Surgical Guidelines

The Surgical Guidelines are a practical document to support you and healthcare professionals. It explains what level of extra medication and monitoring you will need in the event of most types of surgery.

For steroid-dependent inpatients, strict adherence to steroid medication regime is vital to recovery and a safe inpatient experience.

If you are having elective surgery in hospital, we recommend that you give a copy of the Surgical Guidelines to your surgeon and anaesthetist before your surgery date. It is also best to take the Surgical Guidelines with you when you go into hospital and discuss them with your nursing staff.

Download: printer friendly version (Opens in new window 644kb)

Printing advice: Set your printer to A4, landscape, double-sided, flip on the short edge. Printer friendly version includes new accessibility improvements to support people with visual impairments.

You can order the ADSHG’s hospital folder (containing drugs chart stickers and other medical information). If you have a hospital admission coming up, check out our 'Preparing for hospital admission when you have Addison's Disease or Adrenal Insufficiency' article for more tips and resources to support you.

Dental procedures

If you are looking for further information on extra steroid cover for certain dental procedures, you can get this information from our dedicated webpage for dentists.

Supporting the Guidance

Addison’s Disease Self Help Group compiled the guidance with the support of The ADSHG Clinical Advisory Panel (CAP). In particular we would like to thank:

Chair of CAP Professor John Wass, MA, MD, FRCP. Professor of Endocrinology at Oxford University.
Dr Helen Simpson, FRCP, PhD. Consultant Endocrinologist, UCLH NHS Foundation Trust and member of the RCP Patient Safety Committee being senior clinical advisor for the Steroid Emergency Card.
Professor Simon Pearce, MD, FRCP. Professor of Endocrinology at Newcastle University and co-author of "Living with Addison's Disease – A Guide For People With Addison's, Supporters and Professionals".

Download: printer friendly version (Opens in new window 644kb)

Latest

40th Anniversary Addison's Roadshow

Please join our Addison's Roadshow to celebrate 40 years of the ADSHG! Anyone affected by Addison's disease or adrenal insufficiency, and those that support them, can come along.
Ingrid's Story: Exercising with Addison's

Meet Ingrid who has recently taken up a new hobby, going to the gym. Here Ingrid hopes to inspire others to get exercising this New Year while also reminding us of the importance of managing your Addison’s too.
Shona’s Addison's Afternoon Tea Fundraiser

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: Implementation of perioperative guidelines & steroid emergency card

Congratulations Louise Breen on receiving the Annette Louise Seal Memorial Award! Louise shares more about her work as an Advanced Endocrine Nurse Practitioner & first Chair Elect of the Society for Endocrinology Nurse Committee

ADSHG Posters

Help raise awareness of Addison's disease and adrenal insufficiency by sharing our posters.
RCGP Poster: Information for your GP

Our RCGP poster is an A4 printout that can be used to let your GP know about the RCGP course on Addison's and adrenal insufficiency.
What is Addison's Leaflet?

Our leaflet, 'What is Addison's', was developed for use in education settings by the ADSHG with support of our Clinical Advisory Panel (CAP), led by Professor John Wass. It provides an introduction to the condition, it's history, treatment and some of the people who've lived full and active lives while managing Addison's Disease.
Steroid Emergency Cards

People who take steroid medications every day of their life will need to carry a steroid card which identifies to healthcare professionals that their medication cannot be stopped. Find out more about the cards available.
Diagnosis Infographics. "Think Addison's disease - save a life"

Download the CoMICs diagnosis of Addison's disease infographics and accompanying article "Think Addison's disease - save a life", as featured in the Guardian newspaper.
Fasting with Adrenal Insufficiency

A patient leaflet for people living with adrenal insufficiency who are thinking about fasting for Ramadan. It gives tips on reducing the risks of becoming ill if you decide to fast, when it's advisable not to fast and offers alternatives to those who are considered too high risk for fasting.
How to give an emergency injection - leaflets for your kit

Having the instructions for your injection kit helps you, or anyone coming to your aid, to inject you. We have a selection of guides your can print, fold and add to your kit. Be careful to choose instructions that match the type of medication that you have available.
Printable Hospital Stickers

The ADSHG drugs chart steroid alert stickers are intended for people with Addison's to take with them for day case and inpatient surgical procedures to alert nursing and medical staff to their steroid-dependence and their time-critical need for steroid medication when unwell.
Diagnosing Addison's Disease : A Guide For GPs

Our leaflet, 'Diagnosing Addison's: a guide for GPs', has been developed for the ADSHG by our Clinical Advisory Panel (CAP), led by Professor John Wass. It outlines the role of the GP in the early detection of Addison's.
Personal Emergency Plan

This Personal Medical Emergency Plan template is a useful way of summarising your personal medical needs in the event of an emergency, for friends, family or work colleagues.

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.
Adrenal Crisis - Emergency Help

Adrenal crisis is a time-critical, life-threatening emergency and must be treated immediately. Read the guidance on treating a steroid-dependent patient in adrenal crisis.
What is Addison's Disease?

Find out more about Addison's disease and adrenal insufficiency and and how they are treated.
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.
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.
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.
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

The Surgical Guidelines are a practical document to support you and healthcare professionals. It explains what level of extra medication and monitoring you will need in the event of most types of surgery.

Dental procedures

Supporting the Guidance

More Questions?