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Daily Adrenal Disorder Symptom Tracking Log

A comprehensive monitoring tool for patients with adrenal conditions

Endocrinology

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Template Content

Last updated: Mar 24, 2025

Patient Information

Name: ___________________ Date Range: //___ to //___

Daily Vital Signs

  • Blood Pressure: Morning / Evening /
  • Heart Rate: Morning _____ Evening _____
  • Weight: _____ lbs/kg

Medication Log

Medication Dose Time Taken Notes

Symptom Severity Scale (0-10)

Morning

  • Fatigue: ___
  • Dizziness: ___
  • Nausea: ___
  • Joint/Muscle Pain: ___
  • Salt Craving: ___

Evening

  • Fatigue: ___
  • Dizziness: ___
  • Nausea: ___
  • Joint/Muscle Pain: ___
  • Salt Craving: ___

Stress Events

  • Illness: □ Yes □ No
  • Physical Stress: □ Yes □ No
  • Emotional Stress: □ Yes □ No

Additional Notes

Sleep Quality: □ Poor □ Fair □ Good Activity Level: □ Low □ Moderate □ High Special Events/Triggers: ________________________________

Emergency Protocol Reminders

  • Double medication dose for: fever, vomiting, severe stress
  • Seek immediate care if: severe vomiting, confusion, severe pain
  • Emergency Contact: _________________
  • Physician: _________________ Phone: _________________

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