Adrenal Insufficiency in Adults.

Adrenal insufficiency (AI) is a potentially life-threatening disease characterized by cortisol deficiency. The hypothalamic-pituitary-adrenal axis synthesizes and regulates cortisol secretion. Damage in any of these glands may cause AI. The 2 main types of AI include primary adrenal insufficiency, where the adrenal cortex itself is damaged and central adrenal insufficiency, where the hypothalamus and/or pituitary are damaged. This article reviews the physiology, diagnosis, and management of AI focusing on early disease recognition, improved diagnostic assessments, and stress dosing algorithms. Early recognition and optimal management of AI is critical to prevent adrenal crises and reduce associated mortality.