Summary

Adrenal insufficiency (AI) is the medical term for the body’s adrenal glands not producing enough of the vital stress hormone, cortisol. This can lead to a life-threatening situation called an adrenal crisis if left untreated. Cortisol is usually measured in blood samples, but we are developing ways to diagnose adrenal insufficiency by measuring cortisol (and a very similar hormone, cortisone) in saliva samples, which will lead to needle-free testing.

The test where blood samples are taken looks to see if the adrenal glands can or cannot react to stress. A drug called Synacthen (also known as tetracosactide is given via a needle and this mimics the body’s natural response to stress by stimulating the production of cortisol, as your body would do normally.

Our new needle-free test uses a drug called Nasacthin. Nasacthin is the same as the Synacthen drug, except it has another substance added to it to help it to be absorbed from the nose into the blood. It is given via a nasal spray, but works in the same way as Synacthen to stimulate cortisol production.

What we plan to do

We will recruit a total of 32 patients with adrenal insufficiency, and are looking to determine the effectiveness of our new needle-free test, where you receive a drug (Nasacthin) via a nasal spray and measure cortisol levels in saliva, in diagnosing adrenal insufficiency, compared to the standard test (Short Synacthen Test), where drug is given using a needle and cortisol is measured in blood samples.