pl-932.1-short-synacthen-test

Short synacthen test
Information for patients

This leaflet answers some of the questions you may have about having
a short synacthen test. It explains the purpose of the test and the side
effects you may have during the test. This leaflet also explains what you
can expect when you come to hospital. If you have any other questions or
concerns, please speak to the doctors or nurses caring for you.
Confirming your identity

Before you have a treatment or procedure, our staff will ask you your
name and date of birth and check your ID band. If you don’t have
an ID band we will also ask you to confirm your address.
If we don’t ask these questions, then please ask us to check.
Ensuring your safety is our primary concern.
www.kch.nhs.uk
What is a short synacthen test?
This test is done to assess the function of your adrenal glands.
The adrenal glands are situated on top of both kidneys and are
responsible for producing cortisol. Cortisol is a hormone which
is essential for health and is particularly important in stressful
situations. The adrenal glands produce cortisol in response to
adrenocorticotrophic hormone (ACTH), a hormone produced by the
pituitary gland.
During this test you receive an injection of synthetic ACTH to

stimulate cortisol release from your adrenal glands. We are then
able to assess how much cortisol you are able to produce by taking
blood samples.
Why do I need this test?

This test is necessary to find out if there is an adequate level of
cortisol production in response to stimulation.
Cortisol is a hormone produced by the adrenal glands and plays an

important role in your body’s response to stress and illness. Cortisol
is also involved in regulating your blood sugar, blood pressure and
immune system. Greater amounts of cortisol are produced by your
body in times of illness. If your body is unable to produce enough
cortisol you may not be able to cope with illness and could become
very unwell.
What are the benefits?

This test will allow us to find out if your adrenal glands are able to
produce a sufficient amount of cortisol in response to ACTH. The
results of this test allow the endocrine team to decide if you
require treatment or if you are currently on treatment, whether this
should continue.
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What are the risks?
A cannula (tiny plastic tube) will be inserted into a vein in your arm
or hand using a needle. The cannulation process is similar to that of
a blood test. Associated risks with cannulation or a blood test may
include:
• multiple punctures to locate veins
• bleeding from puncture site
• bruising
• haematoma (blood build up under the skin)
• fainting or feeling lightheaded
• infection (a slight risk any time the skin is broken)
• phlebitis (inflammation of the vein)
Keeping pressure on the puncture site for a few minutes after the
needle is removed will help to reduce bruising.
During this test you will be given an injection of synthetic ACTH

(synacthen) into your vein. As with any new medication there is a
small risk of allergic reaction. In extremely rare cases this medication
can cause adrenal bleeding. More commonly you may feel warm,
light-headed, or nauseous (feeling sick). These feelings should
subside quickly.
Are there any alternatives?

To assess for primary hypoadrenalism there are no alternatives to
this test.
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Consent
We must by law obtain your written consent to any operation
and some other procedures beforehand. Staff will explain the
risks, benefits and alternatives before they ask you to sign a
consent form. If you are unsure of any aspect of the treatment
proposed, please do not hesitate to speak with a senior member
of the staff again.
Do I need to prepare for my test?

If you are taking hydrocortisone tablets or any other steroid (for
example, prednisolone or dexamethasone) do not take these tablets
on the day of the test. On the day before the test do not take any
steroid past 9pm. Do not use any steroid inhalers or creams on the
day of the test or 12 hours before the test.
If you are on oral oestrogens (oral contraceptive pill containing

oestrogen or oral HRT) you should stop these six weeks before the
test. You may continue using oestrogen gel or patches. Please call to
discuss with a member of the nursing staff on 020 3299 3034.
Apart from the medications mentioned above you can continue to
take your other regular prescribed medications.
What happens before my test?

Your blood pressure will be taken and the nurse will ask you about
your regular medications. A consent form will be completed and you
will be asked to sign this.
What happens during my test?

A cannula (tiny plastic tube) will be inserted into a vein in your arm
or hand using a needle from which blood samples will be taken.
The nurse will then give the synthetic ACTH (synacthen) through
the cannula. You may have side effects of the synacthen injection
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during the test. You may feel all or some of the following symptoms:
flushing (a warm sensation), nausea (feeling sick), light-headedness,
or a metallic taste. These side effects do not last for long and should
not be felt by the end of the test. Some people do not have any
side effects.
A blood sample will be taken at 30 minutes and 60 minutes after

the synacthen has been given. The test is one hour long.
How long does the test take?

The test lasts for one hour from the time the nurse gives you the
synacthen. You should expect to be in the unit for one and a half to
two hours.
What happens after my test?

Once the test has been completed the cannula will be taken out and
you will be able to go home.
If you are taking steroids: continue to take your steroid tablets as

before until you hear from the hospital.
Results will be reviewed by the endocrine team. They will either be

sent to you by letter or, in some cases, discussed on the phone or
with you at your next clinic appointment. We will also send a letter
to your GP. This may take up to six weeks.
Contact
If you have any queries or concerns please contact the Programmed
Investigation Unit (PIU).
Tel: 020 3299 3034 or 020 3299 1385. Opening hours: 8am to
6pm, Monday to Friday.
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Sharing your information
We have teamed up with Guy’s and St Thomas’ Hospitals in a
partnership known as King’s Health Partners Academic Health
Sciences Centre. We are working together to give our patients the
best possible care, so you might find we invite you for appointments
at Guy’s or St Thomas’. To make sure everyone you meet always has
the most up-to-date information about your health, we may share
information about you between the hospitals.
Care provided by students

We provide clinical training where our students get practical
experience by treating patients. Please tell your doctor or nurse
if you do not want students to be involved in your care. Your
treatment will not be affected by your decision.
PALS
The Patient Advice and Liaison Service (PALS) is a service that offers
support, information and assistance to patients, relatives and
visitors. They can also provide help and advice if you have a concern
or complaint that staff have not been able to resolve for you. The
PALS office is located on the ground floor of the Hambleden Wing,
near the main entrance on Bessemer Road - staff will be happy to
direct you.
PALS at King’s College Hospital, Denmark Hill, London SE5 9RS

Tel: 020 3299 3601
Email: kch-tr.palsdh@nhs.net
You can also contact us by using our online form at

www.kch.nhs.uk/contact/pals
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If you would like the information in this leaflet in a different
language or format, please contact PALS on 020 3299 1844.
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PL932.1 March 2021 Ambulatory Care
Review date March 2024 Corporate Comms: 2508

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Short synacthen test

Information for patients

Confirming your identity

During this test you receive an injection of synthetic ACTH to

Why do I need this test?

Cortisol is a hormone produced by the adrenal glands and plays an

What are the benefits?

During this test you will be given an injection of synthetic ACTH

Are there any alternatives?

Do I need to prepare for my test?

If you are on oral oestrogens (oral contraceptive pill containing

What happens before my test?

What happens during my test?

A blood sample will be taken at 30 minutes and 60 minutes after

How long does the test take?

What happens after my test?

If you are taking steroids: continue to take your steroid tablets as

Results will be reviewed by the endocrine team. They will either be

Care provided by students

PALS at King’s College Hospital, Denmark Hill, London SE5 9RS

You can also contact us by using our online form at

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