Feeling Tired and Exhausted? 4 Adrenal Testing Options

A few years back when I was at the worst stage of adrenal fatigue, I struggled to find a doctor or health practitioner who understood what I was dealing with.

I was feeling tired and exhausted all the time.  I knew that what I was feeling was not normal.  My visit to my local doctor, had not provided me with much joy, and the blood tests she encouraged me to do showed up as normal or on the low side of normal.

While the mainstream medical world has its benefits in times of crisis and medical emergency, I believe in other areas of health, there is a tendency to look at a person as being either in a disease state or ‘normal’.  This ‘normal’ range however, has a vast number of levels, and is of course the precursor to venturing either towards the disease state or pulling things back and heading back to the optimal state.  I know where I would rather be.  How about you?

I came to understand that the key to testing the state of your adrenal glands is to get a feel for how much cortisol they are releasing.   The adrenal glands are really the holders of the stress hormones and decide when and how much cortisol to secrete (amongst other stress hormones like DHEA and Aldosterone) depending on how stressed you are.

While testing your cortisol levels is not the answer to everything, it does provide you with some substantiated results to help you understand if the level of stress in your life is having a greater effect than you may realise.  It can also make it much easier for your natural health practitioner or doctor (who understands adrenal fatigue) to prescribe more appropriate supplements and lifestyle guidance depending on the severity of your results.

The other part of this puzzle is a candid conversation with your practitioner about the signs and symptoms that you are feeling, and the level of lifestlye adjustments that may be needed.  These are not just about looking at some of the physical adjustments to make, but very much looking into the emotional and mental aspects of your life as well.


For each of these tests, I would highly recommend that you do this in conjunction with your doctor or natural health practitioner who understands adrenal fatigue.  Understanding the results of these tests is not always the easiest thing to navigate and while the symptoms between high cortisol and low cortisol can overlap in many ways, the treatment and supplements that may be helpful will vary depending on where your cortisol levels are at.   In fact taking supplements for high cortisol when you should be taking something for low cortisol (and vice versa) can be detrimental to your recovery.  So please, enlist the support of a qualified practitioner.

1) A Simple Blood Test

This is probably the least reliable of the tests because it is literally a moment in time and the broad range of normal does not provide a precise reading.  However, if you do decide to do it, do it before 9am and if you retest it, be sure to do it as close as possible to that same time.  It is good to have a full blood panel done anyway, so get other things checked at the same time to help rule out the possibility of other health issues that may be going on.

2) A 24 Hour Saliva Cortisol Test

This is one of the best tests to do to test your cortisol levels and subsequently get a feel for your adrenal function.  There are many labs around the world that are now set up for you to carry this out, but as I mentioned above please do this with the support of your natural health practitioner so you can get the best help with reading your results and decide on the best course of action together.

The best test is to do what is known as a diurnal saliva test, which is a 24 hour test.  With this test you will test your saliva before breakfast, lunch, dinner and before bedtime.  If you retake the test, be sure to test your saliva at the exact same times to get a fair comparison.   Done over time, 24 hour saliva tests can help build the picture of what is going on with your adrenals.

If your adrenals are healthy, your cortisol levels should show as being highest in the morning around 8am, still fairly high around 11am or 12noon, around mid way 4pm to 5pm and bottoming out at 11pm to midnight.  If your levels show something different, especially opposite measurements to these, then you know you have an adrenal imbalance.

Also note that in the early stages of adrenal dysfunction your cortisol levels will typically be high at night, and if the dysfunction progresses, your cortisol levels will be low all the time.  With constant low cortisol, you will be experiencing an abundance of unpleasant physical symptoms  such as constant fatigue, muscle weakness, extreme mood swings, body aches, respiratory infections, inability to sleep, dizziness, allergies, low blood sugar, emotionally unable to cope and the list unfortunately goes on and on.

3) A Hair Analysis

Again, there are many labs that are now set up that carry out this service and your practitioner will have a lab that they work with.  You will usually be required to collect a roughly 5cm (2 inch) length of hair which will represent a period of around 90 days of cortisol load.  This can show your cardiovascular risk from the stress present in your hair.

4) A 24 Hour Urine Cortisol Test

This is just another way to provide some evidence of how much cortisol is in your system.

When done over a 24 hour period, you can get a greater sense of your cortisol output over an entire day instead of just a snapshot.  Your health practitioner will tell you the best way to prepare for this according to the lab that is being used.

Dr Sara Gottfried has also spoken of a relatively new way of testing urine over a 24 hour period through dried urine hormone testing, ie you simply urinate on filter paper until it is saturated.  There will also be specific times that you will need to do this and again your practitioner will guide you.

These tests can help to build the picture of what is going on with your adrenal function and with the knowledge gained ideally heading on the path to recovery!

Have you had any of these testing options done?  What results did you get?

I wish you well.

Love Lisa


Please note: I reserve the right to delete comments that are offensive or off-topic.

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2 thoughts on “Feeling Tired and Exhausted? 4 Adrenal Testing Options

  1. I did the DUTCH test, (dried urine) & my results confused me. The naturopath didn’t seem concerned, however, I still experience so many symptoms.

    I didn’t realize respiratory problems were a symptom as well. I just progressed from bronchitis to pnuemonia.

    • Hi Christianne

      These tests help to build a picture in combination with the symptoms you are feeling, they are not necessarily conclusive evidence in themselves.

      And yes respiratory related immune issues can be an issue with adrenal fatigue. I hope you get better soon from the pneumonia.

      Keep focusing on slow and calm right throughout your day.