If Short Synacthen Test negative for Addison's, what tests would follow for low cortisol?

[PiggySue]

Hi All

I am looking for some advice and warn that yet again this will be a long post!

I have had several 9am blood tests that show low cortisol and so was sent by my NHS endo to have a SST yesterday morning. The results will take a week, and the nurse doing the test said that if I did not have Addison's (which she felt was unlikely since my cortisol was only just below the level that they test at) then they would need to do further testing, presumably to see if there is a problem somewhere else in the pituatary, adrenal axis (if I have that correct? Not sure).

I have realised that I do have some symptoms that are Addison's, but some of them could be from the menopause (last period in October).

I am also suffering with hip arthritis and bone spurs and am a couple of years away from a (private) hip replacement, and the surgeon has said that I would probably benefit from cortisone injections into the joints. I think it probably will work, as I feel much better today, after the synacthen from the injection I presume!

I would love to be able to walk for the summer (and a party in June: I love to dance!) but don't know whether I should have the injections as I don't know what further testing might be done.

I have not discussed any symptoms to do with low cortisol with the endo because it was an initial appointment to do with suppressed TSH due to T3 only.

Question is what further tests might I expect and would they be affected by cortisone injections?

[Angel_of_the_North]

If you don't have an abnormal short synacthen test, it's pretty unusual for the NHS to do any further testing. All they do anyway is to test until something comes back normal so they can discharge you (if they are really unlucky you have Cushings or Addisons). The next step would be CT scan or MRI and insulin stress test (and ECG is they haven't already done one)

[PiggySue in reply to Angel_of_the_North]

I have already had an ECG, and was previously tested for Cushings (some years ago). The nurse said that if it was not Addison's then there would be more tests, and I stupidly didn't check what they would be and whether they would be affected by cortisone injections.

[Angel_of_the_North in reply to PiggySue]

Well, if they are for adrenals they will be affected by cortisone injections) as was your short synacthen test). Might test for diabetes, but otherwise I don't know as my short synacthen test was abnormal.

[PiggySue in reply to Angel_of_the_North]

Oh no, I'm sorry. Do you have Addison's?

Are you getting the help you need?

I believe that there may be other hormone tests including the gluco-whatever for Diabetes, but not sure what.

[Angel_of_the_North in reply to PiggySue]

No. I was about 1 or 2 points too high for Addisons, therefore I am "normal, no action". I did alternative therapy (glandulars and meditation etc) and am mostly Ok now after a lot of years as long as I'm careful not to overdo the stress (of any sort).