Enjoying the sun is one of the things many people look forward to in the summer or on holiday. But if you have Addison’s or adrenal insufficiency, it can be harder to manage your condition in the hot weather.

It's important to take precautions to ensure that your Addison’s or adrenal insufficiency remains as well-controlled as possible in hot weather. Check out our top tips for when you’re out and about in the sun:

• Stay well hydrated by drinking plenty of water.
• Keep your salt levels up and enjoy lots of salty foods.
• Make sure your fludrocortisone dose is adequate, beware of light headedness and listen to your body.
• Keep alert information like steroid cards and medic alert jewellery on you.
• Check if your medication needs to be kept at a certain temperature, so may need to be refrigerated due to the extreme heat. Make sure to also check how they should be stored (e.g. in a sealed container).
• Stay cool, slow down and keep out of the sun.

Read on to hear from Andrew who has Addison’s himself. He gives his ten top tips from living in Bangkok, managing a hot, tropic climate, and what he's learnt from his first-hand experience of extensive travel under sometimes challenging conditions.

1. Listen to your body. It is easy to want to do everything when you’re travelling. You want to pack all the sights and experiences in, with early starts and late nights. You may not feel stressed but think of all the new places, people, the language barriers, the different food. Addison’s has a knack of catching up with us when we overdo things and just be aware of the telling signs that you need a little rest within the trip or perhaps take an extra half tablet.

2. Don’t hide it. If you’re with travelling companions, share the fact you have Addison’s – it’s nothing to be ashamed of. If you are on your own, carry the NHS steroid card and wear a medical bracelet, preferably one such as Medi-Tag with a back-up phone service. If you are going somewhere far off the beaten track, let someone know where you are heading and for how long. Take your mobile.

3. Information is everything. Take all relevant emergency translations from the ADSHG website. Take the English-language emergency guidelines. You may not have planned every destination but you probably know the main ones. Google should be able to get you the names and contact information for English speaking hospitals and clinics so, if the worst comes to the worst, you already know where to go.

4. Fluids. It is hot, humid and you sweat profusely anywhere near the equator. Make sure you always have water with you but beware that bottled water is often very low in sodium and other minerals and just goes straight through you. It’s therefore important to have some salty snacks and rehydration fluids (available in most chemists) or salts with you. Dress sensibly – long, light, loose clothes and a hat when in direct sunshine.

5. Fludrocortisone. As someone with Addison's, our dose is based on UK temperatures mostly under 20°C. You will find 30°C plus temperatures in the day and not much less at night. Don’t be afraid to top up your dose of fludrocortisone if you feel you need to (see ‘The doctor’s view’ in our Living with Addison's book & our "Why Salt?" blog). Not doing this is perhaps the one mistake I regularly repeat. A reliable sign that you need to take more fludrocortisone is if you start to feel light-headed; this is usually preceded by a feeling of being washed out and drained.

6. Insurance. So easy to overlook or to save on but I had to spend $350USD for a simple medical inspection, saline drip and blood tests in Cambodia recently. Costs mount up very fast and I was pleased to have taken out a policy before travelling.

7. A good supply. Take a good supply of your medication and keep at least as much again in another place – e.g. one supply in your rucksack/suitcase and one in your day bag in case of loss or theft. Take a prescription too or a letter from a doctor saying that you require these medicines. Never put medicines in checked-in luggage, however short and supposedly simple the flight. I know to my cost.

8. Emergency kit. Make sure you have it (or rather two as above). Make sure it is up to date, that you have the instructions and practise a self-injection before you go. You will probably not be able to get to a clinic in time, particularly if you have a sudden stomach infection. Know how to use it and follow the guidance from Prof Wass in when to inject. 

9. Get the jabs. There are lots of diseases in tropical climes which are very dangerous in themselves and much more so when you have Addison’s. Check out TravelHealthPro, Masta, or others for free, professional health advice and the Foreign and Commonwealth Office for general travel advice. Once here, do what you can to avoid mosquito bites, especially in remote areas.

10. Food and alcohol. Street food is tasty, cheap and culturally exciting but it can present a higher risk of picking up an infection or food poisoning. I suggest sticking to places with lots of people (especially locals) eating – they should know after all. Small restaurants and markets can be as cheap and tasty and usually have higher standards of hygiene. Make sure you know what to do (emergency guidelines) if you vomit or get diarrhoea. Wash or peel fruit well and remember that beer doesn’t rehydrate and that overindulgence in alcohol is more likely to get you into all sorts of problems, just as it can do at home.

Author Andrew Glass was diagnosed in 2001 while on holiday in Spain. Since then, his postings with the British Council have taken him to Germany, London, Serbia, Kuwait and Thailand. He took up running in 2008, has six half-marathons under this belt and completed the Virtual London Marathon for ADSHG in 2021! You can watch his training updates on the ADSHG Instagram. Andrew was awarded an OBE in the March 2012 Honours for services to the British Council. He was an ADSHG Trustee from 2014-2022, becoming Chair from 2018-2022.

Before You Go

• Senior Endocrine Nurse Nikki Kieffer's article: 'Making the most of the holidays: tips and reminders'
• Adrenal Crisis Guidelines in different languages
• Members' travel tips

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