With hotter temperatures becoming more common, it’s now more important to know how to look after yourself in the heat. If you have a pituitary condition, there may be extra things you need to consider to stay safe.

In particular, if you have adrenal insufficiency or AVP deficiency (previously diabetes insipidus), you should take extra steps to stay well during heatwaves.

For general guidance on managing heatwaves, see the NHS page on heatwaves and coping with hot weather.

What are the main risks:

  • not drinking enough water (causing dehydration)
  • overheating
  • heat exhaustion
  • heatstroke

Who is most at risk?

A heatwave can be dangerous for anyone, but some people are more vulnerable than others. This includes:

  • people with serious long-term conditions
  • older people, especially those over 65
  • babies and young children aged 5 years and under
  • people with mobility problems
  • people with serious mental health problems, or drug or alcohol addictions
  • people on certain medications, including those that affect sweating and temperature control
  • people who are physically active, for example labourers or those doing sports
  • people who live alone and may not be able to care for themselves

Extreme heat can be more dangerous for people with some pituitary conditions.

Heatwave guidance for people with AVP deficiency

During high temperatures, your body will lose more water than normal through sweating. Often, you lose a lot more water than you might expect. It is important to avoid losing too much water, as this can lead to dehydration, which can be dangerous for people with AVP deficiency. You should always make sure you listen to your thirst and drink when you need to.

What if I don’t have a normal thirst sense?

If you take desmopressin (also known as DDAVP) for your AVP deficiency, this can impact your normal sense of thirst. This can make it hard to tell when you are thirsty. If this is the case, it is important to closely watch your fluid intake. You can do this by monitoring how much fluid you take in by drinking, and how much you lose by weeing.

Children in this situation are probably particularly vulnerable, and parents should consult their paediatric endocrine team if they are concerned about their child (or paediatric A&E if out-of-hours).

Other things you should do
  • Stay cool by staying indoors during the hottest part of the day (between 11 am and 3 pm)
  • If possible, avoid doing too much (like exercise or physical labour) during hot periods
  • Know the signs of dehydration and what to do if you experience them
Spotting dehydration

People with AVP deficiency are more at risk of dehydration and hypernatraemia, where salt levels in the blood become too high. If you have symptoms of dehydration and have AVP deficiency, you should seek medical help.

  • headache
  • tiredness
  • irritability

You should speak to your GP or seek medical help if you have these.

  • vomiting
  • loss of appetite (not hungry)
  • cramps
  • muscle spasms

You should go to hospital if you have these symptoms.

Heatwave guidance for people with adrenal insufficiency

If you have adrenal insufficiency, then you should follow our Sick Day Rules guidance as usual. Hotter temperatures can put extra strain on your body, so it is really important to follow the Sick Day Rules if you are ill, stressed or injured.

pill bottles icon

If you are feeling stressed or struggling a lot with the heat during a heatwave, then you can updose for a few days to help you manage. Follow the Sick Day Rules for guidance on how to do this.

Steroid Sick Day Rules
If you are unwell and take cortisol replacements then this page outlines how to increase your dose. There is also information on the signs of an adrenal crisis and what to do if that is the case.
Emergency Info for AI and AVP-D (DI)
In case of emergency you should call 999. This page outlines the sick day rules and other emergency information for both adrenal insufficiency and AVP deficiency (previously diabetes insipidus).

Medication storage

Medicines that must be stored in a fridge may deteriorate in a heatwave if the fridge does not keep the medication cool enough. Most fridge-storage medicines need to be kept between 2-8°C, so the temperature control in your fridge may need to be adjusted during a heatwave to meet this requirement.

For medicines that are not normally stored in a fridge, manufacturers generally guarantee that they remain stable if stored below 25°C. In a heatwave, ambient temperatures may rise above this. To protect these medicines, store them somewhere cool and out of direct sunlight (but not in the fridge). Avoid places that get very hot, such as in cars, or on sunny windowsills. It is important to store them out of the sight and reach of children.

If you notice a change in your medication during the heat (e.g., tablets disintegrate or creams change texture) then it may be best to get a replacement.

Tips for coping in hot weather

The following advice applies to everybody when it comes to keeping cool and comfortable, and reducing health risks:

  • Shut windows during the day to keep hot air out. Keep curtains and blinds closed during the day to stop rooms heating up. You can open windows during cooler times to let cool air in
  • Avoid the heat: stay out of the sun and don’t go out between 11am and 3pm (the hottest part of the day) if you’re vulnerable to the effects of heat
  • Keep rooms cool by using shades or reflective material outside the windows. If this isn’t possible, use light-coloured curtains and keep them closed (metallic blinds and dark curtains can make the room hotter)
  • Have cool baths or showers, and splash yourself with cool water
  • Use fans and air con if possible
  • You can fill hot water bottles with water and freeze them, to create cooling pads (but they can’t be used for hot water after this)
  • Drink cold drinks regularly, such as water and fruit juice
  • Plan ahead to make sure you have enough supplies, such as food, water and any medications you need
  • Identify the coolest room in the house so you know where to go to keep cool
  • Wear loose, cool clothing and a hat if you go outdoors
  • Use plenty of suncream to protect yourself from the sun if you go outdoors
a small fan on a desk, next to a mug

How do I know if I, or someone I care for, needs help?

If you or someone you care for, feels unwell, find somewhere cool (out of the sun) to rest. Give them plenty of fluids to drink.

If symptoms such as breathlessness, chest pain, confusion, weakness, dizziness or cramps get worse or don’t go away, seek urgent medical help. 

With this guidance and tips, we hope that you find time to enjoy the sunnier, warmer weather. Don’t forget our Endocrine Nurse Helpline is available to ask any medical questions that you might have.