Adrenal Stress Test

Adrenal Fatigue Testing

Adrenal Fatigue Symptoms

In this video I show how important Adrenal Fatigue Testing is to identify the cause behind common health problems.

Adrenal fatigue, also known as Hypthalamus Pituitary Adrenal axis dysfunction (HPA axis for short) is one of the main causes behind the five most common health problems that I see in clinic. The five most common health problems are weight, fatigue, depression, hormone imbalances like PMS, digestion problems like IBS.

Adrenal fatigue also affects thyroid function which can cause a “double whammy” effect as many of the same symptoms of adrenal fatigue are the same as low thyroid function.

Cortisol is the main hormone secreted by the adrenal glands, cortisol controls blood sugar regulation and high cortisol will lead to high insulin levels and weight gain, especially around the waist.

Adrenal fatigue is not caused by one or two stressful incidents but it is caused by prolonged stress over a long period of time. Stress is not just mental stress from work or relationships but it can be physical stress from pain or injury, overtraining, digestion stress from bowel problems, sleep disturbances or food intolerances.

The Stages of Adrenal Fatigue

One of the reason’s that it is important to get tested for adrenal fatigue is that there are three different stages of adrenal fatigue, and knowing which stage of adrenal fatigue you are in is important for treatment and recovery.

Stage one

With stage one of adrenal fatigue your cortisol levels are elevated, many people are in this early stage of adrenal fatigue and don’t yet realise that something is wrong. The symptoms of this stage are usually mild and can be things like poor sleep (that tired but wired feeling), muscle aches and pains, weight gain or difficulty losing weight, afternoon fatigue and the need for stimulants like coffee or simple carbohydrates to get going.

Stage two

During stage two the cortisol levels start to drop, the brain realizes the high cortisol is damaging and will shut down the messages to the adrenal glands to keep making cortisol in response to stress. Symptoms like fatigue, anxiety, weight gain and the craving for stimulants increase.

Stage three

Adrenal exhaustion! Cortisol and DHEA levels decline and fatigue turns into exhaustion, immune function is depleted so you are often picking up lots of minor illnesses like colds and flu’s. The third stage is when people really struggle to get through the day, yet the progression to stage three can be a slow process of a couple of years, so sometimes people have forgotten how good they use to feel and this becomes the new normal or they think they are just getting old.

Adrenal Stress Test indicating high cortisol levels

Adrenal Stress Test indicating high cortisol levels

Adrenal Fatigue Testing

Testing adrenal function is occasionally done by your doctor with a blood test, but this is not a very good way to assess adrenal function and your doctor is only testing to see if you may have Addison’s or Grave’s disease, this is when your adrenal glands are not working at all

The best way to test adrenal function is with a DUTCH Hormone Test which is taken at 4 different times of the day, this is to measure DHEA and cortisol. Your cortisol levels change throughout the day which is why it is important to do the 4 different samples so that we can measure your cortisol rhythm.

A DUTCH hormone adrenal function test can be done wherever you live, you can order the adrenal test through Planet Naturopath and a kit will be sent to you so that it can be done by you at home, it is then posted back to the lab for analysis. Once the results return I will explain them in detail and help you workout a treatment plan to get you back to your optimal health.

About the Author Michael

Michael is head consultant at Planet Naturopath - Functional Medicine and Nutrition Solutions. As Seen

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Leave a Comment:

Caroline Hayes says May 20, 2015

please can I make an appointment to do this test.

    michael says May 20, 2015

    Yes Caroline, you can email me at and I will organize a test kit to be sent to you

Fabienne says May 21, 2015

Please give me an indication on cost for the saliva test

Thanking you

    michael says May 21, 2015

    Hi Fabienne

    The cost of the adrenal function test is $195 including the 30 minute consultation to go through the results and work out a treatment plan

Kate says June 3, 2015

I have had this test and have had 3 different interpretations of the results. Can cortisol appear to be within normal range in later stages of adrenal fatigue?

    michael says June 3, 2015

    Hi Kate

    Yes cortisol can appear to be in the range in Stage 2 adrenal fatigue but the DHEA needs to be very low as well

      Kate says June 4, 2015

      So there’s no point when both will appear within range?

Mateusz says September 19, 2015

I have cortisol level in morning 25,when he should be max to 23 and low sex drive…what is this stage? I feel stressed, somehow overactive and tired. Overtraining lead me to AF. I trained stupid and hard by 3 years. I changed completely my diet over 3months ago added vits, feel somehow lower stressed but i sleep bad. Sometimes i sleep 7 hours per day and sometimes only 4 hours per day. I know that good sleep is important, because if I fall asleep i feel how my nervous system is relaxed somehow off. And it disturb me that i sleep 4 hours at night. Im only 20 years and suffer from AF from 2 years. 2years of tiredness and muscle pains on the lessons in the school. I would like to feel like once…

    michael says September 20, 2015

    You cannot diagnose adrenal dysfunction with just a morning cortisol reading, you need to look at the different levels throughout the day plus your levels of DHEA. These same symptoms may also be caused by high estrogen and low testosterone, getting a full hormone test would help work out what is happening and the best way to treat it

Planet Naturopath: Are your adrenal hormones sabotaging your health? - PALEO CAFÉ says November 23, 2015

[…] symptoms, and while they can be caused by many different things, getting properly diagnosed with a saliva adrenal test or DUTCH urine test which measures cortisol at four different times of the day will let you know […]

Penny Pickering says January 8, 2016

I have done your test through my doctor. My results were morning 11,7, Midday 4.7, Aftn 4.5, Evening 2.5. Total for day was 23.4. My doc says this indicates adrenal fatigue. Can you tell me what stage I would be in. My DHEA morning profile was fine (16.1) but my DHEA/Cortisol AM was 1.35 (extremely high). I am unsure as how to interpret this in terms of being adrenally fatigued? Could you shed some light. Thanks

    michael says January 9, 2016

    Hi Penny, that is a low cortisol reading and an “ok” DHEA reading based on these results that would be a stage 2 of adrenal fatigue. With your DHEA levels of 16 it should be easier to fix than someone who has low DHEA.
    Let me know if you need any help addressing the low cortisol, you can contact me at

      Penny Pickering says January 9, 2016

      Thanks for the reply. Do I need to be concerned about the extremely high DHEA/Cortisol AM level or should that even out when I can get my others levels up to normal and stabilised. Much appreciated

Rachel says March 22, 2016

Hi Michael
I have just had the test done through a dr and my levels were DHEA-S 4.1
Cortisol morning 9 midday 9 evening < 3 and night < 3
What level would this put me at?

    michael says March 23, 2016

    Hi Rachel your cortisol levels are quite low and DHEA is lowish …. this would put you in a stage 2 category

      Rachel says March 23, 2016

      Thanks for the reply I’m trying to find more information about what helps the most but I wasn’t sure what stage I would be and the information shows big differences between the stages as to what to do. I really appreciate your help and will be reading your blog regularly now.

Teresa says April 4, 2016

Hi, how accurate are these tests? I would like to test myself but I am uncertain if it is inaccurate then I would be wasting my money.

    Michael says April 25, 2016

    The saliva adrenal test is accurate for free cortisol and the DUTCH urine test is accurate for total cortisol, free cortisol and cortisone so overall will give you more details

      Anja says November 30, 2016

      Hi Michael. I’m interested to know, is there ever a situation / circumstance when the adrenal saliva test would be deemed sufficient or recommended to a patient over the DUTCH urine test?

        Michael says December 2, 2016

        Hello Anja

        The DUTCH test is more comprehensive but it is also more expensive than the saliva testing so the main reason that I would recommend it over the DUTCH test is for budget reasons. The saliva test is still an accurate test for measuring free cortisol but it does not tell us the full picture of total cortisol production or cortisone levels

Lea says April 24, 2016

May I please order adrenal fatigue test kit. Thank you

    Michael says April 25, 2016

    To order an adrenal fatigue test email me at

Stacey says April 28, 2016

Hi, am thinking of ordering 1 of your test kits. My doctor thought I may have Addison’s disease based on symptoms & hyperpigmentation. My test results so far as follows:
Serum Cortisol 8am 20nmol/L (220-720)
Aldosterone 240 pmol/L (100-950)
Renin 5 mU/L (3-40)
Aldosterone/Renin Ratio 48 (2-75)
The lab missed doing the ACTH test so I had to go back 2 weeks later for another blood test, they also redid the Cortisol and the results are:
Serum Cortisol 8am 560 nmol/L (220-720)
Plasma ACTH 12 ng/L (5-50)

Very confused – after the first test it was confirmed that I had AI and the ACTH would confirm whether I had PAI or SAI. Now after this test Doctor thinks I don’t have either. I had a cortisone injection in my hip 2 days before the first lower level – could this have affected the test result?

    Michael says May 20, 2016

    The cortisone may have affected the test. The best test for adrenal/ cortisol function is the DUTCH hormone test, I can organise this for you

Yola Mokdissi says September 10, 2016

Hi where are you situated? Is this a full hormonal test with DHEA?

    Michael says September 29, 2016

    Hello Yola

    I have an online business so I can work with people in many parts of the world. The full hormone test does include DHEA

Sophia says September 14, 2016

Hi, can the hormone test kit be sent to customers verseas?

    Michael says September 29, 2016

    Hi Sophia

    Yes the test kits can be sent anywhere in the world, to order just contact

Susan says February 27, 2017

I just did the Dutch Test. My cortisol was:

Waking: 15.8
Morning: 189.6
Afternoon: 46.2
Night: 18.3

My dr said she was surprised that my DHEA was 407.0 and my testosterone was 9.8.

My estrogen and progesterone was low so she is going to order a liquid hormone blend for me that she feels will be safe for me to try.

She also has me taking Standard Process Hypothalamex, two tablets in the morning. I was working out at night and was having issues falling asleep. I have been taking the Hypothalamex for two days and stopped working out and notice that I am able to fall and stay asleep much better.

Thank you for reading this and I wondered if you agree with my dr on me taking the Hypothalamex? Have a good day.

    Michael says March 9, 2017

    Hi Susan I don’t use the product that you mentioned but your doctor has your test results and I am sure has taken a thorough history of your signs and symptoms. Your free cortisol levels are very high and that is what I would be addressing also.

sandy honey says July 12, 2017

How much is the kit, testing and getting the results please .. I live in Cairns

    Michael says July 24, 2017

    The DUTCH hormone test kit is $445 and includes the consultation, we can send a test kit to Cairns

Melissa says January 27, 2018

I plan to take a Cortisol saliva test but wonder if I should take it during a normal day of work sitting at my desk throughout the day or when I am active like hiking on a weekend ? My problem is I am totally exhausted/fatigued within 5 minutes of hiking, having been hiking 12 years so it’s not new and I should be easily able to hike anything but over the past 12 years I get worse and worse barely able to hike. Appreciate your guidance.

    Michael says February 16, 2018

    Hi, Melissa, I do not recommend the saliva hormone testing as it provides limited information, and in some cases can be misleading. For adrenal function testing I recommend this test

Kellie Walkom says May 29, 2018

Would love a adrenal gland test kit please

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