Adrenal endocrine disorder evaluation
Treatment options in Shanghai

The clinician reviews symptoms and blood results, then may use an ACTH stimulation test to assess how cortisol responds to stimulation. Interpretation depends on the clinical question; for example, a normal response can be less informative in some recent secondary insufficiency. Other dynamic tests are reserved for selected situations and require specialist supervision. Bring the sampling time, laboratory ranges and medication timing, not only a photograph of a flagged value. Never stop steroids to make a test look more accurate. The prescriber and testing team must decide how required treatment and valid interpretation can be reconciled safely.

After establishing and classifying insufficiency, further investigations may look for autoimmune adrenal disease, relevant infection or structural changes in the adrenal or pituitary region. Not everyone needs the same antibody tests or scans. The sequence should follow the suspected mechanism rather than a package that examines every endocrine organ. Ask what each result could change: a new diagnosis, additional hormone assessment or a different replacement plan. Bring previous pituitary or adrenal surgery records where applicable. Keeping the cause and the hormone deficit separate helps explain why a normal-looking scan does not necessarily settle a functional question.

For confirmed insufficiency, treatment replaces hormones the body cannot adequately supply. Cortisol replacement and, when appropriate, aldosterone replacement have different roles; the latter is not required for every type of insufficiency. The clinician individualises medication and monitoring according to the diagnosis and response. It is useful to clarify whether a current prescription is intended as replacement, treatment of another illness or both. Avoid comparing doses between patients without this context. The plan must address ordinary daily treatment and what changes are needed during physical stress, with written instructions rather than improvised adjustments.