Many patients with Addison's disease have a deficiency in both glucocorticoid and mineralocorticoid hormones, which is associated with hyperkalemia. A patient with Addison's disease may have a low or normal potassium if certain conditions are present.


Reasons for an absence of hyperkalemia in a patient with Addison's disease:

(1) isolated deficiency of cortisol (presence of mineralocorticoid activity)

(2) increased renal loss of potassium (diuretic therapy, protracted vomiting, etc)

(3) shift of potassium into cells (insulin and glucose administration, etc)

(4) very low dietary intake of potassium


It is important to recognize the patient's with Addison's disease may lack the classic signs and symptoms.


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