In a patient with both adrenal insufficiency and hypothyroidism, which condition should be corrected first? | Rounds In a patient with both adrenal insufficiency and hypothyroidism, which condition should be corrected first? | Rounds
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In a patient with both adrenal insufficiency and hypothyroidism, which condition should be corrected first?

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Glucocorticoid Replacement Before Levothyroxine in Coexisting Adrenal Insufficiency and Hypothyroidism

Glucocorticoid replacement should be corrected first before initiating levothyroxine in patients with adrenal insufficiency. [1]

Thyroid hormone accelerates endogenous cortisol clearance and can unmask insufficient cortisol production, which can precipitate acute adrenal crisis. [1]

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