Adrenal Insufficiency

What is Adrenal Insufficiency?

Adrenal Insufficiency is a condition where there is inadequate release or action of the hormones: glucocorticoids, mainly the steroid hormone called cortisol.

Children with Adrenal Insufficiency require cortisol replacement therapy daily. At times of physiological stress, such as illness, trauma or surgery, there is an increased requirement of this replacement therapy, which left untreated can lead to adrenal crisis. Without prompt treatment, adrenal crisis is life threatening.

Children with Adrenal Insufficiency are typically given hydrocortisone as steroid replacement therapy. For patients on hydrocortisone steroid therapy, educating them, their families, and carers about times of illness or stress, usually called sick day dose/rules, is important in preventing adrenal crises. Sick day dose/rules are sometimes called stress day dose/rules, they mean the same thing.


What causes Adrenal Insufficiency?

Adrenal Insufficiency can be classified into three categories:


Results from the dysfunction of the adrenal glands.

Causes of this dysfunction could be conditions such as Congenital Adrenal Hypo/Hyperplasia, Addison’s disease, other autoimmune conditions, Adrenoleukodystrophy, tumours, infections, bleeding, removal of the adrenal glands, the individual taking medication that disrupts steroid production.

Secondary and tertiary:

This type of Adrenal Insufficiency is a result of the dysfunction of either the pituitary gland (secondary) or hypothalamus (tertiary) such as hypopituitarism, pituitary and hypothalamic tumours, radiation or surgery to the pituitary gland/brain, long term steroid use to treat other diseases.


Management and guidelines for Adrenal Insufficiency

The British Society for Paediatric Endocrinology & Diabetes (BSPED) provides up to date guidance on management protocols for health care professionals managing patients with Adrenal Insufficiency.

Click here to view the BSPED Adrenal Insufficiency Consensus Guidelines.


My Cortisol app

The My Cortisol app has been created for Great Ormond Street Hospital for Children NHS Foundation Trust. It aims to help parents and guardians with the administration of hydrocortisone sodium phosphate and hydrocortisone sodium phosphate, which is a prescribed medication for those at risk of adrenal crisis. The app includes a helpful video and a pictorial guide.

My Cortisol for iOS on the App Store

My Cortisol for Android on Google Play

Adrenal Insufficiency Support Pack

We are delighted to share that our Adrenal Insufficiency Support Pack is here and available to order.

The pack includes a booklet, stickers, keyring and folder. Our fab Growth Nurse Specialist Sally has created this short video, below, to demonstrate the contents of the pack and show how it all works.

How to order

To order your copy please contact [email protected] including a note of your full name and address for us to send your pack to.

You can read and download a PDF of the booklet contained in this pack below.

We’re extremely grateful for funding received which has made it possible to produce these packs. 


Child Growth Foundation

c/o Kinnair Associates Limited
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Redburn Road
Newcastle upon Tyne

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