How to Test for Adrenal Function

If you are feeling tired, depressed, anxious, and irritable; if your brain doesn’t seem to work right and you feel dizzy when you stand up too quickly. If you can’t fall asleep or stay asleep and seem to get sick all of the time… you might have adrenal fatigue.

Often overlooked in the traditional medical world, functional medicine doctors investigate the cause of symptoms. All the way back to the organ systems and biochemical processes that might be contributing to the condition.

Since the symptoms of adrenal dysfunction can also be symptoms of iron deficiency, low thyroid, or blood sugar imbalance we want to evaluate these conditions as well. Sadly there is no rule that says you can only have one thing wrong at the time.

To evaluate iron, I test like most physicians do by doing a complete blood count or a CBC. I add a ferritin level as well which tests for stored iron.

Not only do I test glucose and hemoglobin A1c when testing for blood sugar balance, but also insulin. Often insulin will go up even before glucose does, giving us an indicator of things to come if we don’t correct the situation.

As a thyroid and adrenal screen, I will recommend a basal body temperature test. This is done at home. I have you measure your body temperature about 10 minutes before you normally wake up. If it is consistently low we will do further testing.

Thyroid tests are not complete by only measuring TSH and T4. The thyroid cascade is long and to fully evaluate it I recommend also testing free T3, free T4, reverse T3, and TPO. This is because T4 has to convert to T3 to adequately maintain metabolism, temperature, and blood pressure. It is not uncommon to either be unable to convert from T4 to T3 or only convert to reverse T3 which is just as inactive as T4. We call this a thyroid conversion problem and once identified, can be corrected.

Another in-office or at home test is a pupil constriction test. The pupil of the eye will dilate or open wider when in a low light or a dark room and constrict or close tighter when exposed to bright light. Remember in the article The Stress Glands that when you are under stress your pupils will dilate to allow for better peripheral vision? When your adrenal glands are not functioning well, your pupils will be unable to maintain the dilation even under bright lights. You can observe this in the office or in front of a mirror.

Salivary cortisol level is a lab test that functional medicine doctors use to evaluate the amount of cortisol your adrenal glands are producing throughout the day. Cortisol should be highest in the morning when you are bright eyed and bushy tailed and gradually decrease to its lowest level before bed when you are winding down.

There is no test that doesn’t have false positives or false negatives but testing does give us a direction to go in and some insight into what treatments might be best. Stay tuned for next week’s post on my Anti-Stress Protocol. In the meantime…relax.

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