Passed Synacthen test but low baseline serum ATCH

I have just found out my serum ATCH is low. Level was 6 (range 0-45) lab report it's low. The Synacthen test done at the same time was ok. My adrenals can respond to ATCH, great! However the reason my cortisol level was 370 is due to the fact my ATCH is so low. I have terrible fatigue and muscles in my thighs feel so weak, climbing stairs is like doing a session at the gym! I have been on sick leave since November as I was so bad, including awful hypoglycemia and exhaustion. GP put me on HC and I felt better (ish) but told me to come off for Synacthen test. I have not yet heard back from the consultant who ordered these tests. The hospital ward where I had the Synacthen test done rang me on the day to say adrenals were fine but were waiting for the ATCH blood test. They said if all was fine theyd just send a letter and I'd be discharged. I'm worried about my low ATCH level as it sounds like I could have secondary AI which means I should be on steroids. Anybody have low ATCH SERUM levels.

7 Replies

  • Hi what is ATCH? Im due for one of these tests but have no idea what to expect other than it tests adrenal function. Thanks

  • Sally, the synacthen test involves having blood taken, an injection of something to stimulate your adrenals, then more blood after half an hour. It checks if your adrenals respond, but is widely considered pretty hopeless unless you have Addison's. Nothing to worry about while having it done, quite straightforward. I think ACTH is the chemical they use to stimulate.

  • Oh because Helen here is talking about her own ACTH levels being low, so wondered what those were.

  • I think you naturally produce this chemical anyway. They use a synthetic version to do the test. Happy to be corrected if that's my misunderstanding :-)

  • Ok, thanks!

  • Just to be clear, the test should be done in two parts as mine was. They inject you with synthetic ATCH to stimulate adrenal glands, this determines whether adrenals can respond to ATCH. Mine were fine on this. However my baseline cortisol is low at 370 so they also looked at what my own ATCH levels were by drawing blood before commencing the Synacthen test. My own ATCH levels are low. This explains why my adrenals are low on cortisol and the fact that I may well have secondary adrenal insufficiency I.e problem is in the pituatry gland. Sally you should really have this test done as part of Synacthen test.

  • But not all hospitals test for this meaning that Synacthen test done without this will only determine primary AI (Addison's)

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