The goal of therapy is to establish a hormone replacement regimen that closely mimics the physiological diurnal cortisol secretion pattern, tailored to the patient’s daily needs. Diagnosis is based on measurement of the adrenal corticosteroid hormones, their regulatory peptide hormones and stimulation tests. Symptoms of AI are non-specific, often overlooked or misdiagnosed, and are related to the lack of cortisol, adrenal androgen precursors and aldosterone (especially in PAI). The most prevalent form is TAI owing to exogenous glucocorticoid use. Secondary AI (SAI) is more frequent and is caused by diseases affecting the pituitary, whereas in tertiary AI (TAI), the hypothalamus is affected. Primary AI (PAI) is rare and is caused by direct adrenal failure. Adrenal insufficiency (AI) is a condition characterized by an absolute or relative deficiency of adrenal cortisol production.
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