Information for Healthcare Professionals

Our charity has developed a range of clinical guidance publications in collaboration with our Clinical Advisory Panel (CAP) to inform and advise healthcare professionals. Read on to find out more.

COVID-19 Guidance for Clinicians

About Adrenal Insufficiency

For a bite size look at adrenal insufficiency, watch CoMIC's brilliant video infographic explaining everything adrenal insufficiency, from aetiology, sign and symptoms, investigations, management, adrenal crisis and the vital patient training in sick day rules, administering the emergency injection and carrying the NHS steroid card.

The content of CoMICs video was critically reviewed by Dr Alessandro Prete, University of Birmingham; Professor Wiebke Arlt, University of Birmingham; Dr Helen Simpson, UCLH and ADSHG Medical Trustee; Professor Stefanie Hahner, University of Würzburg, Germany. Thank you to Dr Punith Kempegowda from Simulation via Instant Messaging – Birmingham Advance (SIMBA) for their permission to share this fantastic resource.

You can watch our 3-part video series explaining Addison's for the patient and their loved ones, produced with CoMICs, on our YouTube channel.

Out & About: Steroid Cards & Medic Alert Jewellery

NHS Steroid Emergency Card

NHS Steroid Emergency Card: developed by the Society for Endocrinology (SfE), Royal College of Physicians (RCP) and NHS England and NHS Improvement (NHSE&I), the card should be issued to all patients at risk of adrenal crisis. The QR code printed on the card takes you straight to the Society for Endocrinology Adrenal Crisis page.
Alongside the card, new medical guidance on the prevention and emergency management of adrenal insufficiency was released and a National Patient Safety Alert.
The British Society for Paediatric Endocrinology and Diabetes (BSPED) have produced a Paediatric Steroid Treatment Card for Adrenal Insufficiency
To learn more on education on steroid safety with the steroid emergency card and how to order cards for your patients - please visit the Society for Endocrinology Adrenal Crisis page
Please direct your patients to our newly diagnosed page, so they can learn about the importance of carrying steroid cards, medical alert jewellery and injection kits.
Please download our steroid card posters - both for patients and healthcare professionals.

NHS National Patient Safety Alert Logo

National Patient Safety Alert

Guidance for the prevention and emergency management of adult patients with adrenal insufficiency.

Society for Endocrinology Adrenal Crisis page

ADSHG Adrenal Crisis Emergency Wallet Card: the emergency wallet card contains advice authored by the ADSHG Clinical Advisory Panel, on the treatment required to prevent an adrenal crisis in the event of serious injury or illness. It is available in printed form and is sent free to every member when they join the charity as a postal member. Additional cards can be bought in our shop.

Learn about all steroid emergency cards - for adults and children

Adrenal Crisis Care Letter

This simple adrenal crisis protocol gives emergency medical treatment guidance for paramedics or hospital staff in the event of a person with Addison's suffering an adrenal crisis. This letter should be signed by your doctor. This document is also available in eight foreign languages for those who live or travel abroad.

Emergency Injection Kit

Every patient should be issued with a prescription for hydrocortisone IM for emergency use as required for a hydrocortisone emergency injection kit and advised of training for patients and carers/families on their use. Some Endocrinology centres provide the kit as a whole (box including the syringes and needles alongside the prescription) others ask the patients to provide their own storage solution.

Provision of a hydrocortisone emergency injection kit is standard practice and is the advice given by the ADSHG Clinical Advisory Panel, Society for Endocrinology, on the NHS page for Addison's disease and in the RCGP eModule, for the prevention of an acute adrenal crisis.

We raise awareness in our community through our #ShareYourKit campaign, provide clearly labelled kit options in our shop, advice on how to create your own kit in our blog post, provide picture instructions and training videos online.

Visit our "Why should I give my adrenal insufficiency patient an emergency injection kit?" page for further guidance and links to expert clinical guidance, regarding the provision of a hydrocortisone emergency injection kit for a person with Addison's disease and adrenal insufficiency, for the prevention of an acute adrenal crisis.

Why should I give my adrenal insufficiency patient an emergency injection kit?

Primary Care (GPs, Practice Nurses, Pharmacists, Dentists)

Reducing risk of acute adrenal crisis

Free RCGP Training Module

In this 15-minute eLearning module titled 'Adrenal insufficiency with a focus on Addison's disease', we discuss the causes of adrenal insufficiency (AI), how to recognise and diagnose the condition in primary care, and management. We also cover adrenal crisis, how to recognise this condition, and the emergency treatment which should be delivered before hospital transfer. Read our News article to find out more about the making of this course.

The eModule can be accessed from the RCGP website: https://elearning.rcgp.org.uk/addisonsdisease

Diagnosing Addison's : A Guide For GPs

This leaflet, 'Diagnosing Addison's: a guide for GPs', has been developed for the ADSHG by our Clinical Advisory Panel, led by Professor John Wass. It outlines the role of the GP in the early detection of Addison's disease and covers information on symptoms and clinical signs, primary care investigations and referral.

Caring for The Addison's Patient : Information For GPs Dental Care

This leaflet, 'Caring for the patient with Addison's: information for GPs', has been developed for the ADSHG by our Clinical Advisory Panel, led by Professor John Wass. It outlines the role of the GP in managing Addison’s disease at each stage in the UK patient life cycle from diagnosis to old age.

Order paper copies of our leaflets

Dental Care

Addison's Disease: Advice for Dentists

Our Paramedic Training Sessions

Make our Paramedic Training Sessions for trusts and individuals in managing adrenal crisis part of your continuous professional development (CPD). Due to the COVID pandemic, we have moved our sessions online to Zoom.

Visit our Paramedic page to find out more

The sessions are an educational hour on Addison’s and adrenal insufficiency set in context with the JRCALC guidelines for emergency management. Each session is complemented by members’ own experiences, so alongside the theory you hear real life accounts from real people.

Download our poster to share with your Ambulance Trust

Endocrinologists and Endocrine Nurses

Created with the Society for Endocrinology, download the Consultation Reference Guide for adult patients with Addison's disease (AD) This document is a useful consultation guide for endocrinologists and endocrine nurses to support patients with AD at diagnosis, their follow up reviews, treatment monitoring and shared-decision making.

Endocrine Hub

Through conferences moving online during COVID, we have created a Endocrinology Hub page. This links to information and resources our charity would normally share at Endocrine Conferences, to show the support we can offer you as healthcare professionals as well as resources for your patients and their loved ones.

Visit our Endocrinology Conference Hub page

Endocrine Nurses
Read about the Liverpool Nurses who moved their steroid education sessions for their patients with adrenal insufficiency online during COVID-19. If our charity can support you in creating similar resources or you would like more information please get in touch.

Digital steroid coding system: Endocrine Nurse Specialist Becci Watling, from the Royal Bournemouth Hospital updates us on the implementation of their digital steroid coding system, a system which identifies all patients admitted with adrenal insufficiency. Visit our blog article 'Ensuring Sufficiency in Addison's when an inpatient' to learn more.

Tertiary Care

Surgical Guidelines

The ADSHG surgical guidelines are intended for the information of medics and healthcare professionals (including dentists) and have been developed for the ADSHG by our Clinical Advisory Panel. They explain what level of extra medication and monitoring patients with Addison's disease will need in the event of most types of minor or major surgery or dental work.

Nursing The Addison's Patient : Notes for Nurses

'Nursing the Addison's patient: notes for nurses' was written with hospital ward nursing staff in mind, for those times when anyone with Addison's becomes an inpatient. This might be for elective surgery or during the recovery from an adrenal crisis.

Download or Order our Leaflets and Publications

Explore and download our leaflets and publications from our website including Managing Your Addison's, Caring for the Addison's Patient, and Diagnosing Addison's.

Order paper copies of our leaflets

We couldn't carry out this work without the expert support of our Addison's Clinical Advisory Panel (CAP), a group of healthcare professionals with an interest in adrenal medicine. They advise us on our clinical guidelines, write medical commentaries and review our publications for us. They are led by Professor John Wass of the Churchill Hospital, Oxford. We are always looking for more healthcare professionals to join us, in whatever capacity you are able with your work commitments. If you are interested, please get in touch.

Trophy with an ADSHG labelled magnifying glass

Are you interested in undertaking research in this area of Endocrinology? We fund vital research projects into Addison's disease, adrenal insufficiency and steroid dependency.

Stay in touch! Follow us on Twitter, Facebook, Instagram, LinkedIn, YouTube.

Latest

Jennifer's fundraising for Addison's disease

I'm raising money for the Addison's Disease Self Help Group so that they can continue to support people with Addison's and adrenal insufficiency. Addison’s is a rare endocrine condition where the adrenal glands do not produce enough steroid hormones and can be life threatening. It affects approximately 1 in 10,000 people, meaning an estimated 300 - 350 new cases are diagnosed each year across the UK, this makes it roughly 300 times rarer than diabetes.
Behind the Research: U-RHYTHM

Dr Thomas Upton updates us on the development of U-RHYTHM, a wearable device to measure hormones, including cortisol levels, in the body over the full 24 hours, following the release of their clinical trial study,
Behind the Research: The PULSES trial - Pulsatile Cortisol Infusion Pump

Dr Georgina Russell updates us on The PULSES trial, looking at the effect of pulsatile cortisol pump therapy on quality of life, mood, sleep, behavioural and cognitive processing and metabolism.
Getting the Flu Jab

Say No to Flu! Book your flu jab today. There is no need to miss out, as it is free to people who are steroid-dependent (everyone with Addison's disease and adrenal insufficiency). Dr Prete, Consultant Endocrinologist, explains more about the importance of getting your flu jab when you are steroid-dependent.

Sick Day Rules

Minor ailments can affect anyone with a steroid-dependent adrenal condition very differently. Things like vomiting, diarrhoea, colds and flu could cause an adrenal crisis. It’s important that you spot the early symptoms of a bug or cold and adjust your steroid replacement medication.
What is Addison's Disease?

Find out more about Addison's disease and adrenal insufficiency and and how they are treated.
Adrenal Crisis Can Kill
The Emergency Injection for the treatment of Adrenal Crisis

Understanding what an Emergency Injection kit is, how to inject and how important it is to use the injection during an Adrenal Crisis.
Coronavirus Vaccines and Adrenal Insufficiency

Everyone with a steroid-dependent adrenal condition should get the coronavirus vaccine and boosters to reduce their risk of getting coronavirus. This is because people who are steroid-dependent are at increased risk of needing hospital care if they get coronavirus, due to the risk of adrenal crisis.
Why Salt?

Why do people with Addison’s and adrenal insufficiency crave salty, acidic and sour foods at diagnosis, and then salt remains our “pick me up” when diagnosed? Professor Simon Pearce explains the connection between aldosterone, fludrocortisone and why you should always listen to your salt cravings.
Novel Coronavirus (COVID-19) - 02/10/2023

Our medics have been keeping an eye on pandemic developments. This page is up to date but we will continue updating it regularly as we find out more information from the government.
Updated NHS Steroid Card Released

Following the early release of the new NHS Steroid Emergency Card back in March to keep patients with Addison's or adrenal insufficiency safe during the COVID-19 crisis, the NHS steroid card has been updated and physical copies will be available to order from Tuesday 18th August 2020 for hospital teams!
Addison's & Adrenal Insufficiency: Advice for Dentists

The ADSHG guidelines offer illustrative guidance for major and minor dental procedures. It is important to recognise the physical stress of any invasive dental procedure and to ensure that adequate glucocorticoid cover is provided for steroid-dependent patients.
Surgical Guidelines

The ADSHG surgical guidelines are intended for the information of your medical team or your dentist and have been developed by our Clinical Advisory Panel.

Research Grants

Our charity is at the forefront of medical research into Addison's Disease. Help us fund medical researchers working in this important field of endocrine research. Read more