Synopsis

Source of validity: Scientific
Rating (out of 5): 5

Addison’s disease is characterized by primary adrenal insufficiency, leading to deficient production of glucocorticoids and mineralocorticoids, particularly aldosterone. Aldosterone plays a key role in sodium retention and potassium excretion by the kidneys. Its deficiency results in increased urinary sodium loss, hyponatremia, dehydration, and hypotension. Scientific evidence strongly validates the use of sodium supplementation (typically as sodium chloride, or table salt) as part of the management of Addison’s disease, particularly before and during glucocorticoid and mineralocorticoid replacement therapy is optimized.

Clinical guidelines and textbooks consistently recommend additional dietary sodium in patients with Addison’s disease, especially in hot climates, during heavy physical activity, or when gastrointestinal losses (vomiting, diarrhea) occur. Sodium supplementation helps prevent severe hyponatremia and its complications, such as circulatory collapse. With proper mineralocorticoid (fludrocortisone) replacement, the need for extra salt may be reduced, but many patients still benefit from a moderately increased salt intake.

In summary, the use of sodium salt in treating Addison's disease is based on a clear pathophysiological rationale and is supported by robust clinical evidence (rating: 5/5). It remains an essential component of therapy to prevent life-threatening complications of salt loss until adequate hormone replacement is established.

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