What's the most practical way to rule out adrenal insufficiency?
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A morning serum cortisol level >13 mcg/dL reliably rules out adrenal insufficiency, and the test is easy and safe to perform. Because of low specificity, patients with a level of ≤13 mcg/dL need further evaluation with the cosyntropin stimulation test (CST) (strength of recommendation [SOR]: A, meta- analysis of diagnostic cohort studies).
Journal of Family Practice, 58(5) 2009: 281a-281b.