Patients with post-operative serum cortisol levels between 2 and 5 µg/dL require much closer monitoring. These individuals are at increased risk for subclinical CD that is challenging to diagnose. We recommend that the first test be performed at 3 weeks following surgery to evaluate changes in cortisol levels (i.e., identify cases of delayed remission). If serum cortisol level declines to <2 µg/dL, the patient can be considered in remission. If serum cortisol remains elevated or if there is a mild increase in UFC values, the patient could potentially be afflicted with subclinical CD.