I've been mulling over whether I want or need to test my adrenal glands (via the synacthen/ACTH test) , having reached the 7mg Pred dosage level
I consider myself fortunate, as although having had my share of hiccups along the way, I've reached this point in the manner and time I had planned.
I've put together some thoughts and questions on the matter to try and help myself decide, I think I'd like to, but I want to understand as much as possible quite why, and I'd appreciate anyone's view on the matter.
Standard 'short' tests are the norm when testing the adrenal glands for insufficiency due to the effect of long term and/or high dosage steroid use, it is stated that there is no benefit in the 'long' test for this scenario (http://www.pathology.leedsth.nhs.uk/dnn_bilm/Investigationprotocols/Synacthentestsshortlong/StandardShortSynacthenTest.aspx)
What is the proportion of positive and negative tests?
How accurate is the test, what is incidence of false positives and negatives?
'A one-off measurement of blood cortisol is not acurate enough to diagnose Addison's disease as it may be low from time to time in normal people' (http://patient.info/health/synacthen-test)
Having a retake later I guess should give an aggregated better chance of confirmed status.
If positive - reassured
retake test when off Pred to confirm status,
I guess when feeling free of the symptoms of adrenal insufficiency?
If negative - forewarned and forearmed that ongoing low dose of Pred may be required,
to prevent Addison's disease
but would like to continue tapering to see whether it is achievable
or at worst find the minimum necessary dose
retake test to re-verify status