Endocrine Disorders: Evaluation and Management

  • Author: Todd T. Brown, MD (More Info)
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 11/14/16 (What's New)

Summary

  • A serum cortisol sample drawn at 8:00 am (the period of peak cortisol secretion) is a useful screening test in most patients[Salvatori 2005]
  • A confirmed serum cortisol level < 3 µg/dL is diagnostic of adrenal insufficiency; levels > 18 µg/dL rule out the diagnosis[Grinspoon 1994]
  • Caveats in Cortisol Measurement for Adrenal Insufficiency
    • Measurement of serum cortisol may produce false-negative results in some patients with HIV or chronic hepatitis due to high levels of plasma binding proteins
    Confirmation of Adrenal Insufficiency Diagnosis
      Determining the Type of Adrenal Insufficiency
        Determining Underlying Cause of Adrenal Insufficiency

        Action required