Do you take steroid medication?
All patients with ‘primary adrenal insufficiency’ are steroid dependent so will be taking lifelong steroid therapy to help manage their condition.
Some other patients, who take oral, inhaled or topical steroids for other medical conditions, may also become steroid dependent.
This could be as a tablet, as a long term treatment (for polymyalgia rheumatica for example) or multiple short courses for COPD; as an injection to help with joint pain; high dose inhaled steroids for asthma or COPD; potent steroid creams or ointments, some rectal steroids used for inflammatory bowel disease (such as budesonide or prednisolone enemas). Steroid nasal sprays & drops are unlikely to cause problems but if you are also taking steroids for other conditions, this will need to be considered.
If you also take medication such as antifungals (itraconazole, ketoconazole, voriconazole, Posaconazole), potent protease inhibitors (atazanavir, darunavir, fosamprenavir, ritonavir +/- lopinavir, saquinavir, tipranavir) or long-term clarithromycin, these can affect the amount of steroid in your body.
If the above applies to you, it is important that you carry a steroid emergency card with you at all times as it contains important information for healthcare staff so they are aware you are taking steroids. It also includes emergency treatment if you become acutely ill, experience trauma, surgery or other major stressors.
You may also find the following information resources useful:
• Patient guide - Steroid Emergency Card
• Sick day rules - https://www.endocrinology.org/media/4142/ai-and-exogenous-steroids_pis_final.pdf