Primary Adrenal Insufficiency (addison in Medicine / Internal Medicine — 40yo Woman | Endocrinology | SMLE Q#1663
SMLE Question #1663
Medicine / Internal Medicine
Endocrinology
Last updated: February 2026
A 40-year-old woman with primary adrenal insufficiency (Addison disease) is stable on oral hydrocortisone in three divided doses and fludrocortisone. She has started permanent night shifts (20:00–08:00) and now sleeps from 09:00 to 15:00. She asks how to adjust her hydrocortisone dosing to match her new sleep–wake schedule. What is the most appropriate advice regarding her hydrocortisone schedule?
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