Adrenal insufficiency should be excluded before thyroxine replacement is startedBMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7054.427 (Published 17 August 1996) Cite this as: BMJ 1996;313:427
- I A Osman,
- Peter Leslie
- Staff grade doctor in general medicine Consultant physician Medical Department, Borders General Hospital, Melrose TD6 9BS
EDITOR,—We strongly agree with C M Brosnan and N F C Gowing's comment that Addison's disease remains the unforgiving master of non-specificity and disguise.1 We report two cases of Addison's disease in which the finding of a raised thyroid stimulating hormone concentration during investigations of weight loss prompted inappropriate treatment with thyroxine and precipitated an addisonian crisis.
Case 1—A 58 year old woman presented to her general practitioner with persistent nausea, vomiting, and weight …