What is the appropriate corticosteroid supplementation for a patient meeting criteria for adrenal insufficiency?

Corticosteroid supplementation is crucial for patients with adrenal insufficiency, particularly during times of stress or when undergoing medical procedures. In patients who are already on a maintenance dose of corticosteroids, the typical recommendation is to maintain their normal morning dose and provide additional supplementation as needed based on clinical guidelines.

The rationale behind maintaining the normal morning dose is that this provides a baseline level of corticosteroids that the body is accustomed to. Supplementation is then tailored to the situation, such as during surgery, illness, or any physical stress the patient may encounter. This approach ensures that the patient has adequate hormone levels to handle physiological stress, effectively preventing adrenal crisis.

Providing a double dose or skipping the morning dose would not be appropriate as that could either lead to overdose or insufficient hormone levels, putting the patient at risk for adrenal crisis or complications. Therefore, the practice of adhering to the normal morning dosing schedule while adding supplementation as clinically indicated is the standard approach for managing patients with adrenal insufficiency during stressful situations.