Adrenal Fatigue and The Adrenal Stress Test

26 04 2008

Adrenal Fatigue, also known as Hypoadrenia, Non-Addison’s Hypoadrenia, Subclinical Hypoadrenia, Adrenal Neurasthenia, and Adrenal Apathy. Adrenal Fatigue is where the adrenal glands are exhausted and unable to function normally. The adrenal glands release steroid hormones which are extremely responsive to changes in inner physical, emotional and psychological environment. Because of their responsive nature, the hormones are susceptible to becoming unbalanced from any number of factors. Too much stress, physical exertion, environmental and/or psychological stress can deplete the adrenal glands, which leads to a decrease in adrenal hormone manufacturing such as cortisol.

The range of severity are from extremely low, near zero, to almost normal. Addison’s Disease is extremely low adrenal function which can result from either severe stress, or from auto-immune disease. If left untreated, this form of adrenal fatigue may involve structural and physiological damage to the adrenal glands. This can be life-threatening. In order to function, many people will have to take corticosteroids in order to function.

The extreme high-end of adrenal function is called Cushing’s Disease, where circulating levels of cortisol are high. Two common causes of this disease are the use of prescription steroid drugs as well as excessive secretion of ACTH, or Adrenal Corticotrophic Hormone, from the pituitary gland.

These are two levels of adrenal conditions, but what if you are suffering from a form of adrenal fatigue that lies in between the scope of Addison’s and Cushing’s Diseases? And what are some of the signs you are suffering from Adrenal Fatigue?

You don’t have to have Addison’s or Cushing’s Disease to have Adrenal Fatigue. There are many different levels of adrenal function and one way to determine where you stand it so talk to your doctor, or nutritionist, about the three different tests in which your adrenal function is measured. The three different adrenal tests are: saliva, urine, and blood tests.

he Saliva Hormone Test measures the amounts of various hormones. It has many advantages over other lab tests, involving blood and urine tests, in determining adrenal hormone levels. Saliva testing is easy, accurate and reliable. Numerous studies confirmed the test’s accuracy with indicating the level of hormones within cells, which is where the hormones are utilized. Saliva testing is also the best lab test for detecting sluggish adrenals. It is the only test that measures the amount of the hormone inside the cells.

The Saliva test is simple and can be done a couple of different ways. You can carry a small vial with you and through certain times of the day, you spit into the vial and cap it. You can refrigerate the vials when you are done, but you don’t need to. Then you mail the vials to a lab for them to run the test. It may take a few weeks to get the results.

Another way to take saliva samples is to place a small, tubular shaped sponge under your tongue until it is saturated. Then place the wet sponge into the round vial it came in and cap it. You will do this about four times in one day. Your first sample will be taken from 6:00AM-8:00AM (within one hour after waking); your second sample from 11:00AM-12:00PM; your third sample from 4:00PM-6:00PM; your fourth sample from 10:00PM-12:00AM. This saliva test will show your cortisol levels throughout the day. It will also show your insulin levels, and in females, your progesterone levels.

You can refrigerate your samples for up to three days, but you should send the vials out to the lab as soon as you are finished with taking saliva samples. If you can’t send them out right away, send them out within three days.

Blood tests, on the other hand, do not reveal the hormones inside bodily tissues, or those available to the tissues. Blood tests only work on measuring the hormone Aldosterone and cortisol, and sex hormones. From your medical history, clinical presentation, and the results from your blood and urine tests, a trained eye will be able to put the pieces together and form a picture of your adrenal function.

Another blood test, known as the ACTH Challenge Test, detects Adrenal Fatigue by evaluation adrenal reserves and responsiveness. In this test, circulating cortisol levels are measured first then a substance that stimulates the adrenal output of hormones, ACTH, or Adrenal Corticotrophic Hormone, is injected. After the substance is administered, cortisol levels are measured again to see how well the adrenals responded to the stimulating injection. Cortisol levels should be double, but if they are not, or even rise only slightly, Adrenal Fatigue will likely be suspect. Usually, this test is only done if cortisol levels in the blood are found to be low by some other reason.

A useful way to determine adrenal fatigue is to combine the ACT Challenge Test with the 24-Hour Urine Cortisol Test. The 24-Hour Urine Cortisol Test measures the overspill of hormones from the blood. With these combined tests, the Urine Cortisol Test is given before and after the ACTH Challenge Test. The results are then compared. With the second test, if the cortisol isn’t at least double, Adrenal Fatigue is exists.

If you are not sure about the tests, or even if you think you may have adrenal fatigue because you are not feeling well, I would suggest making a list of your symptoms and then compare them with the symptoms of Adrenal Fatigue. A few symptoms of Adrenal Fatigue are: difficulty waking up in the morning, fatigue that is not relieved by sleep, craving sweet and salty foods, lack of energy, daily tasks take more effort, decreased sex drive, decreased ability to handle stress, need more time to recover from stress, illness and trauma, light-headed when standing up, mild depression, less enjoyment or happiness with life, increased PMS in women, your symptoms increase if meals are skipped or inadequate; forgetfulness, thoughts are less focused, decreased tolerance where you are more irritated with people; don’t wake up until 10AM, lows between 3-4PM, feel better after 6PM and after evening meal; decreased productivity where it takes you longer to complete tasks.

Be sure to remember that these symptoms are not a definite diagnosis of Adrenal Fatigue, but merely suggest its presence. As a rule, if you are experiencing more than three of the above symptoms, you may have Adrenal Fatigue.

Adrenal Fatigue can be caused by too much stress that doesn’t abate (marital, financial, emotional, family, work and psychological stress), death of a loved one, lack of relaxation, allergies, over exertion, smoking, caffeine, fear, negative attitudes and beliefs, lack of sleep, poor eating habits, sugar and white flour products, toxins, infections and a few others.

Not everyone can tell they are under stress. It is good to remember that all stress adds up and has a cumulative affect on your body. There are also other conditions related to Adrenal Fatigue such as abnormal, even erratic blood sugar levels in the form of Hypoglycemia. With Adrenal Fatigue (Hypoadrenia), many people experience allergies more often, have Arthritic pain and decreased immune response. Women tend to have more Premenstrual tension and more difficulty during Menopause.

Mental states can also be altered from low adrenal function, and people with Adrenal Fatigue may show increased fears, anxiety, depression, increased confusion, difficulty in concentration and even less accurate memory recall. They are more easily frustrated and have less tolerance. If their hormones are imbalanced, the likely-hood of insomnia increases.

Should these symptoms remain untreated, foundations may be laid for seemingly unrelated conditions such as Respiratory infections, allergies, Rhinitis, Asthma, frequent colds, Fibromyalgia, Chronic Fatigue Syndrome, Hypoglycemia, adult on-set diabetes, auto-immune disorders and Alcoholism.

If you think you may have Adrenal Fatigue, talk to your doctor about being tested. Be warned, however, that most doctors only know about the tests for Addison’s and Cushing’s Diseases. Unfortunately, medicine only recognizes Addison’s Disease as Hypoadrenia, so your doctor may not offer any understanding or sympathy on this matter due to their own uncertainty.

Should you find your doctor is lost in regards to the Adrenal Fatigue you are talking about, that doesn’t mean he/she will be unable to help you. If they are unable, you can easily talk to your chiropractor, or nutritionist about the test for Adrenal Fatigue. No chiropractor, or nutritionist? No problem. You can order the test yourself and send it off to a lab. However, once you have the results, you may find it hard to interpret the results unless you take them to your healthcare provider.

Adrenal Fatigue can be prevented, but if you already have it, gain all of the knowledge you can about it and find someone to talk to. Most of the time, Adrenal Fatigue can be cured with supplements and a recovery plan of reduced stress, increased relaxation, enjoyable activities, exercise (though you may feel too tired), and a balanced diet. Depending on your body and how well you adhere to the recovery plan, it may take up to three years for your body to fully recover.

For more information on Adrenal Fatigue, the causes, tests and treatment of this stress syndrome, take advantage of the following sources:

Support Group (online): I am a part of the following online support group for adrenal fatigue:



James L. Wilson, N.D., D.C., Ph.D, Adrenal Fatigue: The 21st Century Stress Syndrome (Petula, CA: Smart Publications, 2004).

Article written by J.I. Soucie.— You may reprint this article so long as it is not for non-profit use. You cannot put a price on educating people about this elusive syndrome. If you use this article, please remember to give me credit and a link back to my blog. Thanks.