Short Synacthen Test tomoro + did you take your thyroid meds as usual on the day?

[magento]

Hello,

I have the SST test tomorrow to test my adrenals. Just wondered if those of you who have had it took your thyroid meds as per usual on that day? Thanks

[humanbean]

Yes, you should take your thyroid meds as usual. For info on preparation, timing, and what to expect in an SST test, see this link :

imperialendo.co.uk/Bible201...

The SST test is described on pages 68 - 70. Click on the name of the test in the table of contents and you'll go straight to it.

[magento in reply to humanbean]

Thank you so much; I'll have a read now.

[magento in reply to humanbean]

Hello again, just to add that my SST is at 10.30am...I guess this test doesn't need to be at 9am like the straightforward Cortisol bloodtest (mine was 264 nmol)? I know that the saliva tests are more accurate (have had two done with Genova); but want to go through this hoop just in case it leads to the endo helping me.

[humanbean in reply to magento]

If you look at the Method on page 69 it mentions 0900h for the test. You will have to ask your consultant or your doctor what effect there will be on the result having the test at 10.30am. If they say it will make no difference they are lying. Cortisol has a circadian rhythm and changes throughout every 24 hour period. I don't know what you can do about it, to be honest. Perhaps you could print out the first page of that link I gave, and then print out pages 68, 69 and 70 and show them to the staff at the hospital. But I think they will brush you off. Sorry I can't be more helpful.

METHOD

1.0900h: take 7ml blood for cortisol (red or yellow top Vacutainer) and ACTH (purple top, on ice to lab immediately).

2.Give 250micrograms tetracosactridei.m.(ideally) or i.v.

3.0930h: Take 3 ml blood for cortisol.

4.1000h: Take 3 ml blood for cortisol.

5.For the diagnosis of congenital adrenal hyperplasia the samples taken for cortisol are also analysed for 17-OH progesterone to exclude 21-hydroxylase deficiency. In some cases 17-OH pregnenolone is measured to differentiate between 21-OH and 3ß-HSD deficiency.

[magento in reply to humanbean]

Hi humanbean,

Good news in that I called the hospital this am (at 07.55!) expressed my preference for a 9am test & lucky me there was a cancellation so in I went and my first bloods were drawn at 09.08!

Fortunately - apart from rushing to get there - it was all pretty painless. The idea of it was worse than the reality - I hardly felt anything throughout and I am a big baby when it comes to these kind of things.

The sister did admit that earlier tests were better, but they actually do them until midday (!) I think she said. Really pleased I went in for 9am-ish.

Thanks again for your advice. I'll let you know my result.

[humanbean in reply to magento]

Brilliant! Glad to hear it went well.

[magento in reply to humanbean]

Thank you again...I enjoyed a nice cup of tea & snack and twenty mins of Sunday's Poldark as a treat when I got in!

[cwill]

I took my thyroid meds that morning as I had been told the tests that were being performed and thyroid wasn't one of them. Thinking that they were going to do what they said I believed them. And then they did the SST and thyroid thus allowing the consultant to reduce my dose when I felt appalling. Be careful.

[magento in reply to cwill]

Hi cwill,

Yes, I'll have a think as I also happen to have my blood test form for my usual Thyroid Function Tests. I was going to go up the road to my GP surgery to have those done (as per normal), but then I wondered if they could take an extra vial with my first lot of bloods (before the SST injection) tomorrow. I'm probably best to keep them separate..I just saw an opportunity to kill two birds with one stone and not look like a pin cushion in the process! When I normally have my thyroid bloods done I don't take my thyroid meds that morning. Thanks for your reply.

[cwill in reply to magento]

If they use a butterfly then it's just one needle puncture and any number of phials.

[magento in reply to cwill]

Hi cwill,

Back from the hospital...managed to secure a 9am slot in the end. All ok and the sister taking my bloods did take a phial for my Thyroid Function Tests at the same time (so pleased I didn't take my thyroid meds first thing). It was all very painless and stress-free, I just hope my rushing in the morning and being nervous about it won't affect my readings. But after the injection I felt quite relaxed...I think this is because I was building myself up for the 'bee sting feeling' and the unknown, but I didn't have anything like that. As the nurses had no one immediately after me they also suggested I lay down on their couch / bed so hopefully that helped re-settle me in those 30 mins or so.

Thanks again for your advice and I'll keep you posted re my result.

Take care.

[cwill in reply to magento]

Mine was a complete nightmare involving verbal abuse from the 'nurse'. Due to severe ME CFS I said I needed a bed in a quiet room to rest on. Instead was shouted at and left on a bed in the treatment room listening to everyone come and go. And the nurses chatting. To add insult they asked if I wanted a pillow and when they bought it ghastly nurse raised the bed head so I had to sit up. will never go back to endocrinology at that hospital.

I am so glad that your experience was better than mine and that you went prepared.

[magento in reply to cwill]

That is horrendous! I am sorry for you. Why some people are 'nurses' I don't know. Some couldn't be less compassionate or professional if they tried. Surely putting people at ease should be the first step. I was indeed lucky. I went to Southampton (University Hospital).

[cwill in reply to magento]

Mine is held up as a great hospital. Probably by people that don't go the the departments and wards that I have. And of course the staff change so I might have been ridiculously unlucky. Even in my debilitated state I have been able to record three episodes of very poor care at this endo clinic and two very cruel receptionists. These were observed and overheard, not me, so I think that the whole culture and practice is/was damaged. I am so sick of staff using the 'We are very busy' as an excuse for bad care. And then gas with each other re their holidays etc. Rant over for now, but possibly not for today.