Updated 22/09/2020: This page is currently up-to-date, based on the most recent guidance available and is the best advice we have for people with Addison's and Adrenal Insufficiency at this time. This advice is for people living in the UK and ROI. 

Our trustee medics and Clinical Advisory Panel alongside Society for Endocrinology, have been keeping an eye on the emerging situation and the current view is as follows. We hope you find it useful and it answers some of your questions. 

Healthcare professionals managing a patient with COVID-19 and Adrenal Insufficiency - please view the  latest guidance from the European Society of Endocrinology.

As the coronavirus outbreak is a rapidly developing situation, please also check the NHS website for the latest information for people in the UK.

Here are our six COVID-19 (coronavirus) precautions for people who have Addison's Disease or Adrenal Insufficiency.

1. Protecting Yourself

2. Preparing for Emergencies

3. Managing Your Medication

4. Keeping Informed

5. Managing Employment and Finances

6. Getting About Safely

7. Recovering from COVID-19

8. Children and Schools

1. Protecting Yourself

In the UK and ROI guidance is in place to keep the general public safe during the time of COVID-19

UK Coronavirus Guidance

ROI Coronavirus Guidance

According to guidance published in the EJE journal in April: "Patients with adrenal insufficiency are at increased risk of COVID-19; they are at an increased risk of catching this infection and they have a higher risk of complications due to the potential for an adrenal crisis to be triggered by the infection. There is currently no evidence, however, suggestive of a higher likelihood of a severe course of disease in patients with AI falling ill with COVID-19.

According to current government guidance and the Summary Advice Statement released by Society for Endocrinology, you should be particularly stringent in following social distancing measures and work from home, where possible.

Please note this is NOT the same advice as for the shielded category of patients or those who have been advised separately by their doctor to sheild.

Please see section 6. Getting About Safely  below for more information.

Shielding advice

You may hear from the government, NHS (or HSE in ROI) directly with updates on pausing or resuming shielding as appropriate.

When shielding is paused:

If you have Adrenal Insufficiency but no other conditions that would class you as 'clinically extremely vulnerable' or being in the 'highest risk group', you should follow the standard coronavirus advice provided by your local government for the rest of the population (see section 1 above). To check if any other conditions you have would make you 'clinically extremely vulnerable' please look at the latest definition from your local government:

The UK Government definition of 'clinically extremely vulnerable'

The Welsh Government definition of 'extremely vulnerable people'

The Scottish Government definition of 'the highest risk group'

The ROI Government definition of 'people at higher risk

When shielding is in place: Use the above links to check if your health conditions are featured on the lists of conditions that would require you to shield. Where they do not, you can follow the guidelines being provided to the rest of the population. 

If you think you or a loved one are in this highest risk category and have not received a letter from the NHS (or HSE in ROI), the government or your GP, get in touch with your GP or hospital-based healthcare professional by phone or online to find out what's right for you. It’s important to remember that the need for shielding is dependant on your personal health and any combination of health conditions you may have, so we encourage anyone with concerns to speak to their GP, Endocrine nurse or hospital consultant to know what is right for you

For some, the current measures may have taken a huge toll on both their physical and mental health. 

Managing your mental wellbeing

It’s important to look after your mental health right now, whether you’ve had coronavirus or not. Think about ways to keep your stress levels down, what you can control and how being prepared can be a great help. Talk to someone if you are feeling stressed or anxious.

You can read our advice on coping with psychological stress or our blog post Easing lockdown - How are you feeling?. If you are an ADSHG member, we have a useful coronavirus thread on our online forum where you can talk about how you feel. Others can then support you, as other members share information and experiences.

For further support in looking after your mental here, here are some useful link to organisations that can help you do that:

Every Mind Matters

Clear Your Head (Scotland)



Mental Health Foundation

The World Health Organisation has also published advice here about managing your mental wellbeing during the coronavirus outbreak.

NHS support

Even if you're not in the shielding group, if you meet certain criteria you can access support from the NHS volunteer responders. They can do things like helping you with shopping, getting prescriptions or just checking in to see how you are doing. 

You can request this support online or by calling 0808 196 3646.

Other ways to protect yourself

If you're in the UK, follow the advice from the NHS on avoiding catching or spreading coronavirus. 

You may be caring for a person in an at-risk group. If you are, take extra care to protect yourself and the person you care for from coronavirus.

Make sure your vaccinations are up to date. Note that our medics have confirmed that the pneumonia vaccine protects against pneumococcal bacterium and would not protect against the type of Pneumonia caused by COVID-19. This is confirmed on the WHO website on their coronavirus myth-busters page.

2. Preparing for Emergencies

Get your Emergency kit and Emergency Letter ready:

Make sure you have an Emergency Injection Kit containing hydrocortisone vials available from your GP or Endocrinologist, syringes, injection instructions, and plastic vial snaps. Make sure it is up to date, that you have the instructions and practice a self-injection using our videos. Make sure you have a completed Emergency Letter and it is up to date.

Keep your NHS Steroid Card handy:

Keep a copy of both the NHS Steroid Emergency Card and ADSHG charity Adrenal Crisis Emergency wallet card, filled in with your details, in your wallet or purse.

Prepare in case you need to be admitted to hospital:

Read our four tips for preparing for hospital admission

If living in the UK, register with your local ambulance trust.

Make sure you can stay hydrated:

Make sure you have plenty of non-alcoholic drinks, salty snacks and rehydration fluids (available in most chemists) or salts available in your home.

Learn about Self Isolation (different to shielding) in case you are asked to isolate:

You may be required to self isolate after travelling, if you have COVID-19 symptoms or a found to be a contact of someone with confirmed COVID-19. Self Isolation is different to shielding. 

The following links explain what self isolation is, when to isolate and where to look for advice if isolating impacts your employment or finances.

Familiarise yourself with the NHS advice on self-isolation , the HSE self-isolation and limited social interaction ro the Welsh Government's guidance on self isolation so that you are prepared in case you are told to self-isolate. 

Get familiar with how to get medical help in an emergency:

If you need to use the NHS 111 service please use the NHS 111 website in the first instance so that the service can handle more urgent cases over the phone. If you need to contact NHS 111 or call 999 in an emergency, be sure to mention 'steroid-dependent' and 'adrenal insufficiency' when explaining your health status. 

Or in ROI: the HSE contact details are: Callsave: 1850 24 1850, Phone: 041 6850300 or Tweet: @HSELive

3. Managing your medication

Keep taking your tablets as normally prescribed unless you are ill! Steroids taken for adrenal insufficiency are replacement doses and increasing the dose during illness is to try and mimic your body's natural physiological response. In the correctly tailored dosages, they should not suppress your immune system.

Make sure you have a good supply of medication that cover you, in the event, you have to self isolate and fall ill enough to increase your dosing as per our Sick Day Rules.  Please read our Sick Day Rules before increasing your dosing and make sure you have an extra month's worth of medication.

In our latest video, ADSHG Trustee and Professor or Endocrinology explains how to manage your medication should you get ill in the coming weeks.

If your UK or ROI based GP or Endocrinologist does not wish to provide additional prescriptions to provide the above cover, please print and provide them with the below documents as a guide and politely ask again:

EJE Clinical Guidance: Managing Adrenal Insufficiency in the time of COVID-19 

The advice from the Society for Endocrinologists for people with adrenal insufficiency.

The ADSHG Caring For the Addison's Patient leaflet

The Pituitary Foundations's Letter to GPs - Digital Template

Please note: The ADSHG cannot become involved in individual disputes, but our resources can be downloaded to raise awareness amongst medics.

Behind the news: Hydrocortisone as a treatment for Covid-19

4. Keeping Informed

Make sure you have useful ADSHG publications printed, filled in and stored in an easy to find location. Talk to your family about the support and/or treatment you need - make a plan. You could use our Personal Emergency Plan to think everything through together.

Our Sick Day Rules are an excellent set of principles to follow if you become ill. Print them and share them with those who are likely to be looking after you if you become ill.

The Government and NHS are providing regular updates so follow them online or keep an eye on the media for their latest updates.

UK Department of Health and Social Care

On Facebook
On Twitter 


On Facebook
On Twitter 

On Facebook 
On Twitter 

Tailored information for people living in Wales, Scotland and Northern Ireland can also be found at:

Public Health Wales 
Health Protection Scotland 
Public Health Agency (NI) 

Tailored information for British Sign Language users

Read the advice from the Society for Endocrinologists for people with adrenal insufficiency.

Read the advice from the Society for Endocrinologists regarding adrenal crisis.

Please familiarise yourself with the NHS advice on self-isolation in case you are asked to self-isolate. 

Follow the ADSHG on Twitter, Facebook or if you are a member all our updates will also feature on our forum. We'll also include advice on our ADSHG website.

Misinformation can be troubling and misleading. Please review the WHO's Mythbusters to verify the things you are hearing, reading or sharing. 

5. Managing employment and finances

It's best to work from home if you're able to, especially if your commute involves getting public transport. For some, working from home is not possible.

If you are employed, talk to your employer about their plans and your needs. As the Citizen's Advice Bureau advises: "Talk to your employer if you think there’s more they could do to keep you safe. Try to be constructive and explain what you need to happen so that you’ll feel safe when working."

Read the your local governments advice for working during the time of COVID-19 and advice if you're worried about working:

UK and Welsh Government Worker Support page

ROI Citizen's Advice Bureau's Returning to Work Safely page

Northern Ireland's Government advice for workers

You can find the latest advice from the Citizens Advice bureau here, if you are concerned about going to work, sick pay or any benefits you receive. If you are unable to work from home, you should only be going back to work if your workplace is 'COVID-secure'. 

COVID-secure should mean that working times are staggered so people aren’t arriving and leaving at the same time; you’re able to stay socially distant from colleagues in a well ventilated room (keep windows and doors open as much as possible); you can wash your hands or use hand sanitiser frequently and wear a face covering if possible.

Use GOV.UK’s coronavirus employee risk assessment tool to find out if you should be going back to work in England or get more information for ScotlandWales and Northern Ireland

Please note: The ADSHG cannot become involved in individual disputes, but our resources can be downloaded to raise awareness amongst employers, those in HR or occupational health or healthcare professionals involved in supporting you.

Sick Note. If you get coronavirus symptoms and can’t work, then you shouldn’t need a sick note for the first seven days, but most employers will want to see one after that. If you have been told to self-isolate and you need a note for your employer, the NHS can give you a digital isolation note. You can access this service through the NHS 111 website which will be sent via email, or can be sent directly to your employer.

If you’re part of the NHS and public sector, occupational health (OH) services are involved in assessing the risk of people with health conditions going to work. They can offer advice to employers about the deployment of staff during the pandemic. If you’re working in these areas, this information 'Keeping our Workforce Safe’ could be useful.

Unable to Work. If you can’t work and are on a low income, you might be able to get Universal Credit to help. If you’re self-employed and have been negatively affected by coronavirus, you may be able to access a grant through the government’s Self-Employment Income Support Scheme. You might also be entitled to more help with your rent. The government has announced that the Local Housing Allowance will be increased to cover more people’s rents.

6. Getting out and about safely

Part of deciding whether or not to do something is down to your attitude to risk. It might be helpful to think about how much you’d benefit from going somewhere and how much you could potentially be exposed to coronavirus. Always follow the UK Coronavirus Guidance and follow stringent social distancing measures. 

The Scottish government has produced a quick guide to help you understand what sorts of activities are safer than others, which you may find useful. Generally, outdoor activities – such as seeing friends outside, or sitting outside at a café or restaurant – should be lower risk than indoor activities as long as the latest government guidance is followed.

Find out how many cases are in your area. If lots of people in your area are infected with coronavirus, it’s more likely that you will be exposed to the virus. Find official coronavirus statistics for your areaFind out the current R number in the UK, as well as separate ones for England, Northern Ireland, Scotland and Wales. 

Travel. If you are planning to travel, please check the travel advice from the UK Government about the countries you'll be travelling to and from. We have advice on our website about managing your Addison's when travelling.

If you have been travelling abroad, and you think you may have been exposed to Coronavirus, the most up-to-date advice on what to do can be found on the NHS, HSE or UK Government websites.

Going to appointments or into hospital. If you have a medical appointment, check the current advice at the medical centre in question and discuss any concerns with them when considering if you will attend or not. It is important to contact the NHS if you have any healthcare concerns. It's important not to put off talking to your GP or endocrinologist. 

You might find it useful to talk to friends, family or a health care professional about your individual situation, taking into account your Addison's disease or adrenal insufficiency. You can also check out our blog for our hospital and COVID-19 posts:

  • Q&A with Dr Helen Simpson (Consultant Endocrinologist) and Professor John Wass about going into hospital during COVID-19 - read here.
  • ADSHG member Jennifer shares her experience of having emergency surgery during COVID-19 - read here.

7. Recovering from COVID-19

If you have experienced COVID-19 yourself. make an appointment with your GP to discuss how you are recovering since your were ill. It seems to be that recovery from COVID-19 can be a long haul, you might benefit from being referred to a COVID-19 follow up clinic if you are having persistent problems.

It might well be worth your seeing your endocrinologist for an up to date assessment. 

As it is still very early days for the medics generally to know how people are going to recover, there will be no 'one size fits all' approach, so contact your healthcare team, who know your circumstances, and find out the best strategy for you.

8. Children and schools.

The UK Government confirmed in August that children in the UK were to return to the classroom. Schools should be practising social distancing for your child when they are back at school and encouraging regular hand washing, to prevent the virus from spreading between children and your home.

View the latest information from GOV.UK about school and education on what parents and carers need to know about schools and education during the coronavirus outbreak.

If you are worried about the safety of your child returning to school if they have Addison’s or adrenal insufficiency, speak to the school and to your child’s endocrine team about your concerns.

There are also some key things you can do to before your child returns to school:

Medication -  Resupply the school with an in-date hydrocortisone emergency injection kit and medications as prescribed and following your child’s Individual Healthcare Plan (IHP).

An Individual Health Care Plan - Individual Health Care Plans (IHPs), are called different things depending on the nation you live in. But these plans are used to make sure your child’s Addison’s or adrenal insufficiency is managed properly during school time. Make sure your child’s IHP is up-to-date and includes a copy of the latest letter from the medical professional coordinating your child’s care. A sample IHP template is included in our booklet "When a student has Addison's: a guide for schools and parents."

Be Prepared - If your child is old enough, you can support them in making sure they know how to use their emergency injection kit. Read more about kits on our website and watch our Emergency Injectionvideos on YouTube about how to correctly use an emergency injection kit.

For more information on the COVID-19 advice for schools for the four nations, please follow the links below:

Schools guidance in England

Schools guidance in Northern Ireland

Schools guidance in Scotland

Schools guidance in Wales