Pathology Handbook

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Cortisol; Dynamic testing

Alternative Names:

Synacthen Test
Dexamethasone Test

Laboratory:

Clinical Biochemistry

Test Code:

Various

Specimen Types:

Blood

Container Types:

SST
Lithium Heparin (with Gel)

Collection & Request Instructions:

Endocrine consultation is suggested for dynamic testing. e.g. Short/Long Stimulation or Suppression tests using Synacthen or Dexamethasone.

All samples must be clearly marked with patient identification, time and date of sample. Sampling times must also be clearly written on request form.

Transport Instructions between Sites and/or Laboratories:

Room Temperature

Additional Notes:

Short Synacthen Test (SST)

A normal response is a 30 minute post synacthen cortisol value of 430 nmol/L in males, 420 nmol/L in females (over 580 nmol/L in women on oral contraceptives). El-Farhan et al. Clin Endocrinol (2013) 78, 673–680.

Additional Notes: 60 minute values are about 15% higher.

NB A basal cortisol of 340 nmol/L had a 100% specificity for a normal short synacthen test, therefore SST is not needed. Sbardella et al. Clin Endocrinol (2017) 86, 177-184.