Saly, I assume when you say that you have to do the Synacthen test yourself that you have to guide the doctor or the people at the pathology lab as to what to request and do???? You will need to have a person proficient in taking blood and administering the Synacthen to be with you. Also it is wise to have medical backup, because on rare occasions people have a reaction to the Synacthen and its effects need to be reversed by giving intravenous Hydrocortisone.
Tetracosactrin is simply the pharmacological name for Synacthen so either is fine although Synacthen is the 'name' more commonly used.
There is a 1 ug (microgram) - sometimes called the short synacthen test (SST) or the 250 microgram dose (standard) which can be used. There are a lot of studies indication that the low dose 1 ug is quite effective also in diagnosis of adrenal insufficiency.
The ACTH stimulation test (Synacthen) should be done in the morning starting at at 8am (preferably before eating). A baseline level of ACTH, cortisol and other hormones * need to be taken immediately before the giving of the Synacthen, then another blood draw 30 minutes later and then another at 60 minutes. Depending on what condition is being investigated will depend on what hormones are looked at. If you are looking for 21 hydroxylase deficiency CAH then need to include on request for pathology lab 17-hydroxyprogesterone, androstenedione, testosterone, DHEA, 17-hydroxypregnenolone, as well as, cortisol.
There is an ideal time in the monthly cycle to do the test (which I have forgotten) however I think it is better to do it in the first part of the cycle - from memory. Not during the ovulation phase.
