Children and Young People’s Endocrine Team
Your child has been asked to come to either children’s outpatients or the paediatric decisions unit for a standard short synacthen test
The purpose of this test is to assess the production of an important hormone called CORTISOL which is normally produced by the adrenal glands. These are situated just above the kidneys.
What is cortisol?
Cortisol is a hormone which helps the body to cope with stressful situations, for example; illness. Its job is to regulate the blood glucose levels.
The release of cortisol is controlled by a messenger hormone called ACTH (adrenocorticotrophic hormone) which comes from another gland deep in the brain called the pituitary gland.
In order to assess if your child is producing sufficient amounts of cortisol to help their body cope with stressful situations and be able to regulate their glucose level, we need to assess the response to an injection of the messenger hormone ACTH.
Your child does not need to have any special preparation prior to the test and can have their breakfast as normal.
This test is best performed on a morning, you will be told where to go for the test:
- PDU (Paediatric Decisions Unit)
PDU is situated in the maternity entrance to the hospital, up the stairs, turn right along the corridor and next to ward 21 - Childrens outpatients
Enter through the South Entrance, go through the revolving doors opposite the big blue globe, past the lifts and left down the small corridor next to the parking pay station.
Please note there is a parking charge and parking can on occasion be a problem, so please allow sufficient time before your appointment.
The test
The test involves inserting a cannula into a vein.
This is a very small plastic tube which has a needle inside; the needle pierces the skin and introduces the plastic tube into a vein – usually the back of the hand or inside the elbow.
The needle is removed and leaves the cannula inside the vein; it is secured in place with tape and a bandage and flushed with saline to keep it from blocking.
Before we insert the cannula we normally use local anaesthetic freezing spray (cryogesic) to numb the area which works immediately or we can use local anaesthetic cream (magic cream) which takes about 45 min to 1 hour to work.
We will let you choose which you would prefer on the day of the test.
Once the cannula is inserted a sample of blood will be drawn from it. This is the baseline level which will let us know how much Cortisol and ACTH are already circulating in the system.
Any other blood tests that the doctor has requested will also be taken at this time.
An injection of the messenger hormone ACTH will then be injected via the cannula (Synacthen). Synacthen is a synthetic form of the natural messenger ACTH produced by the pituitary gland (SynACTHen).
The dose will be calculated by the doctor or specialist nurse. It’s aim is to stimulate the adrenal glands to produce cortisol.
There should not be any side effects from the medication, however please be assured that we will observe your child closely for any undue effects and act on them accordingly.
30 minutes after the injection of synacthen a further blood sample will be drawn from the cannula and again at 60 minutes. This should allow us to determine the amount of cortisol that your child has produced in response to the stimulation.
The cannula can now be removed and you will be allowed home.
Results
The results will go to the consultant who has requested the investigation. They usually take around 2 weeks, though please be assured that if there is a problem we would contact you sooner than this.
Your consultant will usually explain the results to you at your next outpatient appointment, where the next course of action can be discussed and decided upon.
Contact us
If you have any further questions regarding the test, please do not hesitate to contact one of the following people:
- Julie Stonehouse – Children’s Endocrine Nurse: 01642 854660
- Dr Burns – Consultant Paediatrician for Endocrinology: 01642 837187
- Dr Balasubrahmanyam or Dr Raman – Consultant Paediatricians for Endocrinology: 01642 282723
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.
T: 01642 835964
E: [email protected]
The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW.
Telephone: 01642 850850
