Synacthen test
Posted , 10 users are following.
Had this test last week. Blood test, then synacthen injection, waited half hr then 2nd blood test, then waited another half hour, 3rd blood test, then home. Very easy.
Results were cortisol level a bit down due to being on pred for nearly 4 years, but Synacthen showed I should be able to drop down from 5. 5mg very slowly. Will now use DSNS method as been finding it difficult to drop to 5mg. Glad I had it done as reassuring for now.
1 like, 11 replies
EileenH diana21296
Posted
I think it is important to have the reassurance that the adrenal glands CAN work. They may not in real life but at least it is worth trying to reduce further and isn't going to be causing a risk All the best.
diana21296 EileenH
Posted
Thanks. Will see as I'm so sensitive to drops. No pain as such but just feel ill and sometimes get hot flushes. Your DSNS method will maybe suit me better hopefully👍
EileenH diana21296
Posted
That's why we worked on the DSNS approach for so long - I took note of every bit of feedback I got. Some people do as little as 1/2mg (less if they are very dexterous!) and repeat each step 2 or 3 times!
diana21296
Posted
Yes, I have only dropped a half mg every so often since 16mg and been OK. DSNS from now on trying to get to 5! Could never have dropped by 1mgs that's for sure.
Michdonn diana21296
Posted
Diana, I was rushed into a very bad flare following my doctor's recommendations. Started using DSNS around 30mg and have continued to do so, sometimes with modifications or adjustments. I try never to reduce by more than 10%. Currently I am because I am on 3 tapering to 2.5mg. I would reduce by .25 by make a mess of it. Good luck believe me DSNS has worked for me. 🙂
Susanne_M_UK diana21296
Posted
I'm due to have this test in February, as I've been on high doses of pred for 5 years and low doses 4 years previously due to GCA and before that, PMR.
I've feeling feeling severely fatigued since dropping to 5.5mg and I've had to push for the test.
diana21296 Susanne_M_UK
Posted
Hope it goes well for you.
Susanne_M_UK diana21296
Posted
Thank you.
rocketman42 diana21296
Posted
Is there a specific indication for having the Synacthen test done ?
Wondering if I should request the test or is it only for when you get near physiologic levels of prednisone?
I have been on Prednisone for 3 1/2 years now and am having trouble decreasing below 13 mg. while using the DSNS method.
Rheumy has ruled out other potential diagnoses.
Anhaga rocketman42
Posted
You are right, you would need to be much lower than 13 mg before the test would be useful. Are there any other possible sources of your ongoing pain? For example I've found that pre-existing osteoarthritis has made it more confusing (but think it's sorted out now). Are there other factors in your life which could be causing problems? Do you work? Are you under unusual stress of any kind? And maybe you are someone who doesn't absorb the pred as efficiently as others so you actually need 13 mg whereas someone else might manage with a lower dose because they are absorbing the pred better. I found once I got to 2.5 after several unsuccessful taper attempts to go lower that by repeating each step of the DSNS taper I was able to taper successfully. It meant it took each .5 reduction three months! But as we often say, it isn't slow if it works.
EileenH rocketman42
Posted
Not even at physiological doses - most endocrinologists feel it is a waste until the patient is below 5mg, preferably about 3mg. Otherwise the presence of pred just means it isn't particularly meaningful/
I've had PMR for over 15 years, been on pred for over 10 years and still struggle to get below 11mg - 11mg seems OK, 10mg seems definitely not. I have been lower, down to 5mg at one point, and then it all flared up again. I wonder if in my case it is actually large vessel vasculitis, it has been suggested. There is no sign of any other form of rheumatic disease to cause the symptoms. But when I flare it also makes my atrial fibrillation worse - and that is considered to have been caused by the a/i part of the PMR damaging the electrical cells.