(glucose). this treatment usually brings rapid improvement. if intravenous access is not immediately available, intramuscular injection of glucocorticoids can be used. when the person can take fluids and medications by mouth, the amount of glucocorticoids is decreased until a maintenance dose is reached. if aldosterone is deficient, maintenance therapy also includes oral doses of fludrocortisone acetate. prognosis outcomes are typically good when treated. most people can expect to live relatively normal lives. someone with the disease should be observant of symptoms of an "addison's crisis" while the body is strained, as in rigorous exercise or being sick, the latter often needing emergency treatment with intravenous injections to treat the crisis. individuals with addison's disease have more than a doubled mortality rate. furthermore, individuals with addison's disease and diabetes mellitus have an almost four-fold increase in mortality compared to individuals with only diabetes. the risk ratio for cause mortality in males and females is 2.19 and 2.86, respectively. death from individuals with addison's disease often occurs due to cardiovascular disease, infectious disease, and malignant tumors, among other possibilities. epidemiology the frequency rate of addison's disease in the human population is sometimes estimated at one in 100,000. some put the number closer to 40–144 cases per million population (1/25,000–1/7,000). addison's can affect persons of any age, sex, or ethnicity, but it typically presents in adults between 30 and 50 years of age. research has shown no significant predispositions based on ethnicity. about 70% of addison's disease diagnoses occur due to autoimmune reactions, which cause damage to the adrenal cortex. history addison's disease is named after thomas addison, the british physician who first described the condition in on the constitutional and local effects of disease of the suprarenal capsules (1855). he originally described it as "melasma suprarenale", but later physicians gave it the medical eponym "addison's disease" in recognition of addison's discovery. while the six under addison in 1855 all had adrenal tuberculosis, the term "addison's disease" does not imply an underlying disease process. the condition was initially considered a form of anemia associated with the adrenal glands. because little was known at the time about the adrenal glands (then called "supra-renal capsules"), addison's monograph describing the condition was an isolated insight. as the adrenal function became better known, addison's monograph became known as an important medical contribution and a classic example of careful medical observation. tuberculosis used to be a major cause of addison's disease and acute adrenal failure worldwide. it remains a leading cause in developing countries today. us president john f. kennedy suffered from complications of addison's disease throughout his life, including during his presidency, resulting in fatigue and hyperpigmentation of the face. other animals hypoadrenocorticism is uncommon in dogs, and rare in cats, with less than 40 known feline cases worldwide, since first documented in 1983. individual cases have been reported in a grey seal, a red panda, a flying fox, and a sloth. in dogs, hypoadrenocorticism has been diagnosed in many breeds. vague symptoms, which wax and wane, can cause delay in recognition of the presence of the disease. female dogs appear more affected than male dogs, though this may not be the case in all breeds. the disease is most often diagnosed in dogs that are young to middle-aged, but it can occur at any age from 4 months to 14 years. treatment of hypoadrenocorticism must replace the hormones (cortisol and aldosterone) which the dog cannot produce itself. this is achieved either by daily treatment with fludrocortisone, or monthly injections with desoxycorticosterone pivalate (docp) and daily treatment with a glucocorticoid, such as prednisone. several follow-up blood tests are required so the dose can be adjusted until the dog is receiving the correct amount of treatment, because the medications used in the therapy of hypoadrenocorticism can cause excessive thirst and urination if not prescribed at the lowest effective dose. in anticipation of stressful situations, such as staying in a boarding kennel, dogs require an increased dose of prednisone. lifelong treatment is required, but the prognosis for dogs with hypoadrenocorticism is very good.