Endocrine Abstracts

The current conventional glucocorticoid (GC) replacement therapy in primary adrenal insufficiency (Addison’s disease) and congenital adrenal hyperplasia (CAH) renders the cortisol levels unphysiological, resulting in very high levels alternating with almost undetectable levels of cortisol over the day. This reduces not merely the patient’s quality of life but increases the patient’s morbidity and mortality. The HPA axis is characterised by a dynamic circadian va...

Many patients with primary adrenal insufficiency (Addison’s disease) take extra doses of glucocorticoids before or during stressful events, but benefit has not been demonstrated. We aimed to test the effect of an extra dose of glucocorticoids on cardiorespiratory, hormonal and metabolic parameters in response to physical activity in a randomised placebo-controlled, 2-weeks cross-over, clinical trial (clinicaltrials.gov NTC01847690). Ten women with Addison’s disease a...

Background: The pulsatile endogenous cortisol secretion is crucial for ultradian rhythmicity in blood and this rhythmicity triggers pulses of gene signaling in tissues. Disturbances in cortisol pulsatility can lead to cognitive, metabolic and cardiovascular dysfunction, and could explain why patients with primary adrenal insufficiency on conventional glucocorticoid replacement have reduced quality of life, increased mortality and are at risk of cardiovascular complications. Pu...