The Endocrine Society has issued a new Clinical Practice Guideline (CPG) on diagnosis and treatment of primary adrenal insufficiency or Addison’s disease.

The new guidelines advocate for immediate treatment of severe symptoms, even if diagnosis has yet to be confirmed. “Postponing treatment of more severe symptoms [of Addison’s disease] raises the risk of death,” said Stefan R. Bornstein, MD, PhD, chair of the task force that authored the guidelines. 

Related: Addison’s Disease Patient Information Sheet

Other recommendations include:

  • To establish a primary adrenal insufficiency diagnosis, patients should undergo a blood test to measure levels of adrenocorticotropic hormone (ACTH). 
  • As part of the diagnostic process, patients should also have blood tests to measure renin and aldosterone levels. 
  • Patients with confirmed primary adrenal insufficiency should undergo glucocorticoid replacement therapy – typically with hydrocortisone (cortisol).
  • For patient with primary adrenal insufficiency and confirmed aldosterone deficiency, replacement therapy, typically fludrocortisone, may be initiated. Patients receiving this therapy should be monitored for symptoms such as salt craving, light-headedness, blood pressure changes and swelling of the legs and feet.

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