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Addison's disease / adrenal insufficiency

A Canadian clinical summary of addison's disease / adrenal insufficiency, with source-attributed priorities and explicit jurisdiction boundaries.

JurisdictionCanada
Source check2026-08-20
Clinical reviewiatroX editorial team · Clinical editorial review · reviewed 2026-08-20 · due 2027-08-20
AudienceHealthcare professionals practising in Canada
This is an iatroX educational summary of named Canada sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. British Columbia is used as an explicit Canadian implementation example, not as a national rule. Verify the equivalent pathway, formulary and escalation route in the patient’s province or territory.

British Columbia source: bounded use

This British Columbia source covers recognition, investigation and emergency treatment of adrenal crisis in the emergency department. It does not supply a complete longitudinal adrenal-insufficiency replacement or sick-day-management guideline.
sources for this section:ECBC adrenal crisis

Source-attributed clinical priorities

  • Suspect adrenal crisis with hypotension, volume depletion, vomiting, abdominal symptoms or electrolyte disturbance in an at-risk patient.
  • Do not delay emergency glucocorticoid and fluid treatment for confirmatory testing when crisis is suspected.
  • After stabilization, investigate and treat the precipitating cause and arrange specialist assessment of newly confirmed adrenal insufficiency.
  • Treat suspected adrenal crisis from the clinical presentation; confirmation must not postpone emergency therapy.
sources for this section:ECBC adrenal crisis

Practical assessment and management workflow

1
Identify risk from known primary or secondary adrenal insufficiency, an acute stressor or recently stopped chronic glucocorticoids.
2
Assess circulation and consciousness and obtain sodium, potassium, glucose, kidney function, cortisol and ACTH samples when this does not delay treatment.
3
Give prompt parenteral glucocorticoid, isotonic fluid and glucose when indicated, with close monitoring and supportive critical care.
4
After initial treatment, identify the precipitating illness and arrange internal-medicine or endocrinology investigation of newly confirmed disease.
sources for this section:ECBC adrenal crisis

Safety, red flags and urgent escalation

  • Do not delay crisis treatment for cortisol or stimulation-test results.
  • Escalate hypotension, altered consciousness, vomiting, hypoglycemia, severe weakness or major electrolyte disturbance to emergency and critical care.
  • Abrupt cessation of chronic glucocorticoid therapy is a recognized precipitant and must be identified in the medication history.
sources for this section:ECBC adrenal crisis

Confirm the local pathway before acting

British Columbia is used as an explicit Canadian implementation example, not as a national rule. Verify the equivalent pathway, formulary and escalation route in the patient’s province or territory.
sources for this section:ECBC adrenal crisis

Source and implementation boundary

Read this educational summary with the linked source, current Canadian product information where medicines are involved, and the applicable provincial or territorial pathway. Local formularies, reporting duties, referral routes and service availability can differ.
sources for this section:ECBC adrenal crisis

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Emergency Care BCAddisonian – Adrenal Crisis – Diagnosis & TreatmentLast reviewed 2021-11-09 · accessed 2026-08-20
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