adrenal fatigue tests
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adrenal fatigue testsTRANSCRIPT
Cortisol TestsThe major lab test used to diagnose Adrenal
Fatigue is, as you might have guessed, the cortisol test. But there
is more than one type of cortisol testing, and the correct
interpretation of results is also important.Depending on his or her
preference, your doctor may order a saliva, blood or urine test to
measure your cortisol. These days it is generally accepted that
saliva cortisol testing is the most accurate, as it gives a better
estimate of the cortisol levels within your cells, where the
hormone reactions are actually taking place. Remember that it is
important to be well-hydrated before you do your saliva test
dehydration can skew the results.Heres another important thing to
know about cortisol testing. Taking a single measurement, or even a
24-hour average, is not enough. The best cortisol tests take 4
individual samples at various points of the day and then map your
cortisol levels over the course of a24 hour cycle. Our cortisol
levels vary dramatically, starting high when we wake up and then
tapering off until they reach their lowest point late at night.
This usually represents something like an 80% drop, which is
perfectly normal. Your health care professional needs to see not
just your average cortisol level, but also the size of the morning
spike and how sharply it drops off afterwards.Interpreting the
results correctly can be difficult for a physician without
experience of Adrenal Fatigue. The reference ranges supplied by
labs are so wide that they only flag up extremely low cortisol
levels. So your doctor will need to look at the levels provided and
make his or her own judgment. This is where the importance of using
an optimal range, rather than the reference range, becomes
clear.Lastly, your health care professional should be aware that
more than on cortisol test will be necessary during your treatment
for Adrenal Fatigue. Once you have been diagnosed and started on a
treatment course, saliva cortisol testing is a good way to monitor
progress as your cortisol levels begin to return to normal.Saliva
Testing for Adrenal Evaluation (Dr. Julie Chen)
Salivary cortisolan alternative to serum cortisol determinations in
dynamic function tests (Aardal-Eriksson et al, 1998)
Are Saliva Tests Any Good? (Dr. Andrew Weil)
Saliva Tests for Adrenal Stress (Official Website of John Lee,
M.D.)
ACTH ChallengeThis is another kind of cortisol test that can be
very useful for your doctor. First, your baseline cortisol levels
are measured. Then, a dose of ACTH (adrenal corticotrophic hormone)
is injected. Finally, your cortisol levels are measured again.The
ACTH has the effect of stimulating your adrenal hormone output,
just like it would if you were placed in a stressful situation.
This test allows you to see the response of your adrenals to
stress. If your cortisol exhibits a healthy spike higher (at least
double in a blood test), your adrenals are probably in reasonably
good shape. If the spike in cortisol is not so large, this suggests
adrenal insufficiency.ACTH (cosyntropin) stimulation test (Dr.
Nancy Rennert)
ACTH Challenge Test (MedicalHealthTests.com)Thyroid TestsYou might
wonder what the point of a thyroid test is, when we are looking to
diagnose Adrenal Fatigue? The complexity of the human body means
that one part of the endocrine system (the HPA axis) cannot exist
independently of another part (the thyroid). In reality, there are
connections and relationships that exist between every system in
the body, and a weakness in one area can easily translate into
changes in another.In the case of Adrenal Fatigue, it has been
shown that a weakening in the hypothalamus and pituitary gland (the
other parts of the HPA axis) can lead to lower thyroid function. In
other words, if your blood tests suggest mild hypothyroidism, the
underlying problem might actually be Adrenal Fatigue.There are a
number of different tests for thyroid function, all blood tests.
Here Im going to give a brief summary of the most important ones.
As with the cortisol test, your doctor should be looking beyond the
reference ranges provided by the lab. In fact, these days its very
common for someone to be diagnosed with mild hypothyroidism even if
all their results are within the range.Thyroid Function Tests
(National Endocrine and Metabolic Diseases Information
Service)
Thyroid Function Tests (American Thyroid Association)TSHThyroid
stimulating hormone is produced by the pituitary gland in response
to instructions from the hypothalamus. As its name suggests, TSH
stimulates the thyroid to produce T3 and T4, the two most important
thyroid hormones.The level of TSH is inversely proportional to the
activity of your thyroid. If your thyroid is producing lots of T3
and T4, your pituitary gland produces less TSH (because the thyroid
needs to be stimulated less). Conversely, if you are hypothyroid
then your TSH is likely to be high, as your brain is telling the
thyroid to produce more hormones. This is the same kind of feedback
loop that exists for many other hormones in the body, including
cortisol.In the case of Adrenal Fatigue sufferers their thyroid is
often performing weakly, so they will typically have a TSH reading
of above 2.0. Note that the reference range provided by the lab
will usually be around 0.50 4.50. Once again you can see the
importance of looking for an optimal level rather than just blindly
following the lab ranges.Free T3 (FT3)This is a test that is rarely
conducted by doctors, and even then usually only on hyperthyroid
patients. However it can give a useful insight into the overall
function of the thyroid. T3 is produced when TSH stimulates the
thyroid. When used in conjunction with the other thyroid tests,
this helps to give a complete picture of why the thyroid is
underperforming. Optimal values should be somewhere in the 300-450
pg/ml range. However, the typical lab range allows values as low as
230 pg/ml.Free T4 (FT4)Similarly to T3, this hormone is produced
when TSH stimulates the thyroid. Your thyroid makes much more T4
than T3, but T4 tends to have less of an effect on the body than T3
does. If your thyroid is producing too little T4, often your TSH
level will be higher. This test measures Free T4, which is unbound
and available for immediate use.Total Thyroxine (TT4)This test
should be used along with the Free T4 test. While Free T4 measures
the amount of unbound and available T4 in your blood, Total
Thyroxine also includes the amount of T4 that is bound to carrier
proteins (essentially held in reserve). Using this test together
with the Free T4 test will tell you how much T4 is available for
your body to use, and how much is being held in reserve.Tests used
by integrative doctorsIn addition to the tests listed above, there
is a selection of tests that provide more of an insight into the
relative levels of different hormones or neurotransmitters in your
body. These will rarely be ordered by a medical doctor, but your
integrative doctor or naturopath may ask for them.Cortisol / DHEA
RatioThis test tells us which point along the Adrenal Fatigue
pathway the patient might have reached. In the initial stages of a
stress reaction both cortisol and DHEA will be high. But as the
body begins to struggle to produce sufficient stress hormones, DHEA
levels start to fall. Put very simply, this is because the stress
hormone production steals resources from the sex hormone
production. Further on in the development of Adrenal Fatigue,
cortisol levels will begin to drop too. So this ratio, combined
with other tests and information, helps us to determine which stage
of Adrenal Fatigue the patient has reached.17-HP / Cortisol
Ratio17-hydroxyprogesterone (17-HP) is a precursor to cortisol, in
other words one of the raw materials that the body uses to create
cortisol. In Adrenal Fatigue sufferers it is common to see higher
levels of 17-HP vs. cortisol, as the adrenals struggle to make this
conversion happen.Neurotransmitter TestingIve spoken exclusively
about hormones so far, but neurotransmitters are another important
part of our endocrine system. These chemical messengers transmit
messages between our cells and, just like cortisol, they can become
depleted after long periods of stress. With recent developments in
testing procedures it is now possible to compare a patients
neurotransmitter levels to a reference range for healthy patients.
This test is usually conducted first thing in the morning and is
best accomplished via a urine test. It is only available from a
small number of labs.Functional Adrenal Stress Profiles (BioHealth
Laboratory)
Adrenocortex Stress Profile (Genova Diagnostics)Alternative
TestsWhen Adrenal Fatigue was first diagnosed many of these tests
did not even exist. To help provide a diagnosis, doctors developed
a series of more physical tests that can be conducted quickly in a
doctors clinic or at home. These tests are clearly much less
accurate than the blood, saliva and urine tests mentioned above,
and positive results may reflect other health problems besides
Adrenal Fatigue. However they can be a useful diagnostic tool in
combination with all the other evidence provided.The Iris
Contraction TestFirst described by Dr. Arroyo in 1924, this test
measures the contraction of the iris in response to repeated
exposure to dark light. In those with weakened adrenal function,
the theory goes that the iris will be unable to maintain its
contraction for long.To conduct the test, sit in a darkened room,
in front of a mirror. Take a flashlight and shine it across your
eye, from the side of your face. In a hypoadrenal state, your pupil
will not be able to hold onto its contraction for more than 2
minutes and thus will begin to dilate despite light repeatedly
shining on it. In those with healthy adrenals, the contraction
should last much longer.Postural Low Blood PressureWhen we stand
up, those of us who are in good health experience an almost
immediate rise in blood pressure. In contrast, Adrenal Fatigue
sufferers will see no change in their blood pressure, or even a
slight fall. In very general terms, a larger drop in blood pressure
signifies a more severe case of Adrenal Fatigue.This is a very
simple test to do at home. Use your regular blood pressure monitor
and check your blood pressure while lying down. Then stand up and
conduct the test again.