The diagnosis of adrenal insufficiency and its implications in primary care

Adrenal insufficiency can be clinically challenging to diagnose, due to relatively low incidence rates in the European population. It is a condition requiring active consideration to achieve diagnosis. The main pathologies discussed here are primary adrenal insufficiency (PAI) and tertiary adrenal insufficiency. PAI is also commonly termed Addison’s disease. Secondary adrenal insufficiency is not considered in detail in this article. The article will address the underlying pathophysiology, presentation and investigation of adrenal insufficiency. It will also consider iatrogenic adrenal insufficiency and management of adrenal insufficiency in the primary care setting.