An overview of the epidemiology, genetics, clinical presentation, diagnosis, and treatment of this rare disorder. In particular, diagnosis is confounded by the non-specific nature of the symptoms of adrenal insufficiency and hypothyroidism. Conditions usually present in mid-life, women being affected more than men. The cosyntropin test is recommended for diagnosing adrenal insufficiency, which must be present to diagnose this syndrome. Hormone therapy for each condition is similar to treatment that would be provided if the conditions occurred separately, except that treatment for adrenal insufficiency must be given before thyroid therapy is started when the conditions occur together.
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