How can we tell if we have Adrenal Fatigue?
Adrenal fatigue is still, after many years, a bit of a controversial diagnosis. We natural practitioners feel that it helps to make sense of symptoms that are not easily explained by orthodox methods, also giving us a practical treatment method that can deliver good results. For more information on the condition please see my other blog post or a very detailed summary by Dr Axe here.
Some of the criticisms voiced from a purely medicial perspective (see a good artice by Marcelo Campos, MD from Harvard Medical School here ) are that the syndrome is too vague, and includes too many symptoms. Or that it includes symptoms that may point to more serious underlying disease. Therefore it might be easy to blame everything on Adrenal Fatigue and potentially leave other underlying disorders undiagnosed.
I must admit that I do agree with this last point. It is nice to have a syndrome like Adrenal fatigue, that explains a broad spectrum of symptoms – affecting multiple systems of the body – but we cannot affort to overlook any underlying pathology. An example would be a fatigued person, who is on treatment for their adrenals, will not get better if they actually have an underactive thyroid, anaemia or a chronic infection. This is why I do advocate seeing a professional to confirm a diagnosis of adrenal issues and feel that it should be arrived at after a good case history, physical examination and possibly blood tests.
The things that I find useful to test for are full blood count, iron status, thyroid function, sometimes glucose and insulin or even allergies. It does vary from person to person. Some people feel that adrenal fatigue can be confirmed by disproving any other identifyable causes for the fatigue. But others are still searching for a test specific to the adrenals to prove or disprove this diagnosis.
Most of the ‘medically approved’ blood tests are designed to assess for the more severe condition of adrenal insufficiency, or to diagnose Cushings Syndrome or Addisons Disease. Therefore tests like blood cortisol and Adreno Cortico Trophic Hormone may not pick up the subtle differences that are spoken of in adrenal fatigue (but are still useful to rule out more serious illness). Then we have the ‘internet approved’ home tests involving shining bright lights at people, monitoring pupilary constriction, holding the breath and measuring blood pressure lying and standing. Unfortunately there are too many other physiological, endocrine and nervous mechanisms that affect these reflexes to honestly attibute any changes solely to the adrenals. Measuring baseline body temperature is an interesting concept, but even this is affected by other hormones (like thyroid or menstrual hormones) or even by stress and quality of sleep.
The test that I prefer is a 24 hour salivary cortisol test. Because the adrenal glands have a normal diurnal rhythm, with natural day and night hormal fluctuations, doing a four point reading is a better assessment of adrenal function than a single point blood test. The saliva tests are quite accurate, affordable and done by the local accredited pathology laboritory. I tend to give my patient the saliva tubes up front and then it is easily done in the privacy of your own home. I cannot say it is 100% fool proof, and certainly does still have its critics, but I find the 4 point reading to provide more information and be a useful assessment of where the adrenal glands are at.
If you are considering whether you have adrenal fatigue, I urge you to get yourself assessed by someone who can rule out other underlying issues before undertaking a longtern treatment protocol.