Re: Bump - My Short Synacthen Test Results - Pah!

[Guest guest]

Hi , The short syntacthen test is for diagnosing Cushings Disease- too much cortisol or s' which is complete failure of the adrenals- it isn't for picking up the shades of grey in between that the salivary cortisol does- because it is anartificial stimulation not a natural level. The salivary readings are very low which is not uncommon for poorly treated hypo. > Basal: 577 nmol/L> 30 mins: 1008 nmol/L> 60 mins: 1151 nmol/L> > The Endo said "you must have had a stressful morning as your basal figure is normal". I said "well, yes, a drive on my own, in heavy traffic, in the dark, to the hospital, having fasted for the best part of 12 hours, is bound to be stressful".> > I've left an answerphone message for Dr P's secretary and will be seeing him as soon as I can get an appointment.> > > Thanks in advance> J> > P.S. Just for the sake of completeness, these were my adrenal saliva test results:> Sample 1/8 a.m. 12.8 (12-22)> Sample 2/Noon 1.7 L (5.0-9.0)> Sample 3/4 p.m. 0.9 L (3.0-7.0)> Sample 4/10 p.m. 0.3 L (1.0-3.0)> > Total daily cortisol 15.7 L (21-41)> > DHEA> Sample 2 0.42 (inside range)> Sample 3 0.35 (inside range)> > DHEA : Cortisol Range 2.45> > > > > ------------------------------------> > TPA is not medically qualified. Consult with a qualified medical practitioner before changing medication.> >

[Guest guest]

yvonne,

I am due to get one done shortly was it Ok..? or did you feel woozy at all../ Am

not looking forward to it as i feel endo will just use it as an excuse to right

me off, although it was his idea not mine, I didn't even mention adrenals.

[Guest guest]

Hi

I was kind of hoping they would diagnose 's but it obviously wasn't to

be. I've well and truly had enough of endos now. I've made an appointment with

Dr P for next month, and I'll sure he'll be able to help me.

Thanks for your reply

J

>

>

> Hi ,

> The short syntacthen test is for diagnosing Cushings Disease-

too much cortisol or s' which is complete failure of the adrenals- it

isn't for picking up the shades of grey in between that the salivary cortisol

does- because it is anartificial stimulation not a natural level. The salivary

readings are very low which is not uncommon for poorly treated hypo.

>

>

[Guest guest]

Hi ,

The Synacthen Test is mainly a Test for Primary s disease. It can be

possible to have false negative results if you have a Pituitary or Hypothalamus

dysfunction. ie the adrenals are healthy but are not receiving the messenger to

tell them to work..(ACTH)

For the Test you had a lovely injection of ACTH and your adrenals responded.

This is what happened to me. I forget my exact numbers but they were lower than

yours .... 330, 650, 460 and was told this was normal.

The Endo is just following the text book and not thinking. It is possible for

Secondary AI to have the adrenals work if they receive ACTH - esp in the early

stages of the disease and before they atrophy.

To be really sure re Secondary Adrenal Insufficiency there is another Test -

the Insulin Tolerance Test where Insulin is injected and the levels of Cortisol,

Growth Hormone and Insulin are measured. It is a very dangerous test and not

used a lot. Insulin is brought down to 1.5 or thereabouts.

Re your pre diabetes -I recently lowered my fasting BS by reducing carbs and

eating more eggs, meat and veg. No potato ,fruit or simple carbs. I have been

5.6 for years and considered pre diabetic and it dropped to 5.3 ... I bake GF

muffins with almond flour - low carb there too. Also found I do better on T3

only and not Nature Thyroid.

I was just browsing as I am ill today and spotted your Synacthen Test question.

Hope it helps.

For me - I gave up going to Endos and stayed with my holistic style GP. Much

easier and far better knowledge ;-)

Jane

>

> I saw the Endo again and these are my short synacthen results:

>

> Basal: 577 nmol/L

> 30 mins: 1008 nmol/L

> 60 mins: 1151 nmol/L

>

> The Endo said " you must have had a stressful morning as your basal figure is

normal " . I said " well, yes, a drive on my own, in heavy traffic, in the dark, to

the hospital, having fasted for the best part of 12 hours, is bound to be

stressful " .

>

> He said since 1151 is more than double 577, I don't have an adrenal problem. I

make 1151 just very slightly LESS than double 577...

>

[Guest guest]

Hi Jill, Sorry to chip in. I felt really well during my test. The best I had

felt in ages. As I left the Hospital I started to feel trashed and driving home

was a nightmare. If possible make sure you have a driver. I ended up with a

massive headache and the shakes as all the lovely cortisol left me ... ( I

think) and I felt dumped.

Drink lots of water - it helps them find the veins - if you have low BP the

veins always seem to disappear. As it was, they took 15 mins to find mine ( 2

drs, 3 nurses)and get the IV in and I was nearly on the ceiling by this time....

so my fasting level of 330 cortisol may have been a touch higher than normal lol

I was told it has to be IV as single blood draws each time raises the

patient's cortisol ( needle phobias). For me the IV was there and they crept up

on me ( was reading a book)so I did not even see them start doing the 30 min and

60 min draw... this was to keep it as accurate as possible. Is serum ATCH being

tested in the first fasting ( pre test) blood draw ?

Jane

>

>

>

> yvonne,

>

> I am due to get one done shortly was it Ok..? or did you feel woozy at all../

Am not looking forward to it as i feel endo will just use it as an excuse to

right me off, although it was his idea not mine, I didn't even mention adrenals.

>

[Guest guest]

Hi jane,

I am not too sure just mentioned test for underactive adrenal gland which I'm

presuming is short syc...they didn't mention anything about fasting or serum

ATCH being measured in first draw at all, I presume will either be on

appointment letter ( presume will mention fasting there ) or when get there. Can

i ask did you stop your adrenal supplements ( if on any) and or thyroid meds

before hand..?

Thanks

xx

[Guest guest]

Hi Jill, Yes you need to be off all cortisone before the Test. Its a

controversial subject as some Endos say 12 hours, some say 24 hours and some say

2 weeks. Word I have received froma reliable source is to switch to

Dexamethasone for 2 weeks prior to the test 9 if you can't be without them that

is). Of course - try telling this to a Endo who only knows about diabetes... I

can't quite remember but do not think I had to fast food or thyroid. I may be

wrong here.

I fasted cortisone 12 hours before my Synacthen test. I now know - with the

experience I have had since - that a dose reduction can take up to 5 days to

work 'for me'. Everyone may be different but if I reduce HC ...I often can

manage for 5 days before a near crisis. This fact alone makes me suspect

oddities re the concept of only 12 hour fast or 24 hour fast etc

My lowest reading was 263 before starting HC. Add 200 to that and you start to

see how a Synacthen Test may have come back borderline for me ... had my lowest

reading happened on the day of the Test.

As it was - I only fasted 12 hours, I was stressed to the hilt, had to drive

150km, park the car, fight traffic, find a new Hosp, have 2 Drs and 3 nurses

discuss my vein in terrible detail while sticking needles into me ( you get the

picture)

I don't believe my fasting cortisol level was accurate that day, and neither

does my GP.

Try to check for the fasting serum ACTH level to be tested. It has to be handled

correctly at at the testing lab immed. But it can tell a lot re Primary of

Secondary... And aldosterone /renin. All those 3 need special fast track

processing and if you are at the hosp anyway - may be a good chance to have them

done ( correctly)

Have you had adrenal antibodies tested ?

Good luck with the test!

Jane

>

>

> Hi jane,

>

> I am not too sure just mentioned test for underactive adrenal gland which I'm

presuming is short syc...they didn't mention anything about fasting or serum

ATCH being measured in first draw at all, I presume will either be on

appointment letter ( presume will mention fasting there ) or when get there. Can

i ask did you stop your adrenal supplements ( if on any) and or thyroid meds

before hand..?

>

> Thanks

> xx

>

[Guest guest]

Hi Jill, you're welcome! And good luck with your test - let us know how you get

on.

Hi Jane, thanks for your comments. I hope you're feeling better soon.

It's been really interesting to compare your experience with mine, especially

given that I also found driving home difficult and got the shakes when I got in.

I had 3 separate needles stuck in my arm to draw the blood. However, I'm not at

all needle phobic, so I guess it won't have caused me extra stress and the vein

is always easy to find anyway.

Oh yes, given my nightmare drive to the hospital, I don't believe my fasting

cortisol was accurate either!

I asked the Endo if adrenal antibodies could be tested and he said there was no

point, grrrrr!

I low-carbed since 2004, but I've gone off the rails somewhat in recent months,

especially over Christmas. I reckon I could easily get my blood sugar under

control - I just have to be strict with myself )

Well, I've given up with Endos now - I'm seeing Dr P mid-February

J

>

> Hi ,

>

> The Synacthen Test is mainly a Test for Primary s disease. It can be

possible to have false negative results if you have a Pituitary or Hypothalamus

dysfunction. ie the adrenals are healthy but are not receiving the messenger to

tell them to work..(ACTH)

>

[Guest guest]

>Well, I've given up with Endos now - I'm seeing Dr P mid-February

I can second that ! :-) A good GP is better than 10 bad Endos ;-)

Good luck with the low carb. I am finding almond flour baking is the way to go

and the GF Almond Flour cookbook by Elana Amsterdam is brilliant. She is a

genius for creating low carb/high protein sweet and savoury baking that is

satisfying and healthy. Her interest in low sugar load is due to the fact that

the Coeliac gene sits close to the diabetes gene - so right from the start of

her GF baking she decided it had to be diabetic friendly as well. I have some

apricot squares in the freezer all the time now and my BS fell by 3 points for

first time in 6 years ! And no sugar cravings/false hunger etc

Jane

>

>

>

> Hi Jill, you're welcome! And good luck with your test - let us know how you

get on.

>

> Hi Jane, thanks for your comments. I hope you're feeling better soon.

>

> It's been really interesting to compare your experience with mine, especially

given that I also found driving home difficult and got the shakes when I got in.

>

> Oh yes, given my nightmare drive to the hospital, I don't believe my fasting

cortisol was accurate either!

>

> I asked the Endo if adrenal antibodies could be tested and he said there was

no point, grrrrr!

>

> I low-carbed since 2004, but I've gone off the rails somewhat in recent

months, especially over Christmas. I reckon I could easily get my blood sugar

under control - I just have to be strict with myself )

>

> Well, I've given up with Endos now - I'm seeing Dr P mid-February

>

> J

>

[Guest guest]

Good luck with the test!

Hi Jill/Jane - thanks for all the info, how did you get on with the test Jane?

Saw my nhs endo on Wednesday to try and get HC prescribed - he listened to me

which was a start (he prescribed T3 for me last year) but said that there was no

biochemical indicator to say I needed HC although I told him that without HC I

couldn't touch a grain of T3 (had to go on it as the natural glandulars wouldn't

touch the spot either).

He did say however, that the short synacthen test and the 9 am cortisol blood

tests are both very CRUDE tests and that the salivary cortisol tests were not

recognised by nhs labs.

did anyone see 'Embarrassing bodies' on Wed last week I think - the good looking

doc did SALIVARY CORTISOL tests to test stress in City workers - can't find any

mention in the channel 4 website.

He did say he would let me do another synacthen test (had one in January 08 but

no joy) but by listening to all your posts, don't think I will put my body

through it.

Any more info anyone - my goal is to get the HC on prescription!

Luv Keri

[Guest guest]

Hi Keri - first, copy out the attached document and tell this

endocrinologists that there is nothing in that document that the NHS CANNOT

RECOGNISE. Tell him also that the NHS short synacthen test will test ONLY to

see whether a patient is suffering with 's disease (too little or NO

cortisol output) or Cushing's Syndrome (too high a level of cortisol output)

and that this test is only a snapshot of what your adrenals are putting out at

one period during the day. Tell him that you are a\ware that for anybody giving

synacthen injection (adrenaline) that unless you did have 's, then of

course your adrenals would react, because the adrenaline would make a dead

donkey kick and would show you do not have an adrenal problem at all.

Medical

groups that have studied adrenal-cortisol testing by saliva samples, have

determined this type testing to be accurate, as well as less intrusive and more

convenient than blood sampling. See Dr Thierry Hertoghe's References on our web

site www.tpa-uk.org.uk under

'Information for Physicians' Mention is made in these studies that multiple

levels can be obtained at different points of a full day-cycle (24 hour period)

which would be difficult to accomplish by blood sampling. Saliva samples can be

done in the convenience of your own home while multiple blood draws would

require long stays or repeated visits to blood draw clinics when taking

multiple samples during a 24-hour period - and they won't do that in the NHS.

When citing conclusions on saliva testing to detect Cushing’s syndrome,

the Journal of Clinical Endocrinology & Metabolism states that it is as

accurate as plasma measurements and better than 24 hour urine excretion.

Don't

let this endocrinologist get away with it Keri - there is too much scientific

evidence out there to show him how wrong he is. He needs to do his research See

below

Salivary cortisol Measurements

Read more at Suite101: The Accuracy of Saliva Adrenal Cortisol Testing: How does

Saliva Cortisol Compare to Blood Levels? http://endocrine-disorders.suite101.com/article.cfm/the_accuracy_of_saliva_adrenal_cortisol_testing#ixzz0fXPbxj0g

Luv

- Sheila

He did say however, that the short synacthen test and the 9 am cortisol blood

tests are both very CRUDE tests and that the salivary cortisol tests were not

recognised by nhs labs.

did anyone see 'Embarrassing bodies' on Wed last week I think - the good

looking doc did SALIVARY CORTISOL tests to test stress in City workers - can't

find any mention in the channel 4 website.

He did say he would let me do another synacthen test (had one in January 08 but

no joy) but by listening to all your posts, don't think I will put my body

through it.

Any more info anyone - my goal is to get the HC on prescription!

Luv Keri

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