced symptomatic relief and biochemical improvement, underscoring the therapeutic potential of this intervention. However, ongoing monitoring of serum calcium and calcitriol levels remains essential to ensure optimal dosing and minimize the risk of hypercalcemia.

Conclusion: In conclusion, the case of Sarah demonstrates the successful management of hormonal disruption in Addison’s disease with calcitriol supplementation. Through a multidisciplinary approach involving endocrinology and metabolic bone specialists, Sarah achieved symptom control and biochemical normalization, thereby enhancing her quality of life and mitigating the risk of complications associated with calcium imbalance. This case underscores the importance of individualized treatment strategies and close monitoring in optimizing clinical outcomes for patients with Addison’s disease.

The case study illustrates a hypothetical scenario of managing hormonal disruption in Addison’s disease with calcitriol supplementation. It outlines the patient profile, treatment plan, and outcome, emphasizing the role of multidisciplinary care in achieving favorable clinical outcomes.

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