A normal baseline cortisol range with a subnormal response to ACTH stimulation.
*Mild secondary adrenal insufficiency:
A low or low normal baseline cortisol range with a normal response to ACTH stimulation.
NOTE: If a person is unwell, the diagnosis of adrenal insufficiency cannot be excluded by a serum cortisol level.
"Medical thinking has polarized on the subject of adrenal function, so that, in the minds of most doctors, a person is either in a normal condition or has Addison’s Disease (complete adrenal failure) with no possibility for middle ground. This polarization came about in the early days of treatment with adrenal steroids, the 1950s, when cortisone and hydrocortisone became available. Doctors did not know the proper dosages, guessed too high, got serious side effects and became phobic about the use of adrenal steroids. To allay their fears of disaster, they created a kind of myth that patients were only allowed to have complete failure of the adrenals or nothing at all. If this were the case, and a person shows up with complete failure of the adrenals (Addison’s Disease), naturally the only thing to do would be to treat with adrenal steroids.
If failure is not complete, the patient is defined as “normal” and not treatable. In this manner, the fear of being sued for inducing the side effects associated with abnormally large doses of, for example, cortisone is taken away by the fact that no one receives this therapy except the patient who has complete adrenal failure. In that strange world, it is is better to have complete adrenal failure than to have partial adrenal failure — because in that case a person at least receives treatment." - Excerpt from Adrenal Fatigue by Ron Kennedy, M.D.
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