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The underlying mechanism is thought to involve toxic effects of elevated VLCFA (especially C26:0) on the adrenal cortex, and lifelong monitoring with regular Synacthen tests plus hydrocortisone (and fludrocortisone when needed) replacement is recommended for management (99)

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In some cases, bloodwork or a urinalysis may be required

Nautiyal P, Subramanian KA, Dastidar MG (2014) Kinetic and thermodynamic studies on biodiesel production from Spirulina platensis algae biomass using single stage extraction-transesterification process