Glucocorticoid-induced adrenal insufficiency: physiological dose tapering promotes recovery

Endocrine Connections 2026 Open access

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Authors: Rajeev Mehta, Katharine Lazarus, Angelica Sharma, Pei Chia Eng, Kavita Narula, Sirazum Choudhury, Deborah Papadopoulou, Zin Htut, Tricia M-M. Tan, Karim M. Meeran
DOI: 10.1530/ec-25-0625
Cited by: 0

Abstract

Objective: Glucocorticoid discontinuation is complicated by glucocorticoid-induced adrenal insufficiency. Guidelines discourage tapering below physiological doses (prednisolone 3-6 mg) when morning cortisol is ≤300 nmol/L, with values 2 mg producing larger cortisol increases than 1 mg reductions (both P < 0.05). Among completed wean attempts (n = 47), 81% (n = 38) were successful. Of these, 42% (n = 16) had a nadir morning cortisol

Fields of Study & Subjects

Adrenal Hormones and Disorders Stress Responses and Cortisol Estrogen and related hormone effects

Publication details

Journal / source
Endocrine Connections
Volume
15
Issue
1
Publication date
1 January 2026
Language
EN