Glucocorticoid treatment and the risk of secondary adrenal insufficiency

Ally Prebtani, MD, is a professor of medicine at the Faculty of Health Sciences of McMaster University.

What length of glucocorticoid treatment is associated with a risk of developing secondary adrenal insufficiency?

I would say, it depends on many things. It’s just not the duration of glucocorticoids that can lead to glucocorticoid adrenal insufficiency. You have to also look at the dose of the glucocorticoid, the potency of the glucocorticoid, when it is being administered: is it bedtime, is it during the daytime? Is multiple day dosing used? Looking at the patient’s age and other medications they may be on that can affect glucocorticoid metabolism, any other thyroid issues, other pituitary issues—all these factors need to be taken into consideration before deciding what their risk of glucocorticoid adrenal insufficiency is beyond just the duration of the glucocorticoid.