How is adrenal fatigue diagnosed?
Adrenal fatigue is a clinical diagnosis, meaning there is no test that confirms it; symptoms must be examined to rule out various causes. Watch integrative medicine expert Aviva Romm, MD, explain the methods doctors use to diagnose adrenal fatigue.
Now, there are some tests that can be done. One of them is a 24-hour cortisol test. And that actually looks for frank adrenal problems.
Adrenal fatigue is what we call a clinical diagnosis. It means there aren't necessarily really great tests that can say you do or you
don't have adrenal fatigue. And we base that on symptoms once we've ruled out as physicians other complicating medical problems
that you might have. So there are other things that we think of when someone has a lot of fatigue. For example, anemia might be a reason, or low thyroid.
So we check those things in the clinic. And if that's normal and you fit this other symptom picture, then adrenal fatigue is high on the list of what
might be going on for you. Now, there are some tests that can be done. One of them is a 24-hour cortisol test.
And that actually looks for frank adrenal problems. But if you're on the low end of normal, some integrative or functional medicine doctors
would consider that indicative of having adrenal fatigue. And then some integrative and functional medicine doctors also look at something called the Adrenal Stress Index.
It's a 24-hour salivary cortisol. So you actually collect your saliva for 24 hours.
And we look at the cortisol levels. And we're actually looking not just at the level, but the specific pattern throughout the day
because cortisol is supposed to be high in the morning. It gives you the energy to get up and get out of bed in the morning. And then it's supposed to decrease throughout the day
so that by the time you're ready for bed, it's actually pretty low. And that's normal. And it allows you to settle down and go to sleep.
So sometimes we see flipped patterns in people. And that can tell us that there's adrenal fatigue going on. That test also looks for a few other hormones
that can be out of balance in conjunction with adrenal fatigue, like DHEA, progesterone, and a few other things.
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