Journal
ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA
Volume 38, Issue 2, Pages 407-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.ecl.2009.01.008
Keywords
Adrenal insufficiency; Addison's disease; Cortisol; Aldosterone; Dehydroepiandrosterone; Quality of life; Mortality
Categories
Funding
- Medical Research Council [G116/172] Funding Source: researchfish
- MRC [G116/172] Funding Source: UKRI
- Medical Research Council [G116/172] Funding Source: Medline
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Despite treatment with glucocorticoids and mineralocorticoids, the ability to work and quality of life of patients who have adrenal insufficiency remains low. There are no helpful objective measures of optimal glucocorticoid replacement, so this is best achieved by careful clinical assessment. Adequacy of mineralocorticoid replacement may be judged by assessing postural change in blood pressure, serum electrolytes, and plasma renin activity. Novel delayed-release and sustained-release formulations of hydrocortisone seem to more closely mimic diurnal serum cortisol rhythms than conventional hydrocortisone tablets. Such preparations are currently being evaluated and may play a role in management of patients who have adrenal insufficiency.
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