Stopping HC for Short Synacthen Test

[Guest guest]

Hello,

I have been asked by my lastest endocrinologist to stop my HC (I am

on 30mg daily on the advice of Dr.P) for a week in order to have a

short synacthen test.

I suggested maybe I should taper the HC but he said no, just stop it

abruptly. The test is scheduled for next Friday so I have got over a

week to get off it.

I found something on the web that said HC should not be taken for 24

hours before a short synacthen test. I am not sure how long I need to

stop HC for in order to have this test. Or if the test will be useful

at all.

Once again I was seen by an endocrinologist who was not the one I was

referred to and his attitude towards the treatment I had been

recommended by Dr P was quite hostile.

Can anyone comment about the HC? I don't think it will be very

pleasant to stop it abruptly even if only for a week.

I'm also on 15mcg T3 which I have only been on for three weeks so far.

Jane

[Guest guest]

Hi Jane

Before

such a test, you should stop your HC for at least 6 weeks. Your endocrinologist

is INCORRECT and you should not stop your HC abruptly. Abruptly stopping hydrocortisone for some people can cause

symptoms of corticosteroid insufficiency, with accompanying nausea, vomiting,

and even shock. This is why it is recommended you stop through gradual

tapering. This method minimises the symptoms of corticosteroid insufficiency.

The insufficient adrenal gland function may not recover fully for months after

stopping hydrocortisone abruptly. Telephone Dr P for advice about this as a matter of urgency. Your

test next Friday will show that you have plenty of cortisol and the test will

be a complete waste of his time and your time. Your blood is tested before the

injection and then afterwards. You will get an immediate boost after being

injected with Synacthen and as I keep saying over and over, this injection

would make a dead donkey kick.

Is this

endocrinologist wanting to test your adrenal function himself because he

doesn't believe your 24 hour salivary profile results done privately?

You

could ask to be referred to another endocrinologist of your choice. Is there a

more sympathetic one at your hospital you have seen before. Once you get a good

one you can work with, have the Outpatients Clinic Nurse write on your medical

notes that you will ONLY see that particular person. This is what I do and I

have refused consultations with any other doctor but the one I have chosen.

Luv -

Sheila

Hello,

I have been asked by my lastest endocrinologist to stop my HC (I am

on 30mg daily on the advice of Dr.P) for a week in order to have a

short synacthen test.

I suggested maybe I should taper the HC but he said no, just stop it

abruptly. The test is scheduled for next Friday so I have got over a

week to get off it.

I found something on the web that said HC should not be taken for 24

hours before a short synacthen test. I am not sure how long I need to

stop HC for in order to have this test. Or if the test will be useful

at all.

Once again I was seen by an endocrinologist who was not the one I was

referred to and his attitude towards the treatment I had been

recommended by Dr P was quite hostile.

Can anyone comment about the HC? I don't think it will be very

pleasant to stop it abruptly even if only for a week.

I'm also on 15mcg T3 which I have only been on for three weeks so far.

Jane

[Guest guest]

Thank you so much for your speedy reply Sheila. Yes, the endo did 'poo

poo' my saliva test results... but then he took them to be photocopied

for my notes anyway - which seemed contradictory and dare I say it

hypocritical?

I wish I had refused the appointment with him. My GP had written asking

for me to be seen by one of the professors in the department but the

letter had been ignored. He asked me if I would like to come back

another day and be seen by the professor, but as I had waited three

months for this appointment and jumped through hoops to get the time

off work I went ahead with it.

He wasn't even able to print out my blood test results (from my pre-

appointment three months ago). I got his secretary's number to get them

sent on to me.

There were a couple of out of range - and the one I can remember was

calcuim - it was below the normal range. I am taking Vitamin D and the

endo also scheduled a vitamin D test for the same day as the SST. I

think I should cancel the SST, still have the Vitamin D test if I can,

and then go and see the professor.

In truth I don't know if the professor will be any better. I don't know

any of the consultants there, its just the local hospital and the

professors seemed to be known by my consultant gyneacologist.

Maybe I need to go back to the list you kindly sent of consultants who

are more enlightened. I didn't have any luck when I tried to be seen by

one of them before - I was given an appointment with someone else in

spite of requesting the one from your list by name.

I would like to get my treatment confirmed by a consultant endo as then

my GP will prescribe the meds I need and I won't have to keep ordering

them from the internet.

I think it would be worth the expense of seeing someone privately to

then be able to get my meds for free on prescription (I hold a free

precription certificate as I have hypothyroidism).

Thanks again for the advice. I will call Dr. P and I won't stop my HC

abruptly.

Jane

> Is this endocrinologist wanting to test your adrenal function himself

> because he doesn't believe your 24 hour salivary profile results done

> privately?

I have refused consultations with any other doctor but the one

> I have chosen.

>

[Guest guest]

Hi Jane,

When I was told by my GP to stop prednisone I was carefully tapered

down over 3 months to allow my own adrenals to pick up the strain if they

could ( couldn't, but that is another story. This concerns me. In your shoes

I'd do a bit of reading- try wikipedia for a start.

Stenning

Subject: Stopping HC for Short Synacthen Test

Hello,

I have been asked by my lastest endocrinologist to stop my HC (I am

on 30mg daily on the advice of Dr.P) for a week in order to have a

short synacthen test.

I suggested maybe I should taper the HC but he said no, just stop it

abruptly. The test is scheduled for next Friday so I have got over a

week to get off it.

I found something on the web that said HC should not be taken for 24

hours before a short synacthen test. I am not sure how long I need to

stop HC for in order to have this test. Or if the test will be useful

at all.

Once again I was seen by an endocrinologist who was not the one I was

referred to and his attitude towards the treatment I had been

recommended by Dr P was quite hostile.

Can anyone comment about the HC? I don't think it will be very

pleasant to stop it abruptly even if only for a week.

I'm also on 15mcg T3 which I have only been on for three weeks so far.

Jane

------------------------------------

TPA is not medically qualified. Consult with a qualified medical

practitioner before changing medication.

[Guest guest]

Thanks , I think I will postpone the test.

[Guest guest]

I've read a great deal about corticosteroid treatment, physiological

dosing, and from this it's quite clear that increasing and decreasing

doses must be tapered very slowly indeed, and that a sudden reduction

is dangerous!

Another point is that a lot of people consider the test you are to

have to be of little if any value.

Rgds

H

>

> Hello,

> I have been asked by my lastest endocrinologist to stop my HC (I am

> on 30mg daily on the advice of Dr.P) for a week in order to have a

> short synacthen test.

>

> I suggested maybe I should taper the HC but he said no, just stop

it

> abruptly.

[Guest guest]

Thanks for your comments and H, I will give the SST a miss then.

Still need to have the vitamin D test as my calcium was low in the

blood test results they showed me.

I hope I can work it out with them without appearing 'uncooperative'.

Jane