Further tests

Hello, I am in the process of having further tests, one of which is for low cortisol and so an ACTH test is scheduled? Is it common for such a test to be given at a GP practice as I thought this was done by the endocrinologist? Or perhaps this test is done locally for then referral (if necessary)? If this test proves I have a problem, is this something to be concerned about as reading up about the various possibilities, it sounds like it is something to be taken serious and can be life-threatening?

[humanbean]

ACTH is often tested as part of a Short Synacthen Test.

See pages 68 - 70 in this link :

imperialendo.co.uk/Bible201...

Number one on the list of things to do in the Method section (top of page 69) says that ACTH must be put on ice and taken to the lab immediately. Unless the GP surgery taking your blood sample is actually in the grounds of a hospital with a pathology department I doubt if this would be accurate.

Apart from what I've just written I know absolutely nothing about ACTH testing. It is possible that you are having a test for which putting a sample on ice and taking it straight to the lab is not necessary - but I really wouldn't know, you would have to find out the exact test you are being given.

[greygoose in reply to humanbean]

ACTH (testing)

Your doctor will confirm a deficiency with a CRF (corticotropin-releasing factor) test. After taking a baseline reading, he or she will inject CRF into your veins to stimulate the secretion of ACTH. You have a deficiency if levels of ACTH and cortisol in your blood do not double in thirty to sixty minutes.

The Hormone Solution by Thierry Hertoghe MD.

Doesn't sound like the sort of thing a GP would do. Must be some other sort of test. Is he perhaps sending you to a hospital lab to do that?

[SlowDragon Administrator]

How much Levothyroxine are you currently taking?

What are your most test results and ranges

Low cortisol can result from being under treated for hypothyroidism

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water . This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

[Hidden]

Are they testing for low cortisol by doing an early morning blood cortisol or are they doing an ACTH blood test? Serum cortisol can be done by your GP but an ACTH is usually done at the start of the short synacthen test before artificial ACTH is given. ACTH needs to go on ice straightaway which is why it is done at the hospital. The short synacthen test shows how your adrenal glands respond to the artificial ACTH, the base cortisol number should double at least to 450nmol/Ls. It's important to have the ACTH taken at the start as this shows if the pituitary gland is producing ACTH which in turn causes the adrenal glands to secrete cortisol. It does need to be done by an Endocrinologist as most GP's have little knowledge of the condition. Both primary adrenal insufficiency(Addisons) & secondary adrenal insufficiency (pituitary cause) need to be treated very seriously as you can die if you do not have enough cortisol in your body, treatment is the same for both conditions with steroids. Hope that helps?

[topaz1 in reply to Hidden]

Thank you for this info. I am considering asking for this test as my cortisol levels are below range all day.