How do diagnose and Treat Adrenal insufficiency in primary care practice ?

[@syedriyazahmad9047]

Quite informative and well explained by Dr O J L. Thank you

[@koustubhti]

Nice and very well compiled. Keep enlightening us🙏🙏🙏

[@srinivasaraosirasapalli5104]

So nice doctor, really thankful for case based scenarios

[@Snigdhwala]

Sir 🙏🏻🙏🏻 Take class on type 1 diagnosis nd management Plzzz sirrr🙏🏻🙏🏻

[@applebee4129]

Yes pls

[@EndocrinologyIndia]

🎯 Key points for quick navigation: 00:01 *📋 Introduction and Importance of Adrenal Insufficiency* - Adrenal insufficiency is a critical condition, often overlooked. - It can be a life-and-death matter if untreated. - Misdiagnosis is common, but recognition and treatment are straightforward. 02:18 *📚 Basics of Adrenal Insufficiency* - Overview of the Hypothalamic-Pituitary-Adrenal (HPA) Axis. - Explanation of hormone releases: CRH from the hypothalamus, ACTH from the pituitary, and cortisol from the adrenal glands. - Cortisol’s role in stress response and its negative feedback mechanism. 05:37 *🏥 Types of Adrenal Insufficiency* - Primary adrenal insufficiency: Issues with the adrenal glands. - Secondary adrenal insufficiency: Pituitary gland problems. - Tertiary adrenal insufficiency: Hypothalamus-related issues. - Examples of conditions and surgeries leading to each type. 08:43 *💊 Drug-Induced Adrenal Insufficiency* - Medications can cause primary, secondary, or tertiary adrenal insufficiency. - Examples: Ketoconazole, Eplerenone, Rifampicin, steroids, narcotics, and anabolic steroids. - Emphasis on steroids and their impact on the HPA axis. 11:14 *🔬 Diagnosing Adrenal Insufficiency* - Importance of morning serum cortisol levels. - Interpretation: Less than 3 μg/dL indicates insufficiency, 3-5 μg/dL is indeterminate, more than 5 μg/dL is likely normal. - Follow-up tests include DHEA-S levels and ACTH stimulation test. 15:07 *📈 Evaluating the HPA Axis* - Understanding cortisol and DHEA-S levels. - Using age-specific DHEA-S values to determine adrenal insufficiency. - Ratio analysis: DHEA-S value divided by the age-specific lower limit to assess adrenal function. 23:08 *🌬️ Non-Oral Steroids and Adrenal Insufficiency* - Inhaled steroids can cause adrenal insufficiency due to systemic absorption. - Intra-articular steroids can potentially cause adrenal insufficiency. - Management strategies for adrenal insufficiency in different settings, such as acute adrenal crisis and chronic conditions. 26:31 *🧪 Case Studies Illustrating Adrenal Insufficiency* - First case: A patient with exogenous Cushing syndrome and tertiary adrenal insufficiency. - Signs include moonlike face, striae, and low morning cortisol. - Importance of recognizing steroid abuse and proper history-taking in diagnosis. 32:13 *🏥 Recognizing Secondary Adrenal Insufficiency* - Second case: A patient with a history of pituitary surgery leading to adrenal insufficiency. - Symptoms include hyponatremia and a low response to ACTH stimulation test. - Emphasis on cortisol testing and understanding pituitary surgery’s impact. 37:59 *🔍 Primary Adrenal Insufficiency and APS Type 2* - Third case: A patient with significant weight loss, skin darkening, and hypothyroidism. - Diagnosis of autoimmune polyendocrine syndrome (APS) type 2. - Typical lab findings: low cortisol, high ACTH, hyponatremia, and hyperkalemia. 41:11 *📝 Summary and Key Takeaways* - Key indicators for suspecting adrenal insufficiency: unexplained weight loss, darkening of skin, hyponatremia, and hypotension. - Importance of baseline cortisol and DHEA-S testing. - Referral to endocrinologists for confirmed adrenal insufficiency cases. Made with HARPA AI

[@mustafaalishah8469]

Brother also make vdeos on CAH, AIS, and DSDs ,plz make it

[@user-hd9gu6iw6l]

Useful and interesting discussion. Thank you so much. Should we give replacement dose of glucocorticoid at at a time in the morning or in divided doses?

[@EndocrinologyIndia]

If you are using oral hydrocortisone then 10 in the morning and 5 mg at 5 pm

[@user-hd9gu6iw6l]

@@EndocrinologyIndia Thank you.

[@syedriyazahmad9047]

Are steroids addictive also ?

[@EndocrinologyIndia]

Yes