Short Synacthen Test

[Ahhan]

Hi all,

I've just received my Short Synacthen Test results which state they are 'adequate'. Does anyone know what the range of normal is?

My results were:

O min - 363 (cortisol nmol/l)

30 min - 475

60 min - 514

I'd be grateful for any insight as I don't have another appointment with the endo for 2 months.

[MULLIONAIRE]

Hi Ahhan,

Think it would be a good idea if you looked at this website pathology.leedsth.nhs.uk/dn.... Cortisol levels should rise by 200 and reach more than 600. Plus timing of the test is very important (9am). Hope you find this useful.

[Ahhan in reply to MULLIONAIRE]

Hi,

Thank you so much for your reply. The test was done at 9 am.

But by this measure my results were not 'adequate' (though presumably adequate enough not to have Addison's?).

[MULLIONAIRE in reply to Ahhan]

The Protocol advises that the synacthen test is not reliable when there is a pituitary problem. If you have a thyroid problem, then this could be caused by pituitary dysfunction. If you look at the website it tells you the testing that should be done for hypopituitarism ( low hormone levels). I had the glucagon test because my health would not allow the 'gold standard' test. Your comment about Addison's is true as this is caused by complete failure of the adrenal gland. I now receive replacement cortisol (hydrocortisone) and growth hormone, I was already on thyroxin. The replacement hormones affect each other and my endocrine nurse recognised when I started collapsing despite the supplementation due to stomach problems that although the symptoms were not completely the norm I was going into Addisonian crisis. Experimented with hydrocortisone dosage and have not collapsed for 18 months now. As a word of encouragement I feel better than I have done for 28 years!! My endocrinologist has told me that if I had not educated myself, I would not have got the help I should have had in 1987. They are prepared to work with me now as it is all such a minefield. Hope your endocrinologist is as open minded.

[Ahhan in reply to MULLIONAIRE]

Again, thank you so much for your reply.

It has taken me years to get a diagnosis of Hashimoto's thyroid, but am finally getting there. Ultrasound, goitre and antiobodies all say I have Hashimoto's (my mother and her sister both have it) but as my bloods are T4 at 11.4 and TSH at 3.36 and within the 'normal' range the g.p and endocrinologists kept telling me it wasn't thyroid but must be depression or M.E.

As of yesterday I started Levo at 25mg, to go up to 50mg next week, but my G.P. (a new g.p.) really didn't want to give it to me as he said my thryoid is not underactive and cannot be causing my symptoms. I think he only gave it to me to get me to go away.

I was given a test for Addison's because I had a 'significant postural drop', but it seems that as the results have come back negative for Addison's that they don't seem to mind that the levels are still below normal. I will look into hypopituitarism now you have mentioned it as I'd not heard of it before.

I'm so glad to hear that you have got the help you needed, even if you did have to do all the fieldwork yourself. I have found this process with the g.p's and endocrinologists to be an absolute nightmare so far.

[MULLIONAIRE]

It is a nightmare, but just make sure you get your facts right and if the medics do not respond, put it to them in writing asking why the information is being disregarded.

If you read your thyroxine leaflet, you will see that it warns patients about taking it if you are suffering from untreated adrenal problems; you need to tell your doctor!! My comment how does a patient know whether they have untreated adrenal problems?? In your case it might be the lever you need to get further testing, on the other hand as your GP is not happy prescribing thyroxine, might use it as an excuse to stop prescribing it.

My TSH levels used to swing between hypo and hyperthyroid - a sign of adrenal problems. My GP used the TPO antibodies because they were so high to conclude there was no doubt that I was suffering from hypothyroidism and prescribed thyroxine. Another indication was that the blood fat , triglycerides were elevated, I was very fortunate in 2002 to find a GP who had some knowledge about hypothyroidism.

Fot two weeks after first taking thyroxine, my body responded well. Then it fell to bits again, know now because of the untreated adrenal problems. Hopefully, you will gain your knowledge quicker than I did and in the process get the help you need and educate a few medics. Good luck.

[Ahhan in reply to MULLIONAIRE]

This is really helpful, thank you.

I have been told I have high cholesterol, but was just told to eat more healthily. I presume this is related to blood fat?

I will definitely pursue things further having heard all this from you.