What routine monitoring is recommended for patients on long-term glucocorticoid replacement therapy for Addison's disease?

For patients undergoing long-term glucocorticoid replacement therapy for Addison's disease, routine monitoring includes:

• Blood pressure measurement (lying and standing) to assess for mineralocorticoid replacement adequacy ¹.
• Electrolyte testing to monitor for imbalances related to mineralocorticoid therapy ¹.
• HbA1c testing to monitor for glucose metabolism disturbances ¹.
• Bone density assessment at least once in the 5 years after diagnosis for adults, especially if risk factors are present ¹.
• Lipid profile testing for adults to evaluate cardiovascular risk ¹.
• Regular clinical review of signs and symptoms of under- or over-replacement, including weight changes, fatigue, hyperpigmentation, skin thinning, and metabolic disturbances ¹.
• In children and young people, monitoring height, weight, pubertal development, bone age, and signs of low blood glucose, with additional assessments like bone density if growth has ceased or fractures occur ¹.