A new approach — Home waking salivary cortisone to screen for adrenal insufficiency

Authors

Hershel Raff, Advocate Aurora Health
Catherine D. Zhang

Recommended Citation

Raff H, Zhang CD. A New Approach - Home Waking Salivary Cortisone to Screen for Adrenal Insufficiency. NEJM Evid. 2023;2(2):EVIDe2200306. doi:10.1056/EVIDe2200306

Affiliations

Aurora St. Luke's Medical Center

Abstract

Adrenal insufficiency is a common and potentially life-threatening endocrine disorder that can be drug induced or endogenous and of adrenal (primary) or pituitary/hypothalamic (secondary/tertiary) origin.1,2 Of particular concern in drug-induced disease is the patient with glucocorticoid- or opioid-induced adrenal insufficiency. Adrenal insufficiency of any cause is typically diagnosed biochemically with a subnormal morning serum cortisol (the circadian, awakening peak) and serum dehydroepiandrosterone sulfate, followed by or simultaneously with an assessment of the acute (30 and 60 minutes) serum cortisol response to injected synthetic corticotropin (ACTH[1-24]), if clinically indicated.

Document Type

Editorial

PubMed ID

38320042