Un-necessary use of Short Synacthen Test?

[Guest guest]

Very interesting paper that suggests when the 9am serum cortisol level

is below 100 nmo1/l there should be no need to do the Short Synacthen.

In this Charing Cross Hospital study

http://www.ncbi.nlm.nih.gov/pubmed/11930947?dopt=Abstract 210 people

were given the Short Synacthen Test. Of the 210 tested, not one of

those who had a morning cortisol below 100 nmo1/l showed an adquate

response to the Short Synacthen. On other words if the 9am serum

cortisol level is below 100nmo1/l there is no need to put the patient

through the Short Synacthen Test.

Mine was just 130 nmo1/l on 28th April this year (range 250 - 850).

Had it been 30 nmo1/l less the Short Synacthen would not be necessary

in my case. according to the study which showed that nobody who had

basal serium 9am cortisol less than 100 showed an adequate response to

the Short Synacthen.

Now I am curious, has anyone in this group had a basal 9am serum

cortisol of less than 100 nmo1/l yet still been able to show an

adequate response to the Short Synacthen? I have heard that for the

most part people will show an adequate response, due to the nature of

the test and the fact that they inject you with 100 times more ACTH

than the pituitary would produce. I am wondering what generally

happens to people like myself who are slightly above the 100 nmo1/l

cut-off point, during the Short Synacthen Test.