Short Synacthen Test

Why am I having this test?

The test is used to check whether your pituitary and adrenal glands are working normally.

The pituitary gland is situated at the base of the skull, and the hormone it produces stimulates other organs such as the thyroid and adrenal glands.

The adrenal glands sit on top of your kidneys and one of the hormones they secrete is called cortisol. The adrenal hormones help us to cope with physical stress by maintaining blood pressure and salt balance in the blood.

Your body may not be producing enough cortisol. It is therefore necessary for you to undergo a test to assess the amount of cortisol your body is able to produce.

Cortisol is vital for life, and we all need it:

• to keep our blood sugar levels stable.
• to maintain blood pressure within normal range.
• for our metabolism which is how we turn our food into energy
• for our immune system which protects us from infection
• For our fluid balance which makes sure that our body has the right amount of water

If you do not have enough cortisol in your body, you may feel weak, tired, dizzy and irritable. If the Synacthen test shows that you lack cortisol, you can be given medicines for this.

Who carries out this test?

A nurse who specialises in endocrinology is responsible for carrying out this test.

Where is the test carried out?

• You will be sent a letter with details of the test and which department you will need to attend.
• If you wish you may bring a companion with you. They may stay with you during the test.

What do I need to do before the test?

• If you are taking the contraceptive pill or HRT (Hormone Replacement Therapy) it may be necessary to stop these 8 weeks prior to the test, as they can interfere with the interpretation of the result. Please let the nurse know as soon as possible, as it may be necessary to stop them to make sure that a successful test result is obtained.
• You will need to use another method of contraception during this time.
• If you are pregnant or think that you may be pregnant, please let the nurse know as soon as possible.
• If you are taking hydrocortisone tablets, steroid inhalers, steroid nasal sprays, or steroid creams you may be asked to stop these prior to your test, as these may interfere with the test results. Please see your appointment letter for further details.
• If you are not sure which medication to stop, please contact the nurse who will be able to advise you.

What do I need to do the day before and the day of the test?

• Please take any other medicines as usual unless we have specifically asked you not to.
• Please bring all your medicines with you.
• You may eat and drink as usual before and during the test.

What happens during the test?

• On arrival you will meet the nurse who is responsible for the test. The nurse will explain the test and you will be given the opportunity to ask questions prior to the start of the test.
• It is important to start the test at approximately 9am as this is when your cortisol levels are at their highest.
• An initial blood test will be taken to check your baseline cortisol level.
• You will then be given a drug called Synacthen, which stimulates the adrenal glands to produce cortisol. This will be given in the form of an intramuscular injection in the top of your arm. Alternatively the synacthen may be injected into your vein using a small ‘butterfly’ needle.
• Once you have been given the drug, blood samples are taken after 30 minutes and possibly 60 minutes to measure the effect the drug has on your adrenal glands.

Are there any side effects?

• On occasions you may feel sick, vomit, feel dizzy, have palpitations (fast heart beat) and flushing may occur. These side effects are short lived (only minutes) and you should feel better quickly.
• If you suffer with asthma or have any chest conditions where you use an inhaler, please tell the nurse before the test, as Synacthen may make you feel wheezy.
• Very rarely an allergic reaction may occur.

How long will the test take?

Please allow 1 to 1½ hours for the test.

What happens after the test?

• Generally you should feel no after effects from the test and will be able to resume your normal daily activities.
• If you have been asked to stop any medicines prior to the test, the nurse will let you know when to restart the medicines.
• The results will be discussed at your next clinic visit or the specialist doctor/nurse will write to you and your GP by letter to inform you of the result.
• The nurse will arrange a further appointment if necessary.

If you require more details please contact the Specialist Nurses in Endocrinology:
Tel: 01274 382019 Monday – Friday between 8.00am and 4.00pm except Bank Holidays