Professional Area

Sick day rules - Addison’s disease

Common triggers or causes of the adrenal crisis:

  • Stress
  • Flu
  • Vomiting
  • Infection
  • Migraine
  • Injury
  • Pregnancy or labour
  • Diarrhoea
  • Dehydration

What to do

Increase your regular dose of hydrocortisone or prednisolone if:

  • Your body temperature is 38.0 degrees or higher
  • You get a disease that leaves you feeling ill or weak, such as a severe cold, the flu, diarrhoea, or another illness
  • You sustain a serious injury such as a broken bone

For hydrocortisone users:

  • If your typical daily dose of hydrocortisone is less than 20 mg, you should increase it to 40 mg daily as a minimum dose when you are stressed out or unwell
  • You can achieve this by increasing the two or three dosages you typically take each day

For how long?

  • Use a double dosage for 48 hours. Return to your normal dose if you are feeling better
  • Continue doubling your doses and seek further guidance from your endocrinologist if you don't feel better after 48 hours
  • If you are given antibiotics, keep increasing your dosage until you finish the course or feel fully recovered

It's essential to gradually lower any hydrocortisone dose increase until you go back to your normal dosage. To keep you stable, don't suddenly start taking your normal dose again.

What happens if my temperature is beyond 100DEG F?

  • Immediately seek medical assistance and take 20 mg of hydrocortisone every six hours (or 5 mg of prednisolone every six hours)
  • A serious illness or the beginning of an adrenal crisis are both indicated by a fever this high. Your fluid intake should be inceased.

Anything else I can do?

Rest and drink plenty of water. Make careful to sip water often. Urine that appears concentrated or dark can be seen. If you need to consume extra fluids, this will serve as a guide. When you're feeling sick, water is the greatest liquid to drink.

If you keep vomiting, and unable to keep down steroid tablets due to persistent vomiting, you must take steroid injections and Intravenous fluids. So, go to the nearest medical facility on emergency basis. If nearest medical facility is far away, give 100mg of Hydrocortisone Intra muscularly while being taken to a hospital.

Note: Your endocrine doctor can give you the best advice on how to handle adrenal crisis safely.