What Is Adrenal Fatigue? Symptoms and Labwork to Ask Your Doctor About

Ever feel so fatigued that you struggle to enjoy activities that are typically purposeful and enjoyable? Ever feel like you drink coffee, pop, or other caffeine sources like your life dependent on it? Can you relate? One of the number one concerns patients come into MIMC is because their energy just isn’t like it used to be. Fatigue can be a common result of the pressures to keep up with the demands of home life, social life, and work life.

Nowadays we wear busy like a badge of honor, juggling the many titles we hold whether that be husband, wife, father, mother, student, boss, coworker, volunteer, athlete, artist, socialite. These perpetual demands leave us feeling frazzled and a never ending reliance on stimulants. What you might be experiencing is adrenal fatigue, or also known as Hypothalamic-Pituitary-Adrenal Axis Dysfunction. 

What is Adrenal Fatigue?

The adrenal glands are these small organs that sit on top of the kidneys and are responsible for managing our daily stress response. Although adrenal fatigue is not often accepted as a formal diagnosis, the medical community will often use this to describe a range of symptoms that occur when the adrenals are under pressure, and as a result perform below their typical level.

Adrenal Fatigue Symptoms

A collection of symptoms may occur and vary in intensity with adrenal fatigue. These are popular symptoms that may suggest that your adrenals are not working optimally:  

  • Not waking up refreshed in the morning.
  • Mid-afternoon crash.
  • Low libido.
  • Irritability.
  • Anxiety or depression.
  • Inability to cope with stress.
  • General muscle aches.
  • Brain fog or poor memory.
  • Cravings for sugar, salt or fat.
  • Dizziness or feeling light headed.
  • Poor sleep or sleep disorders.
  • Hormone imbalances.

What Tests Can You Ask Your Doctor for to Assess Adrenal Fatigue?

There are few ways in which we can assess the function of the adrenals. The most common of these is to assess your cortisol levels. Other tests that may be considered is DHEA-S, HbA1c, and Insulin. 

  1. Cortisol: Helps to evaluate your cortisol rhythm throughout the day. This allows us to evaluate your stress response and its influence on sleep patterns.
  2. DHEA-S: Is a pre-hormone that is created by the adrenals that is later converted into estrogen or testosterone. 
  3. HbA1c: An HbA1c test shows what the average amount of glucose attached to hemoglobin has been over the past three months. Blood sugar can be affected by increased output of cortisol. 
  4. Insulin: Evaluates blood sugar regulation.

How to Perform a Cortisol Test

Cortisol can be collected 3 ways.

  1. AM Serum Cortisol: Is a simple blood test that is collected before 10 AM in the morning. This is a cheap method to help understand a snapshot of what level of cortisol is being released in the morning. The downside is that the AM serum cortisol is simply a snapshot; therefore, does not allow us to see the cortisol release pattern throughout the day. 
  2. 4-Point Salivary Cortisol Collection: Is a salivary collection kit that is performed at 4 specific points throughout the day. This allows us to understand the cortisol release pattern throughout the day, and can be specifically helpful for those who have troubles with energy in the afternoon or have troubles sleeping.
  3. Urinary Cortisol Collection: Urinary collection can be performed as well through cortisol metabolites. For those who have a difficult time collecting saliva, this may be a great alternative to the 4-point salivary cortisol collection. In addition, this gives us information on cortisol and the body’s conversion of it to cortisone. 

What Testing Does MIMC Provide?

MIMC provides all 3 options! Working with your provider and discussing your health history will help to determine which test is best to perform. 

When Should You Get Tested for Adrenal Fatigue?

If you are currently experiencing a combination of these symptoms, it is time to get tested! Working with your provider you can further discuss your symptoms and help determine if other testing should be included too. Determining the underlying causes can help to appropriately treat and optimize treatment outcomes.