Addison's Disease

Primary vs. Secondary Adrenal Insufficiency Made Simple! During rounds, distinguishing between Primary (Addison's) and Secondary Adrenal Insufficiency is a classic question. But more than that, it's critical for correct management. 🔍 The Clinical Clue: Look at the electrolytes! Specifically, Potassium. Primary Adrenal Insufficiency: The entire adrenal cortex is destroyed. ⬇️ Cortisol (Glucocorticoid) ⬇️ Aldosterone (Mineralocorticoid) Result: Hyperkalemia & Hyponatremia. Secondary Adrenal Insufficiency: The problem is in the pituitary (ACTH). ⬇️ Cortisol ↔️ Aldosterone is PRESERVED (controlled by RAAS, not ACTH). Result: Normal Potassium, but Hyponatremia (dilutional) may still occur. 💊 Treatment Implications: Primary: Needs BOTH Glucocorticoid (Hydrocortisone) + Mineralocorticoid (Fludrocortisone) replacement. Secondary: Needs ONLY Glucocorticoid (Hydrocortisone) replacement. Save this pearl for your next endocrine case! 🤝 #adrenalinsufficiency #addisonsdisease #endocrinology #doctorsofindia #medicaleducation #clinicalpearls #indiandoctors #hydrocortisone #Fludrocortisone #MBBSLife