====== Thyroid replacement ======

===== Caution in patients with adrenal insufficiency =====

Primary [[hypothyroidism]] may be associated with immunologic destruction of the adrenal cortex (Schmidt syndrome). Secondary hypothyroidism may be associated with and may mask reduced adrenal function. 

✖ Thyroid replacement without adrenal replacement in patients with adrenal insufficiency (as may occur in [[panhypopituitarism]]) may precipitate adrenal crisis (thus giving ≈ 300– 400 mg hydrocortisone IV over 24 hrs in addition to thyroid replacement).