Adrenal Function Tests – Understanding Your Blood Test Results

The fourth podcast in this series, Dr Sandra Cabot and naturopath Margaret Jasinska explain how adrenal function testing can give you a lot of insight into your health. The adrenal glands produce hormones such as DHEA, which helps with energy and strength, and cortisol – the stress hormone. They explain how to interpret your blood test results and what symptoms to look out for that might indicate your adrenal glands aren’t working properly.

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DR CABOT: Hi, everyone. This is Dr Cabot and Margaret Jasinska with you again, helping you to understand your blood test results. And today we’re talking about evaluating your adrenal glands. And that’s very, very important, isn’t Margaret?

MARGARET: Yes. And a lot of people are interested in the health of their adrenal glands. Particularly if they’re feeling tired all the time, particularly tired in the morning. That can be an indicator of a sluggish adrenal gland. Also, the adrenal glands could be making too much hormone and that could be interfering with your ability to lose weight. So, your adrenal glands are important.

DR CABOT: That’s right. Your adrenal glands make the hormone cortisol, C-O-R-T-I-S-O-L, cortisol. They also make aldosterone, which controls your salt and chloride, potassium type of balance, your electrolytes. They also make another hormone called pregnenolone, which is a mother hormone that is used to produce all the other hormones. And the adrenals make DHEA, which stands for dehydroepiandrosterone, but we abbreviate it, DHEA. And that’s an antiaging hormone. So, we want plenty of that one. We make a lot of that when we’re young. But as we get older… oh, wow! Tragically, it diminishes. That’s why a lot of people take DHEA.

So, when we do a test to evaluate your adrenal glands, we will test your level of that hormone, DHEA. And it should be between .5 and 11.7. And a lot of people say, “Well, I don’t want mine to be right at the bottom at .5. Can you give me some DHEA?” Well, DHEA can be useful in people who are very tired or they want to slow down the aging process. Some people find it helps them mentally to be more switched on, too.

MARGARET: Yes. And it can increase your muscle strength, as well. So, people with very low DHEA, a lot of patients with chronic fatigue syndrome have very low levels, so they feel tired. But they also feel that their muscles are weak. And so, raising your arms to hang the washing or to use the hair dryer, they just find that they get muscle fatigue very quickly.

DR CABOT: Yes, they do. And I’m definitely a believer in bioidentical hormones. They’re a little bit controversial in some countries. A lot of doctors won’t prescribe them. But DHEA is very safe. And a lot of people take it as they’re getting older because they want to stay younger as long as they can.

Now, the other very important blood test is to check the amount of cortisol, which your adrenal cortex is making. And normally your adrenal glands produce more cortisol in the morning to get you going because it gives you energy and it helps you face different threats.

MARGARET: And motivates you to get out of bed and get going.

DR CABOT: Yeah, it’s definitely a stimulant, cortisol. So, it should be higher in the morning. And in the morning, we like it to be well over 135, and the upper limit is 700 – that’s in the morning. And then towards the end of the day, late afternoon, it normally goes down to be between 100 and 400. That’s the level in the blood.

So often we’ll send someone to laboratory to have their blood taken early in the morning and late in the afternoon. But generally speaking, cortisol levels should be between 100 to 690. If they’re too low, you have adrenal gland failure, you can be in serious danger. If they’re too high, you will have Cushing’s syndrome, where you will be overweight and bloated, diabetic, puffy. And that needs to be treated differently.

MARGARET: Yes. So, it’s not often that we see patients at one end or the other extreme end. More commonly, we see people close to the bottom range or close to the top range. So, they’re still considered normal. However, they have symptoms of adrenal gland problems and they’re unhappy with their health. So, we need to do something about it.

DR CABOT: That’s right. So, if somebody has a very underactive adrenal gland, we use hydrocortisone. And the other day, I diagnosed a lady with total failure of her adrenal glands. She’d been unwell for twelve years. She hadn’t been given the proper diagnosis because no one had tested her adrenal glands. In twelve years of going to different specialists, she had never had a blood test for her adrenal glands, which was very sad because this woman was very, very sick. Everything in her body was falling apart. Her brain, her gut. She couldn’t function and her level of cortisol was 16.


DR CABOT: I’ve never seen anything that low in my whole life. As you say, it should be well over 100. This lady had 16 and that was repeated on several occasions to confirm it, that she had adrenal failure. And she was put on hydrocortisone and she feels normal. She’s got her life back.

So, the adrenals are important for survival, right? If your adrenals aren’t working, then you’re going to really struggle in life. And if they’re overactive, you might feel okay but you’ll struggle with your weight and you may be diabetic. So very simple, easy, accurate blood tests to check your adrenals is a cortisol level and a DHEA level.

And there you go! Now you understand your adrenal glands, your survival glands.

MARGARET: Thank you for listening everybody.

DR CABOT: Yes. And remember, if you have any questions, you can email us. We love to hear from you. Thanks for listening!