The Surgical Guidelines explain what level of extra medication and monitoring you will need in the event of most types of surgery, whether minor or major. 
They are there to support you and your healthcare professional team.

For individuals with Addison's disease or adrenal insufficiency, who are steroid-dependent, strict adherence to your steroid medication regime is vital to recovery and a safe inpatient experience.   The body requires increased cortisol at times of physical stress, so when undergoing surgery of any kind, you will need to adjust your medication regime, in line with the Sick Day Rules. 

The Surgical Guidelines are here to help tell you and your healthcare professional team, how to manage your medication before, during and after surgery.

You need to ensure that all members of your healthcare professional team, from the anaesthetist and the surgeon, to the nursing staff, are aware of your diagnosis and the Surgical Guidelines BEFORE you go into hospital, in the case of non-emergency (elective) admission.

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Last updated Feb 2026.


Tips and Resources

We have various pages on our website that you may wish to visit if you are preparing for surgery or hospital admission;


Supporting the Guidance

These Surgical Guidelines were compiled by the ADSHG with the support of The ADSHG Clinical Advisory Panel (CAP).  In particular we would like to thank:

Professor John Wass

Professor of Endocrinology, Oxford University

Dr Prethivan Gopalakrishnan

Higher Speciality Trainee in Endocrinology and Diabetes Mellitus

Dr Alessandro Prete

Clinical Associate Professor of Endocrinology at the University of Birmingham


Together, we will improve the lives of those with Addison's disease and adrenal insufficiency!
 

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