What Are the Tests for Adrenal Function?

Clinically speaking, adrenal fatigue is the state that results when the lab tests that measure adrenal function come back within normal limits but you have symptoms of under-active adrenal function. It's not quite a disease state, but it's not a state of normal function, either. The adrenal glands still produce the hormones and neurotransmitters they are supposed to produce, but they don't provide the boost needed when stress strikes. They've tapped out at a higher baseline, so it takes more to kick up the levels.

When the adrenals are taxed to the point at which they are no longer responding to the stresses of life, the nerves feels like they are on edge. This is the result of erratic cortisol levels and disturbances in the cortisol production cycle. In this heightened state the body is programmed to respond literally in a heartbeat, also known as fight-or-flight.

There are various ways to test adrenal function: blood tests, adrenal tests, urine tests, saliva tests and adrenal questionnaire tests.
  1. Saliva Hormone Testing

    • Saliva tests involve collecting saliva samples at certain intervals over 24 hours which provide snapshots that present the fluctuations of adrenal hormones. Saliva hormone testing measures the amounts of various hormones in your saliva instead of in your blood or urine. Several studies confirm the test's accuracy on indicating adrenal hormone levels within the cells, and it is the only test that measures them in this method.

      The best way to determine adrenal hormone levels is to use the saliva test that measures cortisol levels several times per day. It is as simple as carrying around a few small tubes and at designated times of the day, spitting into one of the tubes and then recapping it. The samples do not usually need to be refrigerated and can be sent by mail to the laboratory recommended by the saliva kit manufacturer.

    24-Hour Urinary Cortisol Test

    • The 24-Hour Urinary Cortisol test is measures the hormones excreted in the urine over a 24-hour period. This lab test can be an indicator of the output of several adrenal steroid hormones including corticosteriods, aldosterone and the sex hormones. Although the laboratory range of what's considered normal levels are too broad to be of much value in diagnosing all but the most severe cases of adrenal dysfunction, if the hormonal output is in the bottom 1/3 of the "normal" range, adrenal fatigue fatigue can be relatively certain.

    Blood Tests

    • There are blood tests to measure circulating levels of the adrenal hormones aldosterone and cortisol, and others to measure the sex hormones related to adrenal function. But, by their very nature, blood tests divulge only the levels of hormones circulating in the blood and do not reveal those inside the tissues, or potentially available to the tissues. However, when blood tests and urine tests are interpreted together by a trained practitioner, a picture of your adrenal function can be pieced together, especially when the information is used in conjunction with your clinical presentation and medical history.

    ACTH Tests

    • The ACTH Challenge Test helps to evaluate adrenal reserves and responsiveness and thus can help detect adrenal fatigue. In this test, baseline levels of circulating cortisol are first measured. Then a substance like Adrenal Corticotrophic Hormone (ACTH) that stimulates the adrenal output of hormones is injected. After the challenge substance is given, the circulating cortisol is re-measured to see how well the adrenals were able to respond to the stimulation. A normal response is for the blood cortisol levels to at least double. When cortisol levels do not double or rise only slightly, adrenal fatigue can be suspected.

    Questionnaire

    • The adrenal questionnaire is easy to take and has proven to be extremely useful in a clinical setting. When used in conjunction with any of the above testing, it is also very accurate in diagnosis. The more objective the answers, the more valuable the results will be. The adrenal questionnaire test not only helps to determine the degree of adrenal dysfunction, but also provides information and insight into the present condition.

      Most adrenal questionnaires are taken on a number or point system. For example, in numbers ranging from zero to three, with zero being the least and three being the most common. After reading each statement, the number most appropriate would be placed in the space provided. The total of points or numbers would then be determined and help establish the severity of the condition. The questionnaire could cover subjects such as: signs and symptoms, predisposing factors, diet, energy patterns, aggravating factors and relieving factors.

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