synacthen test

[Creamtea]

I’m to have a synacthen test next week.

I am taking 5 mg of prednisolone daily and have been told to stop the pred 3days before the test. Will this be ok. As have been told never to stop steroids suddenly ?

[SnazzyD]

Oh, who told you that? Normally it is 24 hours so if you take yours in the morning you don’t take it on the day of the test. Take it as soon as you’ve finished. Here is patient information that is typical of hospital info prior to testing.

cuh.nhs.uk/patient-informat...

[Creamtea in reply to SnazzyD]

The nurse at the hospital where I am having the test.

[SnazzyD in reply to Creamtea]

I’ve had 2 myself and was given the usual information, 24 hours. I will also add that my Endocrinologist would not do the test on people about 4mg because the adrenal glands can still be significantly suppressed such that it is likely the result would be low activity. Mine certainly was at 4mg but by 1.5mg it was much better.

[SheffieldJane]

I have been told to get down to 3 mgs, see my Endocrinologist, then go for my synthacthen test having not taken Pred since the morning before ( previous day). If I remember correctly, last time I got to the clinic at 9am, the test took about an hour. I was able to then take my Pred. I went through this before, when my diagnosis was just PMR. I was diagnosed with GCA/LVV shortly afterwards. So fingers crossed the adrenals can work again. I had a Synacthen test when I was on 5 mgs but the dose was too high to give an accurate result.

[arvine in reply to SheffieldJane]

Can I ask if uour rhuemy advised you get that test, or endochronologist, and is that a routine that would be done at low doses of pred or did you have symptons of adrenal glands not recovering, and if so what were they?

[SheffieldJane in reply to arvine]

My Rheumatologist and I discussed my ongoing fatigue and as part of that she agreed that it was a good idea to see my Endocrinologist. My Endocrinologist advised that once my dose was down to 3 mgs, I should make an appointment in his department for a Synacthen test. My symptoms were mostly quite significant fatigue. Nothing that would indicate a crisis.

[Sillydogsmum]

homerton.nhs.uk/synacthen-t... 3 days without Pred not correct and probably unsafe methinks.

[JGBH in reply to Sillydogsmum]

I have found that many nurses we are asked to rely on for advice clearly have no idea! Such advice courbe quite dangerous. We should only rely on people who actually know, not guess. This is concerning.

[cmToddy]

Hi. I have had two of those tests. I just took the Pred after the test when I had tea and a biscuit. Please just take them late on that day but don’t miss the other two just take as normal.

[PMRpro Ambassador in reply to cmToddy]

It is the days BEFORE the test that matter.

[PMRpro Ambassador]

I have heard a demand for 2 days - which is effectively only 1 day without as you take pred on Day 1 which covers you for the next 24 hours, miss a dose n Day 2 and on Day 3 you take the pred late, immediately after the test. And when you think about it, how often does someone forget a day's dose?

[Creamtea in reply to PMRpro]

Thank you for your advice. I have contacted my endocrinlogist who wanted the test done. He has said that I can just omit the steroid 24 hours before the test. Which I am much happier about.

[Creamtea in reply to Creamtea]

I had a blood test which my rhemy wanted done and my cortisol level was low. So was referred to the endocrinologist.

[PMRpro Ambassador in reply to Creamtea]

Of COURSE the cortisol was low if you are still on pred - why don't they know that it suppresses cortisol production? It is physiological ...