Cortisol test

[Bluey-1]

Result of morning cortisal test was 131 which is rubbish (range 102-535) and explains why I feel exhausted some days. Have been on 3mg for several weeks. Looks like it’s a Synacthen test next. Thanks PMRpro for the info on that. Is the experience ok anyone out there who’s had one?

[SnazzyD]

It’s mostly a nice excuse for half an hour’s sit down. They put in a small cannula and take the before blood. Then they put in an artificial version of ACTH (Adrenocorticotrophic Hormone) which is normally made by the pituitary gland. This shouts at the adrenal glands to make cortisol. You may feel nothing. I got a funny warm feeling in my stomach and then a short lived rush of “where’s the fire!”. It was disconcerting but I knew it wasn’t me it was the juice and there was no fire. After that minute or two I had a nap. Then they take your blood again for the after reading and then you go home. One of the least stressful procedures I’ve had.

This test just shows whether the glands are capable of working if they are given a big belt of gee up hormone. It doesn’t tell you if the rest of the adrenal axis or the adrenal glands will perform reliably all day every day and in a crisis. It is though a good start because if your glands are flat as a pancake after a pretty good shout, then the Endocrinologist knows what they are working with.

[Bluey-1 in reply to SnazzyD]

Thanks Snazzy, that’s a comprehensive account so I know what to expect. Was your early morning cortisol test low as well? Wish me luck.

[SnazzyD in reply to Bluey-1]

At 4mg Pred it was very lacklustre and I certainly felt it! By 1.5mg it was ok. I still had bouts of extreme tiredness but by 1.5mg I wasn’t tired all day every day.

[PMRpro Ambassador]

On 3mg it is to be expected you'd get a rubbish result. But it does show signs of life so another in a couple of months at 3mg might show improvement.

Like Snazzy. jinasc of this forum also went to sleep despite having taken a book with her! They very kindly put a bookmark in and saved her glasses falling off ...

[Bluey-1]

You do both give me hope Pro and Snazzy. I’ll take a book with me! My rheumatologist said to stay at 3mg. Ironically I felt fine yesterday having the test but not with it today, absolutely knackered. Had coffee with a friend and that’s it, feet up on recliner and resting…

[Pollyanna16]

Hi, don’t worry as SnazzyD has so beautifully described it’s fine. You might find someone else in the room having a similar infusion to chat to. It’s all very relaxed. Best of luck with the result & going forward.

[Hirondelle]

hello Bluey. I’ve had two synacthen tests over the last year. Sadly both show no cortisol or as the consultant said’ no petrol in your engine’. The actual test is easy. You sit or lie on a bed in hospital and a nurse puts a canula in and over the next 3/4 hours blood is taken and something is injected in to see the reaction. .good luck.

[Bluey-1 in reply to Hirondelle]

Thank you, sorry to hear you’ve had no luck after two tests. I’m on blood thinners so I assume I take those after the test.

[Hirondelle]

the main thing is NO STEROIDS FOR 24 hours before the test - so take them with you. I’m also on blood thinner, no mention about that, it doesn’t disrupt the Sy à then test. I put them in my bag along with the steroids and took them after the test. You can have breakfast.

[PMRpro Ambassador in reply to Hirondelle]

Anticoags won't affect the test - only corticosteroids.

[Bluey-1 in reply to Hirondelle]

Of course re the steroids, same as for cortisal blood test. Just wondered about the blood thinners.