They explain what level of extra medication and monitoring you will need in the event of most types of surgery or dental work. If you are having elective surgery in hospital, for example, a hip operation, it would be sensible to give your surgeon and anaesthetist a copy of the guidelines well in advance of your surgery date. It is also advisable to take the guidelines with you when you go in to hospital and discuss them with your nursing staff, so that they are aware of the post-operative care you need.

These guidelines:

a. List the ten main types of surgical procedure, each requiring a different level of steroid cover

b. Specify the glucocorticoid medication and post-operative treatment requirements for each type of procedure in an easy-to-read table

c. Bring together the most up-to-date endocrine knowledge on cortisol replacement in the steroid-dependent patient

d. Reflect a prudent level of steroid cover that can safely be administered by non-endocrinologists.

These guidelines apply to all individuals who are steroid-dependent, so they are relevant to people with hypopituitarism as well as Addison's.

The leaflet is © ADSHG March 2006. It may be copied for personal use or by medical practitioners for the education of their patients. Otherwise it should not be reproduced without written permission of the ADSHG.