What causes a bad reaction to ACTH test?

[drawingblanks]

hello!

I'm new to this board and am really hoping someone might be able to shed some light on this -- I had a severe reaction to a short synacthen test recently.

I'm 30 and have had low blood pressure for years (which drops when standing), severe acne, insomnia and hormonal issues and suspected adrenal condition. After waiting months and months for a referral, I finally saw an endocrinologist at Birmingham hospital (UK).

A minute after the ACHT was injected, I collapsed and passed out on the floor. My blood pressure fell dangerously low according to one of the nurses and I went pale, clammy and basically felt incredibly poorly. I felt very sick, confused and totally exhausted for the whole day after. The endo nurse who administered the injection didn't seem to know what to do and called my friend in who luckily came with me -- she gave me a sandwich and some water when I came round. The nurse then took my blood half hr later and I was too weak to question whether now the test would be inaccurate ....a week later I got the results and frustratingly my ACTH test came back "normal".

I have basically been dismissed by the endocrinologist now who was supposed to ring me back to discuss this but never did (despite me ringing several times). The endo nurse forgot to make any notes about what happened and I'm now left with no answers.

I've heard that people very rarely get an allergic reaction to the ACTH but I'm still wondering why I collapsed (especially considering the ACTH 'mimics' stress)?

Has anyone else had this? Do you think this is a normal reaction? I'd be very grateful for any advice/thoughts here.

Thanks in advance!

[hogo2000]

Hi.

I had the same think.  Had blood test felt fine. Cortisol was injected and about 30-45 seconds later I started to fell nauseous and felt like I was going to vomit and passed out.

Since then, 3 weeks ago I have had severe fatigue and nausea. Also had an abnormal ECG which was a first.  Anyone long term affects to this cort stim test reaction?

[Willjp]

Hi I had a similar episode, had blood test, then synacthen, felt faint straight after then pain went across my chest then passed out, woke up in a panic with 6 nurses standing around me, worst thing ever experienced. Has anyone had any conclusions to this? Still having ongoing tests Thanks

[rumpled]

The amount they give you should not be so much as to make a normal person not cope and plenty of abnormal people do the test with few issues - I know just one or two that have nausea most like I said may flush or get cold.

Is the doc planning on testing you another way? How is your sodium and potassium? Renin and aldosterone?  

Unfortunately fatigue is a very... general symptom and it can be so many things.

[woody444]

Thank you for your comments. I felt very nauseous immediately before I collapsed. All further testing was abandoned.( I think they were worried.) I was not given any treatment following as they were testing me for Addison's disease and told.me it was a negative result. I do not have the first cortisol reading though I've been told that my ACTH at 6 that evening was 13, and then I was allowed to be taken home. Would it be that my adrenal function was low when I was injected and unable to cope.? I suffer with low energy levels and any lack of sleep renders me almost useless. This all occurred last year and i'm confused.

[rumpled]

I think of a crisis as a drop in sodium - was that tested at all? Often BP drops as well - but one can progress beyond and vomit etc. At least, that is what I do.

In the *bad* reactions I have heard, yours is about the most extreme. So they probably did not get any readings - did they decide to give you replacements? What were your cortisol readings?

[woody444]

I collapsed approx 2 mins after the short synacthen injection, My bp very low all day, monitered every 15mins though i was barely concious and on oxygen mask also most of day .Three doctors visited me later in the evening and just said that it had never happened to them before and gave no other explanation.
Was this adrenal crisis? anyone know.

woody444

[rumpled]

Why were you standing during the test?  I find that strange - I would also be really ticked off at the nurse who failed at her basic duty to note what happened during the test. I know in the US you can report people... dang.

Reactions can vary during the test which is why it has to be monitored - from flushing to a drop in BP - I know I had a cuff on for mine. But I was sitting/laying the entire time. The result is rather surprising considering your reaction. Did you get the actual results? Or just told it was normal.