What routine monitoring is recommended for patients on long-term gluco

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

For patients undergoing long-term glucocorticoid replacement therapy for Addison's disease, routine monitoring includes:

Blood pressure measurement (lying and standing) to assess for mineralocorticoid replacement adequacy .
Electrolyte testing to monitor for imbalances related to mineralocorticoid therapy .
HbA1c testing to monitor for glucose metabolism disturbances .
Bone density assessment at least once in the 5 years after diagnosis for adults, especially if risk factors are present .
Lipid profile testing for adults to evaluate cardiovascular risk .
Regular clinical review of signs and symptoms of under- or over-replacement, including weight changes, fatigue, hyperpigmentation, skin thinning, and metabolic disturbances .
In children and young people, monitoring height, weight, pubertal development, bone age, and signs of low blood glucose, with additional assessments like bone density if growth has ceased or fractures occur .

What routine monitoring is recommended for patients on long-term glucocorticoid replacement therapy for Addison's disease?