Which statement about hydrocortisone therapy in Addison's disease is true?

Which statement about hydrocortisone therapy in Addison's disease is true?

• A. Hydrocortisone is taken only in the morning.
• B. Hydrocortisone has both glucocorticoid and mineralocorticoid properties.
• C. Fludrocortisone is taken three times daily.
• D. Salt additives are unnecessary.

Answer: (B)

The key idea is that hydrocortisone provides both glucocorticoid and mineralocorticoid activity, which is exactly what Addison’s disease needs. When the adrenal glands fail, you lose cortisol (a glucocorticoid) and aldosterone (a mineralocorticoid). Hydrocortisone replaces both, helping with stress response and maintaining salt and fluid balance, so it often serves as the main form of therapy. Dosing is typically spread to mimic the body’s natural rhythm, rather than being taken only in the morning. This helps prevent symptoms of under-replacement later in the day. In addition, while hydrocortisone covers glucocorticoid and some mineralocorticoid effects, many patients also require a separate mineralocorticoid replacement (often fludrocortisone) tailored to blood pressure, electrolytes, and hydration status. Salt intake is not something to ignore. Salt additives or increased salt intake may be needed, especially during hot weather, illness, or heavy sweating, to compensate for mineralocorticoid deficiency and fluid losses. So, the statement that hydrocortisone therapy in Addison’s disease has both glucocorticoid and mineralocorticoid properties is the best choice.

The key idea is that hydrocortisone provides both glucocorticoid and mineralocorticoid activity, which is exactly what Addison’s disease needs. When the adrenal glands fail, you lose cortisol (a glucocorticoid) and aldosterone (a mineralocorticoid). Hydrocortisone replaces both, helping with stress response and maintaining salt and fluid balance, so it often serves as the main form of therapy.

Dosing is typically spread to mimic the body’s natural rhythm, rather than being taken only in the morning. This helps prevent symptoms of under-replacement later in the day. In addition, while hydrocortisone covers glucocorticoid and some mineralocorticoid effects, many patients also require a separate mineralocorticoid replacement (often fludrocortisone) tailored to blood pressure, electrolytes, and hydration status.

Salt intake is not something to ignore. Salt additives or increased salt intake may be needed, especially during hot weather, illness, or heavy sweating, to compensate for mineralocorticoid deficiency and fluid losses.

So, the statement that hydrocortisone therapy in Addison’s disease has both glucocorticoid and mineralocorticoid properties is the best choice.