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| The adrenal glands can be evaluated in several different ways and more than one of these may be required to fully understand the nature of the problem. Conventional physicians routinely test for adrenal function by measuring the levels of the adrenal hormone cortisol. Function Because cortisol is secreted at different levels throughout the day (most in the morning, least around midnight), multiple samples (usually 4) should be taken through out the day at specific times. Individual samples can be taken by blood or saliva. A single serum or saliva cortisol by itself will usually not be very useful. Alternatively, a 24-hour cumulative urine test can be done which will show how much cortisol was secreted during that period. An ACTH (Cortrosyn) baseline and challenge may be the best tests to determine whether your adrenal glands are able to respond to signals from your brain. Some consider two 24-hour urine samples, one before and one after the ACTH injection, to be the best method of testing for adrenal weakness. The dexamethasone test, along with baseline measurements, is usually performed only when adrenal hyperfunction is being evaluated. It can differentiate adrenal disease (altered response to ACTH ) from pituitary disorders (altered production of ACTH). The secretion of ACTH from the pituitary gland is normally regulated by the level of cortisol in the blood. ACTH stimulates the adrenal cortex to produce cortisol. Giving dexamethasone should reduce ACTH levels resulting in decreased cortisol levels. Expected Outcome With or without lab testing, if symptoms indicate adrenocortical deficiency, a low dose therapeutic trial of cortisol for several weeks may prove both informative and helpful. |
| Chronic Fatigue / Fibromyalgia Syndrome Cushing's Syndrome / Hypercortisolism Hypothyroidism Low Adrenal Function / Adrenal Insufficiency |