Updated Diagnostic Cortisol Values for Adrenal Insufficiency

Exclusion Criteria

• •Moderate to severe liver impairment or abnormal albumin or cortisol binding globulin concentrations
• •Renal impairment with estimated Glomerular Filtration Rate (eGFR) \< 60 mL/min/1.73m2 and/or diagnosis of nephrotic syndrome
• •Pregnancy or nursing mothers
• •Use of estrogen preparations
• •Uncontrolled major depressive disorder or psychiatric diseases, severe malnutrition, eating disorders, chronic fatigue syndrome (disorders that alter hypothalamic-pituitary-adrenal (HPA) axis function)
• •Use of any medications that induce hepatic cytochrome P-450 enzymes, e.g., barbiturates, phenytoin, rifampin, aminoglutethimide and mitotane
• •Active medical treatment of Cushing's syndrome (status-post surgical treatment is acceptable)
• •Uncontrolled hypo- or hyperthyroidism
• •Use of biotin within the past 72 hours
• •Regular alcohol and/or cannabis use
• •History of bilateral adrenalectomy
• •Treatment for validated primary adrenal insufficiency for greater than 6 months
• •Be assessed by the investigators as unsuitable for participation in this study for any reason
• •Regular use of any oral glucocorticoid (e.g. hydrocortisone, prednisone, dexamethasone) within 6 weeks of the screening visit
• •Use of oral or nasal steroid (glucocorticoid) inhalers in the past 2 weeks
• •Regular use of any steroid creams, gels, ointments, or lotions
• •Use of steroid (glucocorticoid) injections in the past 6 months (healthy volunteers)
• •Regular use of opioids
• •Regular use of suboxone
• •Regular use of megestrol acetate