SYNACTHEN TEST

[JOHNONE28]

I asked my GP for a synacthen test he said that this test can only be authorised by an hospital I assume that this would mean a referral ?

[MrsNails]

I’m not sure, l’ve had one ordered by my Rheumatologist & carried out on the Day Unit.

[SheffieldJane]

I am pretty sure that my young GP referred me, upon my insistence.He was very keen to become an expert on all things PMR and now he is.

Having said that. Synacthen tests are not routine following long term Cortisoid therapy, there ought to be particular symptoms that make you suspect that all is not well. You also need to be on less than 5 mgs of Pred for the tests to be valid. Everybody’s Cortisol production shuts down when the body is flooded with the synthetic stuff.

Upon reflection, I don’t think I needed the test. My first test showed a sluggish response and my next test showed a return to normal. My only symptom was fatigue and honestly, we all have that. The procedure made the Endocrinologist want to take over my case and switch Pred to Hydrocortisone ( weaker and mimics our own Cortisol production). I ended up being advised differently by two consultants, Endocrinologist and Rheumatologist. I found this stressful and I lost my way with PMR pain for a bit. A very slow taper at the end of your Pred treatment is the best advice.

Read up around Adrenal crisis for symptoms.

[SnazzyD]

My GP ordered mine and then set up a referral to an endocrinologist.

[Yellowbluebell]

My gp just wrote off requesting a test and I hot a date in the post. You don't need a referral to anyone to get on e just a request from your gp. YBB

[Constance13 in reply to Yellowbluebell]

Memories Yb??? "Hot date"!

[Yellowbluebell in reply to Constance13]

More likely wishful thinking!!

[Rokerman in reply to Constance13]

Haha - that’s what came to my mind...! 😆

[Constance13 in reply to Rokerman]

Memories or wishful thinking?

[Rokerman in reply to Constance13]

Both! 😉

[jinasc]

Rubbish, he puts the order in and they will send you a date.

This smells to me of CCG stuff.

[Constance13 in reply to jinasc]

CCG??

[PMRpro Ambassador in reply to Constance13]

Clinical Commissioning Group - the layer of the NHS that coordinates funding in primary care

nhscc.org/ccgs/

[jinasc in reply to PMRpro]

Thank you.

I forgot I should have used the full words.

[PMRpro Ambassador in reply to jinasc]

Even then - would it make sense to anyone else?

[jinasc in reply to PMRpro]

That's true, not everyone realises have the previous govt, tied GPs hands to quite a hefty degree.

Just sent you an email............rather long.

[JOHNONE28 in reply to jinasc]

When I asked my GP for the test ( a new GP to me) he said he was concerned regarding the length of time that I had been on pred ( 7 yrs) & that I should not be taking them unless the decease was active ? inferring that I needed to stop taking them I explained that I have continuously trying to reduce the dose but when I got down to the lower doses 2mg in my case symptoms returned also that on my latest attempt I have managed to reduce to 1mg but was concerned that feeling tired & fatigued perhaps that I should have the test . he just repeated that it had to be done by the hospital, never offering to refer me this was a telephone consultation ,not ideal as it does not seem to promote the same interaction between patient & Doctor I have since spoken to the practise they appear to confirm the need for an referral but offered me another consultation with a different GP if I require.

[PMRpro Ambassador in reply to JOHNONE28]

Well the answer to that one is "it appears to be active" - and anyway, Prof Dasgupta in Southend leaves patients on 2-3mg indefinitely as it seems to reduce the rate of relapse. 2-3mg permanently will do no harm at all - and if it saves needing to return to 15-20mg in a relapse that is even better!