Do I double or triple hydrocortisone when I have a cold?

Only according to your personal plan. Many people take extra doses for fever or infection, but the amount and duration should come from your endocrine team.

What if I vomit and cannot keep my tablets down?

Contact urgent medical advice immediately. You may need injection hydrocortisone if prescribed. Severe symptoms require 999.

Do sick day rules apply before surgery?

Yes — surgical and dental procedures usually need planned steroid cover. Your team should give written instructions before the date.

Sick day rules for Addison's disease explained

Sick day rules tell you how to adjust steroid replacement when you are unwell. They are personal — written by your endocrine team — but usually involve extra hydrocortisone during illness, fever, injury, or before procedures.

Follow the sick-day plan from your specialist, not generic internet advice.
Illness, fever, vomiting, diarrhoea, and major stress often need extra hydrocortisone.
If you cannot keep tablets down, seek urgent medical advice — do not wait.
Keep rules on the fridge, in your wallet, and in your phone.
After any sick-day escalation, note what happened for your next clinic visit.

What are sick day rules?

People with Addison's disease and adrenal insufficiency cannot increase cortisol naturally when stressed or unwell. Sick day rules explain how much extra hydrocortisone to take and when to call your team or 999.

Your plan may differ from someone else's. That is normal. The important part is having it written, visible, and understood by anyone who supports you.

Common situations that trigger sick-day doses

Many plans cover fever, flu, gastroenteritis, dental work, surgery, and significant injury. Some people need extra cover before strenuous events — ask your endocrine team what applies to you.

Vomiting is especially risky because you may not absorb oral steroids. UK guidance for adrenal crisis is to call 999 if you are collapsing, confused, or severely unwell.

Keeping rules visible

Paper on the fridge, a photo in your phone, and a note in your medication tracker all help. Carers should know where to look before you are too unwell to explain.

How MyAddi helps

MyAddi keeps sick-day notes alongside medication reminders so extra doses and illness episodes are logged in one place for you and your care circle.

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Frequently asked questions

Do I double or triple hydrocortisone when I have a cold?: Only according to your personal plan. Many people take extra doses for fever or infection, but the amount and duration should come from your endocrine team.
What if I vomit and cannot keep my tablets down?: Contact urgent medical advice immediately. You may need injection hydrocortisone if prescribed. Severe symptoms require 999.
Do sick day rules apply before surgery?: Yes — surgical and dental procedures usually need planned steroid cover. Your team should give written instructions before the date.

Sources

This guide is for general information only. It does not replace advice from your GP, endocrine team, or emergency services. If you think you are having an adrenal crisis, call 999.