Mineralocorticoid Replacement in Addison's Disease
Journal of Clinical Endocrinology & Metabolism (2004)
Plasma renin activity is the most reliable biomarker for guiding fludrocortisone dosing.
Fludrocortisone
Oral tablet (0.1mg)Available in all 50 statesMarketing purposes only. Actual medications, if prescribed, are dispensed by a licensed pharmacy.
hormones
FludrocortisoneFludrocortisone
Synthetic mineralocorticoid for aldosterone replacement in primary adrenal insufficiency. Also used for orthostatic hypotension and POTS to expand plasma volume.
Only oral mineralocorticoid available
Restores sodium balance and blood pressure
Improves orthostatic symptoms
Essential in adrenal insufficiency
No commitment · HSA/FSA eligibleNo commitment · HSA/FSA eligible
How it works
Mechanism of action
Binds mineralocorticoid receptors in the collecting duct, upregulating ENaC and Na+/K+-ATPase, promoting sodium/water reabsorption and potassium excretion. Expands plasma volume and raises blood pressure.
The baseline panel.
Every Marek client receives this baseline panel before a provider review. Your provider may add additional biomarkers based on your health history, symptoms, and goals, pulling from 1,000+ available markers. See more biomarkers →
Hormone Profile
12 markers
Sex hormones
- Total TestosteroneLC/MS
- Free TestosteroneEquilibrium Dialysis
- Estradiol, Sensitive / UltrasensitiveLC/MS
- Sex Hormone Binding Globulin (SHBG)
- ProgesteroneLC/MSFemale panel
- Prolactin
- Luteinizing Hormone (LH)
- Follicle-Stimulating Hormone (FSH)
- hCG, Total, QuantitativeFemale panel, pre-menopause
Adrenals & neurosteroids
- Cortisol
- DHEA-S
Growth hormone / IGF-1
- Insulin-Like Growth Factor I (IGF-1)
Thyroid Status
3 markers
Thyroid hormones
- Thyroid Stimulating Hormone (TSH)
- Free T4
- Free T3
Heart Health
9 markers
Cardiovascular health
- Total Cholesterol
- HDL Cholesterol
- LDL Cholesterol
- LDL:HDL Ratio
- VLDL Cholesterol
- Triglycerides
- Apolipoprotein-B (ApoB)
- C-Reactive Protein, High Sensitivity (hsCRP)
- Lipoprotein(a) (Lp(a))
Metabolism
3 markers
Insulin sensitivity
- Blood Glucose
- Fasting Insulin
- HbA1c
Organ Function
26 markers
Liver & pancreas
- AST
- ALT
- Bilirubin, Total
- γ-Glutamyl Transferase (GGT)
Kidney function
- BUN
- Creatinine w/ eGFR
Comprehensive Metabolic Panel (CMP)
- Glucose
- Blood Urea Nitrogen (BUN)
- Creatinine
- eGFR
- BUN/Creatinine Ratio
- Sodium
- Potassium
- Chloride
- Carbon Dioxide, Total
- Calcium
- Protein, Total
- Albumin
- Globulin, Total
- Albumin/Globulin (A/G) Ratio
- Alkaline Phosphatase (ALP)
- AST
- ALT
Prostate health
- Prostate-Specific Antigen (PSA)Male panel
- Free PSAMale panel
- % Free PSAMale panel
Nutrient Status
31 markers
Vitamins & minerals
- Vitamin D, 25-OHD (25-Hydroxy)
- Magnesium, RBC
Iron status
- Iron
- Iron Saturation
- TIBC
- UIBC
- Ferritin
Complete Blood Count (CBC)
- White Blood Count (WBC)
- Red Blood Count (RBC)
- Hemoglobin (Hgb)
- Hematocrit (HCT)
- MCV
- MCH
- MCHC
- Red Cell Distribution Width (RDW)
- Platelets
- Neutrophils
- Neutrophils (Absolute)
- Lymphocytes
- Lymphocytes (Absolute)
- Neutrophil/Lymphocyte Ratio
- Monocytes
- Monocytes (Absolute)
- Eosinophils
- Eosinophils (Absolute)
- Basophils
- Basophils (Absolute)
- Immature Cells
- Immature Granulocytes
- Immature Granulocytes (Absolute)
- NRBC, w/ Reflex for Immature Cells
Clinical evidence
The research behind Fludrocortisone.
Safety profile
Monitoring & safety information.
Commonly reported side effects
- Fluid retention/edema
- Hypertension
- Hypokalemia
- Weight gain
Less common but serious risks
- Severe hypertension with excess
- Severe hypokalemia (arrhythmia risk)
- Heart failure exacerbation
Generally not appropriate for
- CHF
- Severe hypertension
Typical monitoring
- Electrolytes (Na, K)
- Blood pressure (supine and standing)
- Plasma renin activity
- Weight
FAQ
Quick answers.
Synthetic mineralocorticoid for aldosterone replacement in primary adrenal insufficiency. Also used for orthostatic hypotension and POTS to expand plasma volume.
Only oral mineralocorticoid available. Restores sodium balance and blood pressure. Improves orthostatic symptoms. Essential in adrenal insufficiency.
Common side effects include: fluid retention/edema, hypertension, hypokalemia, weight gain. Most side effects are dose-dependent and may resolve with continued use or dose adjustment.
Synthetic mineralocorticoid for aldosterone replacement in primary adrenal insufficiency. Also used for orthostatic hypotension and POTS to expand plasma volume.
Treatments are dependent on licensed clinical prescription. Client costs vary based on individual labs and panel in treatments and services.