Are synacthen tests safe for an elderly lady with Heart Failure and renal Failure?

[dwsmith]

Mom has just seen Dr Boardman and suggested this test, but i seem to remember when i had one that my heart raced for several hours after the test, has anybody else had this response?

[Moggie]

Nope - I didn't feel a thing. Does that reaction mean you were diagnosed with some sort of adrenal illness?

Moggie x

[rosetrees]

I can't answer that directly as I've ever had that test done. But I'd question why any doctor would want to do such a test, which involves (as I understand it) artificial stimulation of the adrenals, on a frail, elderly person. What are they hoping to achieve? Surely there are more gentle tests that would tell them what they need to know, such as the urine or blood tests. How would they feel about you ordering a cortisol saliva test? Assuming, of course, that your mom would be able to produce enough saliva.

Don't start me off on treatment of older folk, but sometimes you have to make your own decisions about what is, or isn't, appropriate, necessary or desirable.

We hear a lot in the press about neglect of older folk, what we don't hear is the side that I have personal experience of, which is the rush to give invasive treatment at all costs, with no thought of the effect on the patient.

[Hidden]

The question to ask is - is it a test worth having. Having had the long synacthen test, the answer is a resounding NO.

It is gruelling and takes 1.5 days of having the blood sucked out of you at regular intervals. Since i have p anaemia, i have developed a deep aversion to IM injections; the IM cortisol injection is not fun.

I made the mistake of agreeing to this procedure as i was concerned about being seen as non-compliant.

Since i must self fund and self medicate my diseases in any case, who cares what the nhs thinks about being compliant or not? In my naive days i was compliant and got nothing anyway

But the bottom line is this: your results are always "normal". The NHS makes sure of this because when you get the results, (this is no joke) the print out syas "no reference ranges established".

This is a box ticking waste of time if ever there was one. It is the nhs way of fobbing you off. My morning cortisol was rock bottom (prrevious blood test) and i have all the classic symptoms of adrenal fatigue -a condition not recognised by the NHS.

Please do not waste your time having this test; the result will be "normal" no matter what

Unless of course you are having it privately - in which case I imagine they have established ref ranges

[Hidden]

PS. the cortisol saliva test is a good one, however the nhs will not act on these results

[dwsmith]

Thankyou all for your replies, I think I will cancel tomorrows test and have a good think about it, I will suggest the saliva test which is as you say non invasive, I actually do think it would be traumatic for my Mom as when having bloods taken, they always struggle to find a vein and end up hurting her. x

[behappy1]

It's a dilemma but if she is adrenal insufficient then she needs hydrcortisone and the only way to know that is a short sycnathen test. My mum is a frail 70 year old with severe osteoarthritis, heart problems and mixed connective tissue disease. She had one done a few weeks ago and was absolutely fine.

I've also had several without any issues (apart from discovering mine are not working).

I'd suggest you do it , if there is a genuine concern the adrenals are compromised. Saliva tests are not accepted.

[Jackie]

Hi I expect you are thinking of the cortisone tablet at midnight. It is an extremely ,low dose. I was worried as normally must never have any cortisone, even local injections. I have end stage cardiac and kidney disease+ lots of other things. I have had this important test twice and fine. With these conditions it is vital to have any tests seemed necessary as all the diseases associated do effect heart and kidneys, if in this posibtion. She is always very conscious of heart etc and actually often in my experience knows more that a lot of cardios.

I hope this is waha you wanted.

Jackie