Adrenal Insufficiency

Adrenal Insufficiency

In some cases, your specialist may refer you for a scan of your adrenal glands – this could be a computerised tomography (CT) scan or a magnetic resonance imaging (MRI) scan. As well as a synacthen stimulation test, your thyroid gland may also be tested to see if it’s working properly. Your GP may refer you to an endocrinology unit (a unit that specialises in the study of hormones) for the test.

However, if you are uncertain about your child’s treatment, speak to your doctor or specialist nurse. Cortisol deficiency is easily managed with replacement hydrocortisone tablets given a few times a day. Steroid replacement is vital for your child to grow and develop normally.

Section 2: Peri- and post-operative management – major surgery

Furthermore, he has specialist experience in testosterone replace… Adrenal insufficiency is a condition in which the adrenal glands (small hormone producing glands sitting above the kidneys) stop producing enough cortisol. Cortisol is a naturally occurring steroid hormone which regulates blood pressure, blood sugar and muscle strength. It is a hormone that is essential for health; severe deficiency can cause illness or even death.

  • People with Addison’s disease often have an underactive thyroid gland (hypothyroidism), where the thyroid gland does not produce enough hormones.
  • Dexamethasone makes your body more resistant to insulin, making your blood sugar levels go very high.
  • You’ll receive the latest expert advice, guidance and ADSHG news, whilst being part of our inspiring and supportive community.
  • If you have Addison’s disease, you’ll need to take steroids on a long-term basis, so you should keep a steroid emergency card with you at all times.

Ask your GP if there’s one they recommend, or go to the MedicAlert website. Some women may also have irregular periods or miss some periods completely. Children with Addison’s disease may experience puberty later than usual. It’s caused by lack of the hormone aldosterone in your body, which is used to regulate the balance of salt and water.

Adrenal crisis

If a patient is Cushingoid due to exogenous steroids it is almost certain they will have adrenal suppression. Individuals on inhaled steroids, or having received an intra-articular glucocorticoid injection, co-prescribed CYP3A4 inhibitors such as antifungals and protease inhibitors will be at high risk. For more resources regarding the management of pituitary/adrenal insufficiencies and other endocrine conditions, you can visit the Society for Endocrinology’s website.

When you have diabetes, it’s important to know how to cope when you’re unwell. Especially if you have to go into hospital.

Being aware of kidney function is important in order to maintain health. Many people live with mild and moderately low kidney function, which is often referred to by health professionals as early stage chronic kidney disease or stage 3 CKD. Being ill can upset your diabetes management, so you need to know what to do to keep your blood glucose (sugar) levels as close to target as possible. Please assess for risk of diabetes and if high risk or have impaired glucose tolerance or diabetes ensure monitoring consistent with national guidelines in place.

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There’s also a risk your brain won’t get enough oxygen if treatment is delayed, which can cause permanent disability. However, additional strees, caused by another illness or an accident, for example, may cause your symptoms to suddenly get worse. Likewise patients on high dose inhaled glucocorticoids plus other glucocorticoids such as nasal or high dose topical steroids will be at higher risk. This is usually administered as hydrocortisone, but prednisolone, dexamethasone, plenadrene and some other steroids also used.

Sick Day Rules for medications

There is significant variability in the susceptibility to adrenal suppression eg 10% of individuals on high dose inhaled glucocorticoids will have evidence of adrenal suppression. For individuals with Addison’s disease or hypopituitarism undergoing surgery it is considered best practice to collaborate with their consultant endocrinologist. We recommend all adults with adrenal insufficiency should carry this card. A time difference of 1 to 3 hours should not cause any problems.

You are entitled to receive your medication free of prescription charges. Your GP must certify your entitlement to free prescriptions on a Medical Exemption card. So it’s important to be prepared and follow our advice on coping when you’re sick.