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Is Testing The Adrenals Necessary?

I have been recommending adrenal saliva panels to most of my patients for approximately seven years.  There are numerous reasons for this, which I will explain in this blog post.  On the other hand, some natural healthcare professionals don’t do any adrenal testing.  They instead assume that most of their patients have adrenal problems and simply recommend general adrenal support to all of their patients.  So is it best to test the adrenals, or since most people have adrenal issues is it best to just treat the adrenals, and not do any testing?

When I was diagnosed with Graves’ Disease I obtained an adrenal saliva panel.  The results showed depressed cortisol and DHEA levels, along with a depressed secretory IgA.  Even though I didn’t think that stress was a factor, after seeing the results of my adrenal saliva panel it made me realize that stress probably was one of the biggest factors, and perhaps the main factor in the development of my Graves’ Disease condition.  But this of course was just my experience, and so this doesn’t necessarily mean that everyone should get their adrenals tested, right?  Well, what I’d like to do is discuss why I choose to test the adrenals in my patients, and then for arguments sake I’ll also list some reasons why you might not want to have the adrenals tested.

Why Do I Choose To Test The Adrenals In Most Of My Patients?

Here are the main reasons why I recommend for most of my patients to obtain adrenal saliva testing:

1. Most people have adrenal problems.  Of course everyone deals with stress, but the main problem isn’t the actual stressor, but one’s perception of the stressor.  Unfortunately most people don’t do a good job of handling stress.  As a result, most of the patients I work with have adrenal issues.

2. Not all adrenal imbalances are treated the same.  While some natural healthcare professionals offer general support for the adrenals, the problem is that not all adrenal problems are the same.  Sure, everyone should manage their stress levels, and regardless of the state of your adrenals it usually won’t hurt to take adaptogenic herbs and some nutrients such as vitamin C.  But this doesn’t mean that everyone with adrenal problems can or should be treated the same way.  As an example, when I was dealing with Graves’ Disease, I took herbs and nutrients which helped to increase cortisol production, which made sense since I had depressed cortisol levels.  However, many people have elevated cortisol levels, and when this is the case they of course want to do things to decrease cortisol production.  And the only way to know for certain if someone has elevated or depressed cortisol levels is through testing.

3. Blood testing doesn’t look at the circadian rhythm of cortisol.  Some doctors will test the morning cortisol levels through the blood.  And while this has some value, blood testing doesn’t look at the circadian rhythm of cortisol.  This is important because even if the morning serum cortisol looks good, this doesn’t mean that the person has a normal circadian rhythm, as it’s possible for cortisol to be depressed or elevated at other times during the day.  Plus, remember that cortisol increases during stressful situations, and many people get stressed out when getting blood drawn, which can lead to a false high or normal reading of cortisol.

4. Seeing is believing.  What I mean by this is that some people need to see that they have compromised adrenals before they will start to make the necessary lifestyle changes.  This definitely described me, as before I received the results of my first adrenal saliva test I didn’t expect the results to show depressed cortisol and DHEA levels.  Prior to doing the saliva test I always thought I did a good job of handling stress, but the results of the saliva test proved me wrong.  And without seeing the results I probably wouldn’t have worked on improving my stress handling skills, which is not only a big factor when it comes to restoring one’s adrenal health, but is also important when it comes to maintaining healthy adrenals.

5. The saliva panel I recommend doesn’t just evaluate cortisol and DHEA.  In addition to looking at cortisol throughout the day, along with DHEA, the company I use looks at a few other useful markers.  One of these is 17-OH progesterone, which is a precursor of cortisol.  This can provide some value, as depressed 17-OH progesterone levels are common with weakened adrenals.  Secretory IgA is also evaluated, and I spoke about the importance of this marker in an article entitled “How Does Secretory IgA Relate To Thyroid Health? [1]

Why Shouldn’t You Test The Adrenals?

Let’s look at a few of the reasons why you might not want to do an adrenal saliva test.

1. Most people have adrenal problems.  Of course I used this same argument as a reason why most people SHOULD get adrenal testing, but as I mentioned earlier on, some healthcare professionals use this as a reason NOT to get the adrenals tested.  They just recommend for all of their patients to do things to improve their stress handling skills, give their patients general adrenal support, etc.  And while some people will do fine with taking some general support, others need more specific support based on their individual adrenal state.

2. Adrenal saliva testing can be expensive.  The truth is that most testing is expensive, and you therefore want to prioritize the testing that you obtain.  I’m pretty conservative when it comes to testing, but at the same time I will recommend those tests I feel are necessary.

In summary, different natural healthcare professionals will take different approaches with regards to testing the adrenals.  Some natural healthcare professionals won’t do any adrenal testing, but instead will recommend general adrenal support.  On the other hand, I have most of my patients obtain an adrenal saliva panel, and I gave a few reasons for this in this blog post.  While it is true that many people have adrenal issues, different adrenal imbalances shouldn’t be treated the same say, and seeing compromised adrenals on a saliva panel can serve as further motivation to do what is necessary to improve the health of the adrenals.