Dr Charlotte Elder

BSc, MBBS, PhD, DRCOG, MRCPCH

School of Medicine and Population Health

Senior Clinical Lecturer in Paediatric Endocrinology

c.j.elder@sheffield.ac.uk

Room 10, The Damer Street Building, Sheffield Children's Hospital

Full contact details

Dr Charlotte Elder
School of Medicine and Population Health
Room 10, The Damer Street Building
Sheffield Children's Hospital
Western Bank
Sheffield
S10 2TH

Profile

Charlotte Elder received her undergraduate medical degree from Imperial College, (University of London) UK in 1999, undertook her early postgraduate training in London, later moving to Sheffield to complete her higher specialist training in Paediatric Endocrinology and Diabetes (CCT 2017). Dr Elder studied for her PhD at the University of Sheffield (awarded 2015), continued her research as an NIHR Academic Clinical Lecturer (2015-2018), and was later supported by an MRC funded UKRI Biomedical Science Innovation Scholarship (2021-2024). Charlotte has been a Senior Clinical Lecturer in Paediatric Endocrinology at the University of Sheffield since 2018.

Dr Elder is an honorary consultant Paediatric Endocrinologist at Sheffield Children’s NHS Foundation Trust. Charlotte provides a general endocrinology service, but her specialist interests are steroid induced adrenal insufficiency and Paediatric and Adolescent Gynaecology.

Charlotte is passionate about fostering research interests in junior colleagues and making research accessible for all health care professionals. She has supervised and mentored over 100 under- and postgraduates, helping them present, publish and win prizes. Charlotte is Deputy Director of Studies for Phase 3a and was Director of Undergraduate Medical Education at Sheffield Children’s NHS Foundation Trust until 2024. She developed and then led the Paediatric Endocrinology module on the University’s Clinical Endocrinology & Diabetes MSc.

Research interests

Dr Elder’s primary research focuses on developing non-invasive approaches to improve the assessment of adrenal function, for which she has secured over £3.2 million in research funding. She leads a team developing a non-invasive Short Synacthen Test for the diagnosis of adrenal insufficiency, using a novel intranasal formulation of Synacthen (Nasacthin) with the measurement of the adrenal response in saliva. Nasacthin has been granted a patent in six global territories, including Europe and the United States.

In close collaboration with colleagues in Sheffield’s Adrenal Insufficiency Research Group, Charlotte has co-developed a home-based waking salivary cortisone screening test, and secured NIHR funding to design an implementation strategy to support its widespread adoption across the NHS. Her group is also conducting studies to evaluate the use of these non-invasive technologies to better define adrenocortical function in premature neonates in premature infants.

Current projects:

Nasal Tetracosactide and Chitosan for Adrenal Stimulation - Chief Investigator on £1.2m MRC DPFS award to deliver
- Randomised, double-blinded, placebo-controlled cross-over trial in healthy women, men and children
- Randomised cross-over trial in a patient population with adrenal insufficiency
- Normative data study in healthy children to derive reference centiles for The Nasacthin Test (£156k UKRI Innovation Scholarship)
Neonatal adrenal function studies - lead
Steroid weaning studies - co-lead

Publications

Show: Featured publications All publications

Featured publications

Journal articles

Dixon S, Lewis J, Debono M, Elder CJ, Caunt S, Jacques RM, Newell-Price J, Whitaker MJ, Keevil B & Ross RJ (2024) The cost-effectiveness of using waking salivary cortisol in the diagnosis of adrenal sufficiency. HEDS Discussion Paper Series(24.04). View this article in WRRO
Arshad MF, Elder C, Newell-Price J, Ross R & Debono M (2024) A retrospective study on weaning glucocorticoids and recovery of the hypothalamic-pituitary-adrenal axis. The Journal of Clinical Endocrinology & Metabolism, 109(11), e2031-e2037. View this article in WRRO
Debono M, Caunt S, Elder C, Fearnside J, Lewis J, Keevil B, Dixon S & Ross R (2023) Real world evidence supports waking salivary cortisone as a screening test for adrenal insufficiency. Clinical Endocrinology, 99(6), 517-524. View this article in WRRO
Lawrence NR, Arshad MF, Pofi R, Ashby S, Dawson J, Tomlinson JW, Newell-Price J, Ross RJ, Elder CJ & Debono M (2023) Multivariable model to predict an ACTH stimulation test to diagnose adrenal insufficiency using previous test results. Journal of the Endocrine Society, 7(12). View this article in WRRO
Mushtaq T, Ali SR, Boulos N, Boyle R, Cheetham T, Davies JH, Elder CJ, Gan H-W, Hindmarsh PC, Katugampola H , Krone N et al (2023) Emergency and perioperative management of adrenal insufficiency in children and young people: British Society for Paediatric Endocrinology and Diabetes consensus guidance. Archives of Disease in Childhood, 108(11), 871-878. View this article in WRRO
Debono M, Elder CJ, Lewis J, Fearnside J, Caunt S, Dixon S, Jacques RM, Newell-Price J, Whitaker MJ, Keevil B & Ross RJ (2023) Home waking salivary cortisone to screen for adrenal insufficiency. NEJM Evidence, 2(2). View this article in WRRO
Tonge JJ, Keevil BG, Craig JN, Whitaker MJ, Ross RJ & Elder CJ (2022) Main salivary steroid collection in children under conditions replicating home sampling. Journal of Clinical Endocrinology and Metabolism, 107(11), 3128-3136.
Elder C, Vilela R, Johnson T, Taylor R, Kemp E, Keevil B, Cross A, Ross R & Wright N (2020) Pharmacodynamic studies of nasal tetracosactide with salivary glucocorticoids for a non-invasive Short Synacthen Test. Journal of Clinical Endocrinology and Metabolism, 105(8), 2692-2703. View this article in WRRO
Elder CJ, Langley J, Stanton A, De Silva S, Akbarian-Tefaghi L, Wales JKH & Wright NP (2019) A simulation study assessing the accuracy and reliability of orchidometer estimation of testicular volume.. Clinical Endocrinology, 90(4), 623-629. View this article in WRRO
Elder CJ, Harrison RF, Cross AS, Vilela R, Keevil BG, Wright NP & Ross RJ (2018) Use of salivary cortisol and cortisone in the high and low dose synacthen test. Clinical Endocrinology , 88(6), 772-778. View this article in WRRO
Cross AS, Kemp EH, White A, Walker L, Meredith S, Sachdev P, Krone NP, Ross RJ, Wright NP & Elder CJ (2018) International survey on high- and low-dose synacthen test and assessment of accuracy in preparing low-dose synacthen. Clinical Endocrinology , 88(5), 744-751. View this article in WRRO
Elder CJ & Bishop NJ (2014) Rickets.. Lancet, 383(9929), 1665-1676.
Elder CJ, Sachdev P & Wright NP (2012) The short Synacthen test: A questionnaire survey of current usage. Archives of Disease in Childhood, 97(10), 870-873.
Elder CJ, Sachdev P & Wright NP (2012) The short Synacthen test: a questionnaire survey of current usage.. Arch Dis Child, 97(10), 870-873.

All publications

Journal articles

Date K, Baster K, Caunt S, Cohen J, Debono M, Fearnside J, Laud P, Ross RJ, Taylor R & Elder C (2026) Determining the comparative pharmacodynamic equivalence of a non-invasive diagnostic test for patients with adrenal insufficiency using a randomised 2-way crossover trial: the STARLIT-3 study protocol. BMJ Open, 16(2).
Loh EW, Elder C, Newell-Price JDC, Ross RJM & Debono M (2025) MON-491 Long term outcomes in patients assessed by waking salivary cortisone as a screening test for adrenal insufficiency. Journal of the Endocrine Society, 9(Supplement_1). View this article in WRRO
Arshad MF, Ahmed A, Beddows S, Mullamitha A, Newell-Price J, Ross R, Elder C & DeBono M (2025) Morning serum cortisol predicts short synacthen test response during glucocorticoid weaning in children and adults. Endocrine Abstracts, 110, P128-P128. View this article in WRRO
Date KL, Baster K, Caunt SL, Cohen J, Debono M, Fearnside J, Johnson TN, Ross RJ, Taylor RN & Elder CJ (2024) Randomised, placebo-controlled, double-blinded, four-way crossover trial to demonstrate the comparative pharmacodynamic equivalence of a non-invasive diagnostic test for adrenal insufficiency in a healthy population: the STARLIT-2 study protocol. BMJ Open, 14(12). View this article in WRRO
Dixon S, Lewis J, Debono M, Elder CJ, Caunt S, Jacques RM, Newell-Price J, Whitaker MJ, Keevil B & Ross RJ (2024) The cost-effectiveness of using waking salivary cortisol in the diagnosis of adrenal sufficiency. HEDS Discussion Paper Series(24.04). View this article in WRRO
Arshad MF, Elder C, Newell-Price J, Ross R & Debono M (2024) A retrospective study on weaning glucocorticoids and recovery of the hypothalamic-pituitary-adrenal axis. The Journal of Clinical Endocrinology & Metabolism, 109(11), e2031-e2037. View this article in WRRO
Tavernier M, Ross C, Jessica C, Balagamage C, Keevil B, Ross R, Debono M & Elder C (2023) Home waking salivary cortisone to screen for adrenal insufficiency in children. Endocrine Abstracts, 95(OC5.9). View this article in WRRO
Debono M, Caunt S, Elder C, Fearnside J, Lewis J, Keevil B, Dixon S & Ross R (2023) Real world evidence supports waking salivary cortisone as a screening test for adrenal insufficiency. Clinical Endocrinology, 99(6), 517-524. View this article in WRRO
Lawrence NR, Arshad MF, Pofi R, Ashby S, Dawson J, Tomlinson JW, Newell-Price J, Ross RJ, Elder CJ & Debono M (2023) Multivariable model to predict an ACTH stimulation test to diagnose adrenal insufficiency using previous test results. Journal of the Endocrine Society, 7(12). View this article in WRRO
Fahad AM, Elder C, Newell-Price J, Ross R & Debono M (2023) Retrospective study of steroid weaning in tertiary adrenal insufficiency comparing prednisolone and hydrocortisone. Endocrine Abstracts, 90. View this article in WRRO
Mushtaq T, Ali SR, Boulos N, Boyle R, Cheetham T, Davies JH, Elder CJ, Gan H-W, Hindmarsh PC, Katugampola H , Krone N et al (2023) Emergency and perioperative management of adrenal insufficiency in children and young people: British Society for Paediatric Endocrinology and Diabetes consensus guidance. Archives of Disease in Childhood, 108(11), 871-878. View this article in WRRO
Cross AS, Moustafa M & Elder CJ (2023) Fifteen-minute consultation: approach to the adolescent presenting with hirsutism. Archives of disease in childhood - Education & practice edition.
Debono M, Elder CJ, Lewis J, Fearnside J, Caunt S, Dixon S, Jacques RM, Newell-Price J, Whitaker MJ, Keevil B & Ross RJ (2023) Home waking salivary cortisone to screen for adrenal insufficiency. NEJM Evidence, 2(2). View this article in WRRO
Tonge JJ, Keevil BG, Craig JN, Whitaker MJ, Ross RJ & Elder CJ (2022) Main salivary steroid collection in children under conditions replicating home sampling. Journal of Clinical Endocrinology and Metabolism, 107(11), 3128-3136.
Low A, Parry-Okeden S, Ferguson EC, Wright N & Elder CJ (2022) Fifteen-minute consultation : the child with obesity. Archives of Disease in Childhood: Education & Practice, 107(3), 182-187.
Craig JN, Sharman MR, Fitzgerald CG, Wigg D, Williams BS, Wilkinson EE, Wright NP, Langley J & Elder CJ (2021) Training using a simulation-based workshop reduces inaccuracies in estimations of testicular volume. Journal of Pediatric Endocrinology and Metabolism, 34(1), 65-70.
Elder C, Vilela R, Johnson T, Taylor R, Kemp E, Keevil B, Cross A, Ross R & Wright N (2020) Pharmacodynamic studies of nasal tetracosactide with salivary glucocorticoids for a non-invasive Short Synacthen Test. Journal of Clinical Endocrinology and Metabolism, 105(8), 2692-2703. View this article in WRRO
Devaraja J, Elder C & Scott A (2020) Non classic presentations of a genetic mutation typically associated with transient neonatal diabetes. Endocrinology, Diabetes & Metabolism Case Reports, 2020(1).
Ferguson EC, Stewart EK, Hannah C & Elder CJ (2020) Obesity : unrecognised or avoided? We are missing opportunities to ‘make every contact count’. Archives of Disease in Childhood, 105(3), 310-311.
Bacila I-A, Elder C & Krone N (2019) Update on adrenal steroid hormone biosynthesis and clinical implications. Archives of Disease in Childhood, 104(12), 1223-1228.
Lawrence N, Cheetham T & Elder C (2019) How do paediatricians use and monitor antithyroid drugs in the UK? A clinician survey. Clinical Endocrinology, 91(3), 417-423.
Elder CJ, Langley J, Stanton A, De Silva S, Akbarian-Tefaghi L, Wales JKH & Wright NP (2019) A simulation study assessing the accuracy and reliability of orchidometer estimation of testicular volume.. Clinical Endocrinology, 90(4), 623-629. View this article in WRRO
Elder CJ, Harrison RF, Cross AS, Vilela R, Keevil BG, Wright NP & Ross RJ (2018) Use of salivary cortisol and cortisone in the high and low dose synacthen test. Clinical Endocrinology , 88(6), 772-778. View this article in WRRO
Cross AS, Kemp EH, White A, Walker L, Meredith S, Sachdev P, Krone NP, Ross RJ, Wright NP & Elder CJ (2018) International survey on high- and low-dose synacthen test and assessment of accuracy in preparing low-dose synacthen. Clinical Endocrinology , 88(5), 744-751. View this article in WRRO
Cockill TG, Hewitt A, Heafey C, Wright NP & Elder CJ (2017) The use of a radiolucent template to improve bone age X-ray quality (BASIC study). Journal of Pediatric Endocrinology and Metabolism , 30(12), 1277-1280. View this article in WRRO
King D, West N & Elder CJ (2017) Integrating teaching into everyday clinical practice. Archives of Disease in Childhood Education and Practice Edition, 102(2), 94-99.
Elder CJ & Dimitri PJ (2017) Diabetes insipidus and the use of desmopressin in hospitalised children.. ADC Education & Practice, 102(2), 100-104. View this article in WRRO
Calvert A, West N & Elder C (2016) G354(P) ‘bridges and barriers’ : middle grade perspectives about contacting on-call general paediatric consultants. Archives of Disease in Childhood, 101(Suppl 1).
Elder CJ & Dimitri P (2015) Hydrocortisone for adrenal insufficiency. Archives of Disease in Childhood.education and Practice Edition, 100(5), 272-276. View this article in WRRO
Elder CJ & Wright NP (2014) Height estimation using long bone segment length is unlikely to play a role in the routine measurement of healthy preschool children. Developmental Medicine and Child Neurology, 56(10), 921-922. View this article in WRRO
Elder CJ & Bishop NJ (2014) Rickets.. Lancet, 383(9929), 1665-1676.
Elder CJ, Somerset LM, Ram V, Wright NP, Wales JK & Dimitri PJ (2014) Letter in response to Chitale et al.: determining the utility of the 60-minute cortisol measurement in the short synacthen test.. Clin Endocrinol (Oxf), 80(6), 925.
Jackson C, Wernham EM, Elder CJ & Wright NP (2013) Early glycaemic control is predictive of long-term control: A retrospective observational study. Practical Diabetes, 30(1), 16-18.
(2012) Correction. Archives of Disease in Childhood, 97(11), 1008.1-1008.
Elder C, Hinchliffe C & Wright N (2012) Response to Alleyn et al. Comparison of longitudinal point‐of‐care and high‐performance liquid chromatography HbA1c measurements in a multi‐centre trial. Diabetic Medicine, 29(9), 1213-1214.
Elder CJ, Sachdev P & Wright NP (2012) The short Synacthen test: A questionnaire survey of current usage. Archives of Disease in Childhood, 97(10), 870-873.
Elder CJ, Sachdev P & Wright NP (2012) The short Synacthen test: a questionnaire survey of current usage.. Arch Dis Child, 97(10), 870-873.
Elder CJ & Natarajan A (2010) Mauriac Syndrome - A Modern Reality. J PEDIATR ENDOCR MET, 23(3), 311-313.
Elder C, Hinchliffe C & Wright N (2010) HbA1c league tables: might assay variability encourage foul play?: Figure 1. Journal of Clinical Pathology, 63(7), 660.1-660.
Elder CJ, Wright VJ & Wright NP (2009) Time to end the routine testing of growth hormone and cortisol on hypoglycaemia screens?. ARCH DIS CHILD, 94(12), 1000-1001.
Elder CJ, Ackerman B & Kingdon C (2008) Audit cycle of newborn observations on the postnatal wards.. Archives of Disease in Childhood Fetal & Neonatal, 93(6), f475.
Elder CJ, Ackerman B & Kingdon C (2008) Audit cycle of newborn observations on the postnatal wards. ARCH DIS CHILD-FETAL, 93(6), 1475-1475.
Elder CJ, Barton JS, Brook CGD, Preece MA, Dattani MT & Hindmarsh PC (2008) A Randomised Study of the Effect of Two Doses of Biosynthetic Human Growth Hormone on Final Height of Children with Familial Short Stature. Hormone Research in Paediatrics, 70(2), 89-92.
Pilling EL, Elder CJ & Gibson AT (2008) Growth patterns in the growth-retarded premature infant.. Best Pract Res Clin Endocrinol Metab, 22(3), 447-462.
Elder CJ, Sprigg A & Coombs RC (2008) Severe chest recession causing translucency on an x ray.. Arch Dis Child Fetal Neonatal Ed, 93(1), F23.
Elder CJ & Urquhart DS (2006) Limitations of empirical therapy for bacterial meningitis in a healthy child with Listeria monocytogenes meningitis. Journal of Pediatric Neurology, 4(1), 65-67.
Arshad MF, Ahmed A, Beddows S, Marsh I, Mullamitha A, Newell-Price J, Ross R, Elder C & Debono M () Diagnostic performance of morning serum cortisol for glucocorticoid weaning in children and adults. European Journal of Endocrinology.
Mushtaq T, Ali S, Boulos N, Boyle R, Cheetham T, Davies J, Elder C, Gan H-W, Hindmarsh P, Katugampola H , Kerr S et al () Recommendations for hydrocortisone doses for emergency management and peri-operative care for childhood adrenal insufficiency. BSPED consensus guidelines. Endocrine Abstracts. View this article in WRRO

Conference proceedings

Craig J, Tavernier M, Ross C, Lewis J, Jacques R, Keevil B, Ross R, Debono M & Elder C (2024) Screening for Adrenal Insufficiency in Children by Home Waking Salivary Cortisone testing. HORMONE RESEARCH IN PAEDIATRICS, Vol. 97 (pp 98-98)
Ahmed A, Hattangadi I, Gopalakrishna N, De Silva S, Elder C & Ferguson E (2024) Prematurity and low birth weight may be key indicators for a low peak cortisol on neonatal Short Synacthen Tests. HORMONE RESEARCH IN PAEDIATRICS, Vol. 97 (pp 265-266)
Ahmed A, Hattangadi I, Gopalakrishna N, De Silva S, Elder C & Ferguson E (2022) Effect of maternal steroid medication prescribed during pregnancy on neonatal adrenal function. HORMONE RESEARCH IN PAEDIATRICS, Vol. 95(SUPPL 2) (pp 127-128)
Tonge J, Keevil B, Craig J, Langley J, Whitaker M, Ross R & Elder C (2022) Collection of salivary steroids in children under conditions replicating home sampling. HORMONE RESEARCH IN PAEDIATRICS, Vol. 95(SUPPL 2) (pp 111-111)
Aji A, Colyer S, Burn S, Dimitri P, Wright N, Krone N & Elder C (2018) The relationship of baseline, incremental and peak cortisol following a Short Synacthen Test - single-centre analysis of three years' data. Endocrine Abstracts, Vol. 58. Birmingham, UK, 7 November 2018 - 7 November 2018. View this article in WRRO
Burn S, Colyer S, Dimitri P, Wright N, Krone N & Elder C (2018) Borderline peak plasma cortisol following synacthen stimulation - single-centre analysis of three years' data. Hormone Research in Paediatrics, Vol. 90 (pp 146-146). Athens, Greece, 27 September 2018 - 27 September 2018. View this article in WRRO
Aji A, Colyer S, Burn S, Dimitri P, Wright N, Krone N & Elder C (2018) The relationship of baseline, incremental and peak cortisol following a Short Synacthen Test - single-centre analysis of three years' data. Hormone Research in Paediatrics, Vol. 90(Suppl 1) (pp 128-129). Athens, Greece, 27 September 2018 - 27 September 2018. View this article in WRRO
Cross AS, Sachdev P, Wright NP, Jabbar I & Elder CJ (2017) G175(P) Current dilution methods cause large variations and inaccuracies when making up 1MCG synacthen dose. British Society for Paediatric Endocrinology and Diabetes and British Society of Paediatric Gastroenterology, Hepatology and Nutrition
Arshad MF, Ahmed A, Beddows S, Marsh I, Mullamitha A, Newell-Price J, Ross R, Elder C & Debono M () Diagnostic performance of morning serum cortisol in glucocorticoid weaning in children and adults. Endocrine Abstracts. Harrogate, UK, 10 March 2025 - 10 March 2025. View this article in WRRO

Research group

Lydia Foriestier-Zhang, MD Student

Professional activities and memberships: Dr Elder’s other roles include Chair of the Awards Committee of the British Society for Paediatric Endocrinology & Diabetes, member of the Athena Swan Committee and University of Sheffield Partner Governor on Sheffield Children’s NHS Foundation Trust’s Council of Governors.