It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....

Addison's Disease Message Board

  • Need help fast...Medication Question for test...

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 03-08-2005, 09:44 AM   #1
    Join Date: Jan 2004
    Posts: 94
    mngirl HB User
    Need help fast...Medication Question for test...

    I have a medication question...Re Drug: Metrypone (Metropine)

    My doctor called and says this medication is in for this test they want to do. I stop my prednisone for 24 hours then midnight tomorrow night I take this medication. I have to take 10 PILLS of this!!! I found info about drs. recommend that it be done in a hospital setting because people who do have adrenal insuffiency can go into what they call an adrenal crisis. I talked with my doc about it and he says that it should be okay to take it at home because he does not think I have adrenal insuffiency. Never mind that if he is wrong and I do, something could happen.

    Unfortunately there is not another endocrinologist in this town to get a 2nd opinion from. My mom has a friend who is a pharmacist, but she had never heard of this medication (it took my doc 2 weeks to even find it!). I just want to know what the side effects of this drug is and the potential hazards.

    I think I am going to run into Target to ask too, but i am not sure that they will give that info out.

    I am very concerned about taking it at this point. They want me to come and pick it up right now.

    I know if my gut says no, I shouldn't but I do not know what else to do!


    Anyone out there that can help? Do you know about the meds?


    Sponsors Lightbulb
    Old 03-08-2005, 02:48 PM   #2
    Join Date: Feb 2004
    Posts: 342
    WandaB HB User
    Re: Need help fast...Medication Question for test...

    I have never heard of this & seems very strange to me. If you are already on prednisone why is there a need to check your adrenals????

    Please do a search with ****** for Metyrapone. Look at the first site. Looks like it is not a great thing to use. I would not do it.

    You need to ask WHY your endo wants to do this. What will it tell him? Don't be afraid to say NO to the test. People who have had addisons for a long time know more about it than most docs/endos so if you have questions please ask on all the forums you can find before doing anything.

    Old 03-08-2005, 04:04 PM   #3
    Join Date: Jan 2005
    Posts: 69
    sadie-mae HB User
    Re: Need help fast...Medication Question for test...


    I would agree with Wanda about this. Metapyrone testing is essentially outdated because of much safer and easier alternative testing that likely offer just as or more accurate results. Metapyrone testing can put you at risk of adrenal crisis-so you definitely need to be supervised by medical professionals during the test. It doesn't sound like they have planned that for you. It is my guess that your doctor is suspicious of secondary adrenal insufficiency (failure of your pituitary gland to make enough ACTH, which is what stimulates cortisol release from your adrenals). It can be a difficult diagnosis without the right stimulation tests and often 250mcg ACTH stimulation tests (the standard test run for primary adrenal failure) is normal, even when you have a problem.

    You have two issues to contend with. First of all, the use of this test is quite unusual and red flags are going up that maybe your doctor doesn't deal with secondary Addison's very often-it is quite rare so that's to be expected. The other issue is that now that you are on prednisone, skipping a single dose isn't going to give you information about what your own natural adrenal and pituitary function is. Prednisone has a much longer half life than hydrocortisone and will cross react in the cortisol measures-making your cortisol levels look higher than they are. It will also cause suppression of natural cortisol function, lower your ACTH levels and reduce your hypothalamic CRH levels-all part of the normal cycle of cortisol release. Low doses (<5mg) MAY not have much effect, but without going off of it, who is to know what is drug side effect and what was already a problem prior to your going on the prednisone.

    You are in the ultimate pickle that Addisonian patients get stuck in when they end up on prednisone without proper testing first. I am very frustrated for you about it.

    Could you possibly ask your doctor if he could first slowly and carefully switch you to hydrocortisone (cortef) therapy for several weeks (at least) prior to running any further tests? Then, if you stop the medication for 12-24 hours, it wont interfere with test results-it has a short half life. The other less appealing option would be dexamethasone, which is a strong steroid and can suppress the adrenals quite easily on low doses, but doesn't cross react with the cortisol assays. It sounds like you get quite sick without some sort of steroid on board, so it doesn't seem wise to just pull you off of it altogether.

    The next thing I would consider asking your doctor is whether he would be willing to run a different test of your pituitary function, such as a low dose ACTH stimulation test. This uses only 1mcg of synthetic ACTH and carries almost no testing risk. It is also easy and can be finished in less than an hour. I have included the testing protocol (which is easy) for you to give to your doctor to show him you are motivated to do a safer test than the metapyrone test. This protocol is from Vanderbilt's pituitary center:

    1mcg Cosyntropin Stimulation Test
    Indication: Diagnosis of central adrenal insufficiency


    1. Insert saline lock (catheter) into peripheral vein

    2. Obtain blood samples for baseline serum Cortisol (red top tube)

    3. Inject 250mcg Cortrosyn to 250ml 0.9% NaCL and mix well

    4. Inject 1.0ml of the mixture IV (not IM) through saline lock

    5. Inject 3cc 0.9% NaCL into saline lock to prevent blood from clotting

    6. Waste 5cc blood at 30 minutes

    7. Obtain a repeat serum Cortisol level at 30 minutes (red top tube)

    Interpretation: A rise in serum Cortisol to greater than 18ug/dl within 30 minutes suggests a normal result. A serum Cortisol of less than 18ug/dl suggests the presence of central adrenal insufficiency.

    If this doctor is worrying yourself. Just because you can't go to someone in your own town doesn't mean that you can't consider traveling to find someone who deals with pituitary patients. My husband had to travel out of state for his diagnosis of pituitary failure with secondary addison's disease. Your life and health are worth the trouble and in many cases insurance will cover out of state providers, even if it might take a little letter writing. The squeaky wheel gets the oil.

    Happy squeaking. And keep listening to that little voice that is telling you something isn't quite right about this's probably not.

    Closed Thread

    Related Topics
    Thread Thread Starter Board Replies Last Post
    CONFUSED with THYROID readings?? I need help? meds do nto seem to be working? bluetou Thyroid Disorders 17 05-12-2011 07:18 PM
    In Desperate Need of HELP! PLEASE read my story... Zoe26 Acid Reflux / GERD 46 01-14-2011 07:01 PM
    Do I need to fast for a TSH and Free T-4 test? irish eyes 1025 Thyroid Disorders 2 10-27-2009 10:47 AM
    Help/Advice neededASAP -Fentanyl detox, pain pat. abused meds will need meds in futre Confused089 Abuse Support 34 07-06-2008 05:33 PM
    Need Opinion - Graves or Hashi's???? VegasQ Thyroid Disorders 8 03-30-2007 05:48 PM
    Do you fast before labwork? huh? Thyroid Disorders 7 01-19-2004 07:07 PM

    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is On
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off

    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 02:35 AM.

    © 2020 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!