How To Test For Adrenal Fatigue & Dysfunction

For part two of the adrenal health series, we are going to talk about the importance of testing and how to test for adrenal fatigue and dysfunction. If you missed part one, you’ll want to read it here to know all about the adrenals, how they work, and what adrenal fatigue is. 

The Truth About Adrenal Fatigue (1)

As I mentioned in part one, nearly every single one of the women I work with has some degree of adrenal dysfunction and approximately 90% of the population has some level of adrenal stress. Given this information, one might think you could just assume that there is adrenal dysfunction present and to follow an “adrenal healing protocol” to begin the recovery process. Although I am sure this happens, I would caution against this and recommend getting tested. Adrenal hormone testing is extremely important and highly recommended as the various stages of adrenal dysfunction and fatigue require different recovery strategies and protocols.

Testing gives a health care provider, such as myself, a detailed look at what is exactly going on, how to approach the case, and develop an individualized adrenal dysfunction recovery protocol.

Before explaining the type of testing I recommend and why, I would like to explain the natural rhythm of cortisol.

As I explained in part one, cortisol is a hormone that is produced by the adrenal glands and is necessary for our health. It helps decrease inflammation and support proper digestion and immunity, however, when chronically elevated, cortisol has negative health effects. In an ideal case, cortisol is highest in the morning and gradually decreases throughout the day, being at it’s lowest in the evening, which is why we should feel tired and ready for bed around 10 – 11 pm. This is an example of the proper rise and fall of cortisol:


Unfortunately, the majority of our population will not demonstrate this ideal rhythm of cortisol as we are all exposed to stress and, quite often, the stress we experience becomes chronic and goes unaddressed.

When stress is chronic, cortisol levels are elevated and when elevated cortisol levels continue for a period of time, a person will reach a “tipping point” (as I explained in greater detail in this post) and cortisol levels will begin to fall or crash. This demonstrates the varying levels of adrenal dysfunction and fatigue.

According to the course I am currently taking from Restorative Wellness Solutions on adrenal health and dysfunction, there are three stages of adrenal fatigue:

Stage one demonstrates elevated levels of cortisol, usually above the optimal range.

Stage two occurs when the stressors causing stage one to happen go unaddressed. Sometimes, the overall cortisol will be within optimal range, however, the rhythm will be off. The rhythm of the cortisol throughout the day will not reflect the rhythm shown in the picture above. For an example, someone with stage two adrenal fatigue may have low cortisol in the morning and high cortisol in the evening, which is often the case and reason for the “tired, but wired” feeling at night. In stage two, since the elevated cortisol has not been addressed, other hormones will usually take a hit. Hormones such as DHEA, progesterone, and estrogen will suffer due to high cortisol production and I plan to explain this in greater detail in an upcoming post.

If stage two continues without being addressed, the individual will eventually reach the last stage of adrenal fatigue, stage three. In stage three, cortisol levels will usually all be lower than the normal range.

Each stage of adrenal fatigue requires a different approach and the rhythms occurring within each stage will vary from person to person. There is no one single cortisol pattern than defines a particular stage. One person in stage two may have low morning cortisol whereas another person may have high, which is why testing is so important when trying to truly understand what is going on and how to begin recovery.

So how do you test?

Salivary tests have been widely determined to be the most accurate way to test adrenal function and are the tests I use with my clients when testing for adrenal fatigue. Salivary tests are far superior to blood tests as they will give you a full day view of where the cortisol is and what it is doing compared to a blood test, which will only give you a snap shot. It is necessary that we know the pattern of cortisol throughout the span of an entire day to approach supporting the adrenals properly and most effectively.

With the salivary tests I have my clients take, the client will collect their saliva at four different times throughout the day – first thing in the morning, late morning/early afternoon, late afternoon, and evening. This will give us four different measurements at four different times throughout the day to see where cortisol is at and how to develop an appropriate protocol.

If you’re interested in learning more about testing, feel free to contact me here or if you’d like to work one on one with me to address current adrenal imbalances, I’d be happy to help you! For more information about my one on one coaching, read about it here.

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