How To Diagnose Adrenal Fatigue - 3 Different Ways

Adrenal Fatigue is a phrase being thrown around a lot lately (especially in holistic circles). But what does it mean to have Adrenal Fatigue? And how do you get a concrete diagnosis? I wrote a post for My Health Journey series sort of introducing the topic. I was told I had adrenal fatigue in 2013, and have gone through three different avenues/doctors to diagnose and understand the severity. It's extremely important to not only know IF you have it, but to understand HOW advanced it is. Adrenal fatigue affects immunity, disease, pregnancy, hormone production and about 100 different other body processes. You cannot let it go untreated.

The symptoms of Adrenal Fatigue are as follows: 

  • Daily feelings of fatigue
  • Weakened Immune System
  • Cravings for salty foods
  • Low morning energy, high night energy (backwards circadian rhythm)
  • Inability to handle stress
  • Asthma, allergies or respiratory complaints
  • Dark circles under the eyes
  • Dizziness
  • Dry skin
  • Extreme tiredness an hour after exercise
  • Frequent urination
  • Joint pain
  • Lines in your fingertips
  • Loss of muscle tone
  • Low blood pressure
  • Low blood sugar
  • Low sex drive
  • Lower back pain
  • Numbness in your fingers / Poor circulation
  • Weight gain

Well that's a wonderful list isn't it. And yes, I had almost every single symptom. However, as with any list of symptoms, there can be overlap in conditions. So you must know for sure what you're dealing with. It took me two years and four doctors to get a true picture of what was going on with my adrenals. So let's talk about how to properly diagnose Adrenal Fatigue.

1. A comprehensive blood workup. This will only be able to be done by a holistic practitioner. This was the way I was first diagnosed. Of course, my doctor is brilliant and he could tell I was in bad shape without any additional testing. I apologize for the crinkles - pretty sure I spilled something on it. It's like 2 years old okay. Here's what that looked like: 

2. Cortisol Stimulation Test. I went to Mayo a few months later for a bunch of issues. While I was there, I brought up the fact that my holistic Dr. had diagnosed me with Adrenal Fatigue. I knew they are very conventional so probably wouldn't respond well. They said, "Oh we don't really believe in that sort of thing here." Well, when they did my complete blood workup they tested my AM cortisol. And here was the result.

You can't read the reference range on this scan, but it's supposed to be 25. Well my AM cortisol was 5.2. So after seeing that, Mayo Dr. was like, "Well, we can do a cortisol stimulation test to see if they respond to stimulation." In other words, that is to see if they still work. Once you get to a certain point with adrenal fatigue there is no coming back. Then you get - Addison's Disease.

A stimulation test is basically a baseline measurement of your AM cortisol. Then they give you an IV of ACTH to stimulate them. They measure them at 30 mins and 60 mins afterward to see if there's a change. 

The good news is, my adrenals responded, which means they do work. In their words, my adrenals were "sleepy." I thought this was sort of hilarious. They couldn't just admit that I have adrenal fatigue. Anyway, the problem with conventional doctors is that they have no solution or help to give you unless you are to the point where you need drugs: Addison's Disease.

So, you have to find someone who can keep you from getting to that point.

3. 24 Hr. Cortisol Saliva Test. When I started working with Dr. Kalish in 2015, he suggested we do the 24 Saliva Test to see how my cortisol levels were throughout the entire day - not just in the AM. This is very important in determining how you will treat your Adrenal Fatigue. You can't just take some generic supplement for adrenals, or do what your friend is doing because we are all different. Specific herb and supplements are for calming and certain ones are for stimulating.

Basically, you spit into a jar every four hours and they measure the hormones. Here is what the results look like:

I believe his words to me were, "Wow. You are really bad." He proceeded to tell me that I was probably in the bottom 10% of people he treated (sick wise). As you can see, my morning cortisol is not only way lower than the average person, but it is basically flatline all day. My overall sum cortisol for the day is 9.6 and should be from 23-42. Yup. In other words, I'M TIRED ALL THE TIME.

That isn't the greatest news to hear. But, he has treated people like me with my various issues (adrenal fatigue is just one of them) and so at least I've got the right Doctor. He did say that I am so bad I won't probably ever bounce back to where a "normal" person is, but at least I can get somewhat better.

I'm not going to go into treatments or curative measure in this post - I just wanted to first outline HOW to diagnose Adrenal Fatigue because that is where you need to start.

Wondering who's the mysterious wordy genius behind these posts? Follow this little rabbit trail to read more About Me! The use of the term genius is open to interpretation.