Short synacthen test results. Please I need your opinions.

I can't remember the ranges because they're not in front of me right now. But these were

Baseline was 210

60 mins later. 930

That seems like a massive reaction.

My endo said that it proved that my adrenals were very healthy. I'm not quationing him but I would like to know if anyone has any thoughts. I thought it was suppose to double not quadruple?

X

[LouiseRoberts]

Hi

Sorry no one has replied yet - hopefully someone will pick this up from Latest Activity..

L

x

[lynmynott Partner Thyroid UK]

Hi Joesmum,

This is taken from Patient.co.uk:

Short Synacthen® test[3]

This may be performed in primary care if there is sufficient expertise and time. Otherwise, referral to secondary care is appropriate. All children with suspected adrenal insufficiency should be referred for an urgent paediatric opinion.

• 0 minutes - baseline blood for cortisol; followed by 250 micrograms Synacthen® IV/IM.

• 30-60 minutes - cortisol level.

• 95% sensitivity and 97% specificity.

• Less useful alone in secondary adrenal insufficiency.

Interpreting results of the short Synacthen® test[3]

If initial cortisol is >140 nmol/L and second cortisol is >400-500 nmol/L, this excludes Addison's disease. The test can be performed at any time of day, as it is the post-stimulation increase that is diagnostic and this occurs irrespective of any physiological variation.

This may be useful for you: dundee.ac.uk/medther/tayend...

Your endo is right in that it is normal. However, we are just in the process of having a new article checked by adrenal patients about this. If the synacthen test is "normal" and the patient has symptoms of adrenal insufficiency, there may be secondary hypopituitarism.

The Society for Endocrinology have admitted that the synacthen test can be normal but a patient can have secondary hypopituitarism and therefore more dynamic tests should be done. This article explains more:

patient.co.uk/doctor/pituit...

Hope this helps.

[Hidden in reply to lynmynott]

Thank you Lyn,

Great reply. Many thanks. X

[Priyapriya in reply to lynmynott]

HI!

I have been trying to access the dundee university link on several occasions, but it says it is outdated. DO you by any chance have the full link or know anywhere the content is still available?

Thanks very much!

[lynmynott Partner Thyroid UK in reply to Priyapriya]

Hi Priyapriy, Oh, that was a long time ago. This link might be useful: derbyhospitals.nhs.uk/easys...

[Priyapriya in reply to lynmynott]

Thank you!

[ukangell]

i had this test done recently. it only is really accurate for primary adrenal insufficiency. it's rubbish at detecting secondary. in my experience the endos will not treat secondary adrenal problems until you're in A&E.

my results were

baseline 195 nmol

30 mins 545 nmol

60 mins 617 nmol

i was told we're happy with this..... discharged.

the 30 min is more important than the 60 min result.

i also know that if i had a baseline of 185 or less and a 30 min result of 540 or less then they'd have had to do further tests. i'm boarderline in all the cortisol results and they do nothing.

i've taken hydrocortisone from a private dr's advice and felt amazing. it took about 6 weeks to feel that way. then i got this sst test through and had to stop taking it all and felt like a zombie again. it's total rubbish.

i told the endo i saw that i'd taken HC and she was .... "did you not gain weight?" nope! i lost weight. "did you not have problems with your BP!" nope! i was lower than it is now. "did you not have trouble sleeping" nope! out for the count every night but i was managing to stay awake past 9pm. "oh" was her reply. "well it's too dangerous for you to be taking this and you shouldn't etc etc" i took 25mg split into 3 doses. so i'm back on it but just the morning dose to kick start me but i feel rubbish from 2pm onwards every day and all i want to do is sleep!

i asked the endo why they didn't treat until the adrenal glands were almost dead. she told me that they can still function at 10% efficiency. she mentioned that people cope well on 30% of the heart when the other 70% has died and that people can live with just a tiny bit of the pancreas working. i did think that there wasn't much life to live if you are this ill.

my next step is to go private.