Corticosteroid Replacement Therapy For Periods of Intercurrent Illness Only

During an illness, infection or operation, the body normally produces an increased amount of cortisol. This helps the body recover from the stresses of the illness.

Treatment
You have been asked to take replacement Hydrocortisone tablets, because your adrenal glands are not able to produce enough of the hormone Cortisol when you are unwell. This may be because of a problem with the adrenal glands themselves, or because of a problem with your pituitary gland. You do not need to take the Hydrocortisone tablets on a regular basis.

Sick Day Rules – if you are feeling unwell

Since your adrenal glands cannot respond to an illness in the normal way, you should take the Hydrocortisone dose at times of illness in the following situations:

• If you have a severe cold, flu, other infection, or fever (high temperature) and are unwell, please take the Hydrocortisone tablets; 20mg twice daily (morning and teatime). We recommend that you take the Hydrocortisone tablets with milk/food as this may prevent an upset stomach or heartburn. Take these tablets for three to five days or until the illness settles. If you do not feel better, please see your GP as soon as you can. Please see the attached Hydrocortisone information leaflet for further advice.
• If you are seriously ill, or have diarrhoea and vomiting, the tablets may not be effective on their own. You must seek medical advice early from the endocrine team (contact details can be found below) because you may need an injection of Hydrocortisone. At this point you may require admission to hospital until your symptoms settle.

You will be provided with an emergency Hydrocortisone pack which you should keep at home at room temperature. Please make sure this is in date by checking the expiry date regularly. Your GP/Endocrinology team/Emergency Department will decide if you require this injection and administer it for you.

If you require an operation or are involved in an accident, it is very important that the doctors/paramedic know about your Hydrocortisone tablets in this situation.

You should carry a steroid warning card (this is provided in your emergency injection pack) or a medic alert pendant at all times.

Travel
If you are away from home or abroad, it is important to take additional Hydrocortisone tablets with you. You will need to take two emergency Hydrocortisone injection packs and this information leaflet with you in case you become unwell.

If you are travelling abroad, the endocrine specialist nurses can provide you with a holiday letter which may be required at the airport.

Contact Details
If in doubt, or the above advice has failed to control your symptoms, you should contact: Specialist Nurses in Endocrinology
Tel. 01274 382019 between the hours of 8.00am and 4.00pm Monday – Friday except Bank Holidays.

For out of hour’s enquiries you must contact a GP/NHS 111 Service/999.