The ADSHG is delighted to announce the award of £20,000 to Dynamic Therapeutics, the team behind U-RHYTHM, a wearable device that can collect and analyse hormones, like cortisol, over a full 24 hours as you go about daily life. Many of you may remember reading our previous updates, and some of our members have even worn the device themselves as part of the HORIZON 2020 ULTRADIAN study.
Dynamic Therapeutics' mission, which the ADSHG are delighted to support, is to provide accurate and well-validated technology for the measurement of hormone rhythms, improving the lives of patients across the world. Research already completed has shown that 24-hour U-RHYTHM hormone profiles, particularly overnight, help clinicians to rapidly and reliably diagnose and improve the treatment of hormonal conditions, which include Addison's disease and other causes of adrenal insufficiency. They recognise that every patient is different and deserves individually tailored therapy.
Dynamic Therapeutics is seeking financial support to fund UKCA marking of the U-RHYTHM device, which will enable it to be used more routinely in the clinic. The ADSHG is thrilled to support the work of Dynamic Therapeutics by approving £20,000 funding towards these costs.
Research Facts
- Organisation: Dynamic Therapeutics (spinout company from the University of Bristol).
- Disease: U-RHYTHM can be used to help better understand diseases that are caused by, or affected by, changes in biological rhythms, e.g., hormone diseases such as Addison's disease.
- Research: The U-RHYTHM device was developed by researchers at the University of Bristol. In 2023, the company Dynamic Therapeutics Ltd was spun out of the University of Bristol so U-RHYTHM could be provided to other researchers also interested in understanding biological rhythms in health & disease.
- Timeline: Predicted time to UKCA is 6 months –1 year.
Research link: Links to research performed using the U-RHYTHM device can be found on Dynamic Therapeutics website.
Journal of Internal Medicine: Circadian and ultradian rhythms: Clinical implications
We catch up with Professor Stafford Lightman, inventor of U-RHYTHM, for the latest on the device's journey from research tool to a device your own clinical team can soon access. We find out what it means for U-RHYTHM to hold a UKCA mark, why cortisol dosing isn't one-size-fits-all, and how this research could shape the future of adrenal insufficiency management.
Please can you tell us about the U-RHYTHM device and why it is important for the adrenal insufficiency community?
The U-RHYTHM device is a wearable sampling device that collects biochemicals (e.g. hormones) from the fluid in your body tissues every 20 minutes. The wearer can go about their everyday life and sleep during sampling. The stored samples are sent off for state-of-the-art analysis to reveal a very accurate and reliable 'dynamic' 24-hour biochemical profile. In terms of the adrenal insufficiency community, as far as we are aware, U-RHYTHM is the only device that can accurately assess cortisol dynamics over the whole day and night in real life!
Why is it important to know your levels of cortisol all across the day?
One common misconception about cortisol is that it is a hormone that just responds to stress. In fact, it is an anticipatory hormone that - in good health - is secreted in anticipation of your body's needs. Thus, prior to, and during the early hours of sleep, when your body is relatively quiescent (at rest), levels of cortisol are very low. But later in the night, in preparation for waking, there is increased secretion of cortisol getting into the body, and particularly the brain, ready for activity the next day. This allows you to wake up refreshed and ready to go.
It is the failure of this early morning rise of cortisol that is a major cause of the apathetic (flat or sluggish) and generally unwell feeling of many patients who only take their first cortisol medication after awakening. Interestingly, this does not occur in everyone, and it is likely that this is due at least in part to the fact that some people still have residual function of their adrenals and thus have their own bodies attempt to increase cortisol in the morning to a sufficient level to avoid symptoms.
The only way we can tell if there is an abnormal rhythm of cortisol in subjects on treatment for adrenal insufficiency is to measure throughout the day, and most particularly during sleep at night. If we can confirm a long period of low cortisol levels overnight, only increasing after the morning dose, then the patient should discuss with their endocrinologist whether they should change the timing or the type of cortisol replacement.
I think it is important to emphasise that every patient is different, including in their ability to absorb and break down their cortisol replacement therapy. There is no one replacement regime that fits all patients, and in an age of personalised medicine each patient deserves to know how their body deals with their replacement therapy.
Is it still important to do this when we have new longer-acting treatments becoming available?
Yes, and in some ways even more so. We must not be lulled into believing any one treatment regime suits everyone. Different people will absorb and metabolise these preparations differently, and what may be suitable for one person is not necessarily suitable for another. Again, I believe that patients deserve to see how their bodies deal with the replacement therapy they are given.
Will this help us improve our understanding of how we should treat stress or severe exercise?
I could talk all day about how different people respond to different types of stress. This is such a complex question, and what one person perceives as a stressor, another might find quite relaxing. For instance, I quite enjoy talking at conferences to large audiences, but I fully understand others may find this very stressful. Maybe I should talk about this another day!
With respect to exercise, this is a very interesting question. Strangely, with the exception of the response to extreme military levels of exhaustion stress, we really do not have a good understanding of the normal physiological response to, say, an energetic football match or a long-distance cycle ride. The reason for this, of course, is that it is next to impossible to take multiple blood tests during these activities. My hope is that the use of U-RHYTHM will allow researchers to investigate what the optimal physiological response to exercise is and use this to help us improve our treatment of exercising patients with adrenal insufficiency.
The ADSHG is delighted to award Dynamic Therapeutics £20,000 to help fund UKCA marking. What difference will it make to have a UKCA mark?
The current situation for helping patients with adrenal insufficiency is very frustrating. I get multiple emails from patients in the UK and indeed from all over the world asking me how they or their clinicians can access U-RHYTHM to help improve the management of their condition. What I would like to do is either inform them of a local endocrinology unit/specialist who would be able to perform a 24-hour profile, or to provide them with the details of how their department could obtain a system for clinical use.
Unfortunately, U-RHYTHM is currently a research-use-only device, only to be used in research studies, so the only way a patient can get a profile is to find a centre that is recruiting patients for a specified research project. This is unlikely to be of use to the great majority of patients with adrenal insufficiency.
The UKCA mark (UK Conformity Assessed) is the confirmation that demonstrates that a medical device meets UK regulatory requirements. Once U-RHYTHM is UKCA marked, it can be used in a clinical setting for sample collection over 72 hours. Samples can then be used to help inform the diagnosis, management and treatment of adrenal insufficiency.
What are the next steps for U-RHYTHM?
Once we have the UKCA mark, we can make the U-RHYTHM system available for purchase by any hospital/clinic that requests it. This is why the £20,000 funding by the ADSHG towards the UKCA costs is so important. Thank you for your support!
If you're a clinician and would like more information on the U-RHYTHM device, please get in touch with us by emailing info@dynamic-tx.co.uk
How can people with adrenal insufficiency support this work?
Use of U-RHYTHM in the NHS will most likely be dependent on local funding decisions. These will be sensitive to patient support group pressure, which is why ADSHG community support is so valuable! A combination of clinician awareness and patient pressure on NHS (or private) purchasing will increase the likelihood that the U-RHYTHM system will be available in your local outpatient setting, to improve the quality of life of patients with adrenal insufficiency.
Please follow us on LinkedIn, visit our website, or contact us on info@dynamic-tx.co.uk if you have any questions or suggestions!
Next steps
The ADSHG is delighted to welcome Dr Susana Paul-Stols from Dynamic Therapeutics to our Manchester Get-Together on Saturday 26 September 2026, to share the latest updates on the device and to answer questions from the audience.
We will continue to share updates with ADSHG charity members as work on U-RHYTHM continues. Join our charity to receive these updates through our monthly member emails, 'Keeping You Posted' newsletters and magazine.
Catch up on our previous content
- Use the power of social media and comment on the Journal of Internal Medicine's Instagram and/or Facebook post about the device to show there is a demand for this new device for our rare disease!
- Watch Professor Stafford Lightman and Dr Thomas Upton, explain how U-RHYTHM works on our YouTube channel.
- Read the BBC article: 'Device developed in Bristol offers 'revolution' in hormone understanding'.
ADSHG member Suzanne shares her experience of participating in the research trial in 2021 for the ULTRADIAN study testing U-RHYTHM. Read her story on our blog,
Applying for ADSHG Research Grants & Support
All grant applications received by the ADSHG go through an evaluation process by a sub-committee of the board of trustees, and are marked against pre-determined eligibility criteria. For further information on eligibility for this grant or others, and for all the ways that the ADSHG can support researchers, including patient engagement and letters of support, please visit our Research page.
Thank you to our members, fundraisers and donors: your support allows us to commit to awarding financial grants such as this one, that directly impact the future care of people with all types of adrenal insufficiency, including Addison's disease.