Thank you Dr. Thetford for an excellent case presentation on primary adrenal insufficiency!

Key Learning Points:

• Have a high suspicion for adrenal insufficiency in those with:
  • Present with constellation of symptoms (dizziness, fatigue, n/v/d, orthostasis, hyperpigmentation)
  • Electrolyte abnormalities (classically low Na, high K)
• Screen for AI with ACTH and AM cortisol
• If one of the above is abnormal, confirm with ACTH stim test

Per Dr. Mikhail:

• Remember that patients with lower albumin (especially <2) will have lower cortisol levels (by approximately 30-50%)