Support for Those Living with Adrenal Insufficiency

Research Topics N-Z

Welcome to the AIU/AIC research library. The articles and documents here are listed by subject. Beneath the following subject headings you’ll find links to current information on that topic. We check the links periodically, however, if you find one that is no longer working, please contact us.

Thank you for visiting, we hope you find our library useful.

Link to topics A-C: Adrenal crisis, Adrenal fatigue, Adrenal insufficiency, Adrenal suppression, Adrenal Insufficiency in the News, Better living tips, Children with adrenal insufficiency, Circadian rhythm, Coexisting conditions, Cortisol pump

Link to topics D-M:  Dosing, Electrolytes and hydration, Emergency care, Emotional aspects of AI, Financial/Gifting Organizations, Guidelines and reviews, Hormones, Injection kit, Medication interactions

N-Z: Overview of endocrine system, PAI, Pain management, Physiology of AI, Pregnancy, Recent developments, Related Conditions, SAI, Sleep, Stress, Steroids used to treat AI (glucocorticoids and mineralocorticoids), Surgery guidelines, Tapering, Testing

Overview of endocrine system

Primary Adrenal Insufficiency (PAI

Pain Management

This comprehensive article explains every aspect of testosterone including its links to pain management, depression, sleep, energy, tissue healing and osteoporosis. It gives a clear explanation of its role in the HPA axis and conversion of cholesterol to hormones. Also interesting is how opioid pain medications can suppress testosterone production leading to complications for patients regarding control of symptoms.

A study from the Netherlands: Hydrocortisone dose influences pain….

This 2016 article from the Shanghai Jiao Tong University, in Shanghai, China explains in detail the connection between endocrine hormones and pain.

Hormones in pain modulation and their clinical implications for pain control: a critical review

Cortisol Screening in Chronic Pain Patients

Physiology of Adrenal Insufficiency

Here’s some interesting slides from a presentation by Dr. Panamonta, MD.

Mineralocorticoid Deficiency, Primary Hypoaldosteronism

This is an in depth look at the physiology of adrenal insufficiency. There are 46 slides packed with every variation possible.


Recent Developments

Content for Accordion Toggle 3 goes here…

Related Conditions

Secondary Adrenal Insufficiency


This fascinating article details the connection between the HPA axis and the central and peripheral clocks that control circadian rhythm.

This article recognizes the need for overnight steroid coverage. It details a study on modified release hydrocortisone to replicate circadian rhythm.

This is an excellent article about the effects of electromagnetic fields on circadian rhythm and cortisol production.

Glucocorticoid Replacement Is Permissive for Rapid Eye Movement Sleep and Sleep Consolidation in Patients with Adrenal Insufficiency – See more at: JCEM


From BijnierNet  Increasing your hydrocortisone to prevent an Addison Crisis.

Published in JCEM in 2014, we feel this article may be helpful to patients having difficulty getting their doctor to approve stress dosing for emotional stress. The article states the three most common causes of adrenal crisis are gastrointestinal distress, fever, and coming in at number three, emotional stress.

These two links discuss childhood trauma and how it can affect health and chronic illness.  How childhood trauma affects health across a lifetime.  Adverse Childhood Experiences, or ACE test: How to evaluate your score. Got your ACE Score?

Steroids used to treat AI (Glucocorticoids and Mineralocorticoids)

CAH IS US provides several leaflets to help education patients.  Look for their leaflets on Hydrocortisone & Plasma renin activity and fludrocortisone

Surgery Guidelines

Addison’s Disease Self Help Group Surgical Guidelines 

Management of adrenal insufficiency during the stress of medical illness and surgery   The Medical Journal of Australia by Caroline Jung and Warrick J Inder.

UCLA Endocrine Surgery this links take you to their patient education page.


Glucocorticoid tapering and adrenal suppression testing guide: This tapering guide is a compilation of medical information available and patient experience. References for the medical information are provided at the end of the document. This guide is not a substitute for advice and direction from your own physician. You may find this a useful discussion point if you are encountering difficulties in your attempts at tapering.

Pathway for the Child at Risk for HPA Suppression: Stress Steroid Dosing and Weaning Recommendations  This is a valuable graphic for parents of adrenal insufficient children from the Children’s Hospital of Philadelphia.


A brief overview of several different tests and what their use is.

 Adrenal Insufficiency and Addison’s Disease: A list of tests used to diagnose adrenal insufficiency.

Aldosterone and renin testing

Cortisol testing in saliva, blood, and urine

Endocrinology Expected Values and S.I. Unit Conversion Tables: This shows the range of many hormones relating to adrenal insufficiency.

Factors influencing the ACTH test including the use of Oral Contraceptives. Important information for any woman using ORAL CONTRACEPTIVES.

UCLA Endocrine Surgery (tests listed on the right side)

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