Addison's disease and pregnancy
Are there any special things I should be aware of concerning Addison’s disease and pregnancy?
Yes. Cortisone circulates in the blood in 2 forms, the largest amount being stuck on to a carrier protein with a small amount being free in the blood, this latter part being the active component of cortisone. The cortisone stuck on the carrier protein is inactive.
In early pregnancy, as a result of the stimulatory effects of the very high levels of oestrogen (a female hormone) in the liver, the liver produces larger quantities of the cortisone carrier protein which then ‘mops up’ quite a bit of the free or active cortisone.
For the first 2 or 3 months of pregnancy you may need to take some additional cortisone to saturate the newly formed cortisone-binding protein so that the levels of cortisones in the blood do not fall.
A similar thing happens to thyroid hormones in pregnancy in women who are on thyroxine, the dose of thyroxine usually needing to be increased the first 2 or 3 months of pregnancy because of the increase in levels of thyroxine-carrier protein.
Last Reviewed: 03 June 2007