What is the role of adrenal function assessment in the workup of myxedema coma (crisis)?

Updated: Aug 31, 2020
  • Author: Mohsen S Eledrisi, MD, FACP, FACE; Chief Editor: George T Griffing, MD  more...
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Assessment of adrenal function should be performed. A random serum cortisol can be obtained; however, the test is only helpful if it’s very low (20 mcg/dL). Since most patients will have serum cortisol levels in between these values, an ACTH stimulation test is usually needed to assess the adrenal function. This test should not delay starting treatment. In contrast to hydrocortisone, which interferes with the cortisol assay, leading to falsely normal serum cortisol, dexamethasone does not interfere with the testing and can be administered immediately and continued until the results of the test become available.

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