Adrenal Gland Testing
What are the Adrenal Glands?

These are tiny glands located at the upper borders of the kidneys on either side of your body. The adrenals are part of your endocrine system, a collection of glands and organs in the body that release important hormones that travel through the blood and body fluids to act on other organs, tissues and cells in your body. The hormones that your adrenals secrete are responsible for a number of normal body functions and are absolutely necessary for life. Some of the important hormones secreted by the adrenals and some of their functions are listed below:

  • Cortisol: helps stabilize blood sugar levels, maintains proper muscle mass, involved in your energy to function physically and mentally, acts to stimulate immune system, acts as natural anti-inflammatory, helps prevent excess allergy reactions in body, keeps you alert and awake in the daytime, lowers at night to allow you to sleep, helps you deal with stress.
  • DHEA: a natural anti-inflammatory hormone and touted as anti-aging. Helps prevent tendency to auto-immune disorders, helps with energy, mental focus and stress, is used to convert into other hormones that your body may need.
  • Aldosterone: is involved in the balance of salt and water in your body, therefore affects your blood pressure.
  • Adrenaline: this hormone has some of the same actions as cortisol but its effects are thousands of times stronger. It gives that well-known “adrenaline rush” sensation and is part of the “fight or flight” reaction of extreme or sudden stress.

Elevated acute stress

When you are under elevated acute stress, such as studying for final exams or having to work longer hours at work to finish an important project, or skipping a meal, your adrenals respond by producing more cortisol to help you deal with that stress. This adrenal response can be helpful and harmless in getting you through the stress in the short-term. You sometimes hear people acknowledge this adrenal phenomenon when they say, “I got through that on adrenaline.” However, if the stressful situations continue for too long and the cortisol levels remain chronically elevated, there can be significant health repercussions.One thing that occurs when the cortisol levels have been chronically elevated from stress is that the body’s serotonin levels are suppressed. As you may know, Seratonin is a neurotransmitter responsible for a sense of well-being in your brain. Without sufficient serotonin, you may begin to suffer from depression, fatigue, and premenstrual tension, for example. Many people in this condition are diagnosed with simple depression and placed on anti-depressants, often an SSRI type which increases serotonin levels in the brain. The SSRI may actually help for a while.

However if the stress continues and if no attention is given to the adrenal imbalance then the person’s condition may worsen. The cortisol level my drop as the adrenals begin to fail to keep up with the person’s need for stress hormones. At this point the person may feel increasing fatigue and lethargy. They might find that simple daily tasks become more and more taxing and that exercise, which used to be energizing now exhausts them. Sleep which used to come easily, may be difficult or may just feel unrefreshing. If the cortisol drops in the daytime, the pituitary, a master gland in the brain, will send hormonal signals to the adrenals in attempt to stimulate them to produce more appropriate amounts of cortisol. In some cases, by the time the fatigued adrenals are able to respond to the stimulation from the pituitary, the daytime hours have passed and it is now nighttime. Normally, at night the cortisol levels should be lowered to allow for proper sleep, but if the adrenals produce too much cortisol in the evening the sleep with be poor quality. This leads to more daytime lethargy and mental sluggishness. In addition, with less ability of the adrenals to produce higher cortisol levels as needed, the person finds that their blood sugar no longer regulates well and that they may develop symptoms of reactive hypoglycemia, such as shakiness, confusion or irritability between meals. This is because in healthy adrenal patients cortisol is released in slightly higher amounts between meals to keep their blood sugar from dropping too high.

Also, when upsetting, or startling stresses occur the adrenal fatigued person finds that they may over-react with anger, frustration, or may startle very easily. They often report increasing generalized anxiety and difficulty recovering from general stresses of life. Many adrenal fatigued patients suffer from occasional rapid heartbeat, heart palpitations, shaky or weak feeling and mood swings. This is because of the worsening of the adrenal function, but sometimes they are told that they need to take more anti-depressants to cover up these symptoms. If you have severely fatigued adrenals, they are unable to secrete extra cortisol in case of an acute stress, and your may find that you “over-react” to acute stresses. For example, you may feel an adrenaline rush when someone criticizes you, or you may react with an extreme startle reaction when a spouse walking up behind you and startling you while you were concentrating on a task at hand. This is because without the ability to produce a little cortisol for these minor stresses, your adrenals release adrenaline, a powerful fight or flight hormone that makes everyday stresses exhausting and can make you feel out of control.

Other symptoms

Other symptoms can occur when the adrenals are not functioning properly. Because the level of aldosterone can also drop in adrenal fatigue, some patients suffer from increasing thirst and a sense of constant dehydration. They complain that they have weak or hyperactive bladders that need to be emptied more and more often. They may also develop a tendency to get lightheaded or weak at times. This is because with less aldosterone, the kidneys will excrete water from the body faster and this leads to increased urination, lowered blood pressure, and increased thirst.Occasionally people with adrenal problems have an unexplained backache in the midback that they often wake with. This aching seems to be coming from the adrenals themselves but the mechanism for the pain is not known.

Other symptoms of adrenal problems can include headaches, muscle tension, fibromyalgia, allergies, chronic hives, mental confusion, digestive disturbances, increased susceptibility to infections, a feeling of aging too fast, joint pain and swelling, increased susceptibility to autoimmune conditions, excess sweating, and intolerance to both cold and heat.

Two extreme conditions

Conventional medicine recognizes two extreme conditions of adrenals; Addison’s disease (extreme, potentially deadly hypofunctioning adrenal glands) and Cushing’s disease (extreme hyperfunctioning Adrenals with high excess cortisol). Lab tests for diagnosing Addison’s and Cushing’s diseases include blood levels of cortisol and urinary levels of cortisol and aldosterone. If your labs and symptoms are not severe enough to qualify you for one of these two diagnoses, then your adrenals are considered normal. Naturopathic and holistic doctors believe that health is more of a continuum, with people moving slowly away from optimal toward disease and vice versa. We believe that there are less extreme, but none-the-less troubling changes in adrenal functions that may not constitute a diagnosable disease but are certainly not “normal or optimal.”Most patients instinctively know this about their bodies and many people with adrenal problems have gone to their doctors complaining of one or more of the symptoms mentioned above, only to be told that there is nothing wrong or to be diagnosed with anxiety or depression or irritable bowel syndrome or another condition.

There is an alternative lab test capable of detecting these non-optimal adrenal conditions. It is a simple saliva test that measures several parameters of adrenal function. The test kit is given to the patient in the doctor’s office and instructions are provided for collection. The patient then collects saliva on a cotton roll four different times through-out a single day and the sample is sent to a specialized lab that deals with saliva hormone testing. In two weeks a comprehensive report returns to the doctor’s office that shows the level of two key adrenal hormones: cortisol and DHEA. The cortisol has an important daily rhythm and so four separate values are given from the four saliva collections. Because the adrenals affect the blood sugar, insulin, and the immune system, the saliva test also gives information on these body functions. I have found this test to be invaluable in helping to determine which treatments are best for my different adrenal patients. With the information from this test, I can decide what time of day a person needs treatment and how much and what type of adrenal support each person requires. I can see if their immune system or insulin levels have been adversely affected or not and treat accordingly. I have found that adrenal problems are remarkably common among people with long term stress, anxiety, or fatigue, and treatment generally leads to significant improvements in time. Development of adrenal problems do not develop overnight and as you can imagine, improvement takes time, but I am pleased to see the improvements that my patients make when we tailor their adrenal treatments to their individual needs.

If you are suffering from the symptoms mentioned in this article and you want to know if adrenal problems could be the cause of your symptoms you can contact us to have your adrenals tested.

Please be aware that adrenal fatigue is not a diagnosable disease, so the adrenal saliva test is not considered medically necessary by insurance and is unfortunately not covered by medical insurance. But considering the amount of information provided and the value of this test, it is surprisingly affordable.