Adrenal Testing Explained: My personal journey and how to leverage your results for better health
In today's fast-paced world, many of us experience the effects of chronic stress, which can take a toll on our overall health and well-being. As someone who frequently navigates the complexities of adrenal health with my clients, I decided it was time to run an adrenal test on myself in an effort to identify what might be driving my own blood sugar dysregulation.
While using a continuous glucose monitor (CGM), I struggled to pinpoint specific dietary components or exercise as major factors contributing to the spikes and dips in my blood sugar. This uncertainty prompted me to perform an adrenal test to examine my stress response. Although hormone testing does not reveal the exact sources of stress affecting the body, it can be a pivotal tool that offers clues based on patterns of dysregulation, helping to inform a strategy for support.
In this blog post, I will share my personal experience with the Dutch adrenal test, explore some of the unique aspects of the Dutch adrenal test specifically, and discuss how we can leverage this valuable information to enhance our health and resilience in the face of everyday challenges.
What is adrenal testing?
Adrenal testing helps to evaluate our stress response, particularly in relation to adrenal hormones such as cortisol. When assessing adrenal health, we are really assessing the body’s stress response and ability to handle stress. This type of testing typically looks at cortisol and DHEA, both produced by the adrenal glands and capable of causing dysregulation in the body when either too high or too low, or as in the case of cortisol, falling outside the diurnal pattern that is expected. While most of us may be familiar with cortisol, DHEA is an anabolic (building) hormone affected by chronic stress exposure as well, and is the precursor to our sex hormones, estrogen and testosterone.
The concept of adrenal fatigue, suggesting that the adrenal glands cannot produce enough cortisol is outdated and not supported by the current research. The real issue lies higher up in the cascade of the brain's signaling mechanisms, between the hypothalamus, pituitary, and adrenal glands, often referred to as the HPA axis. When this communication breaks down, dysregulation ensues and we need to bring the entire system back online, not just view this as a problem with the adrenal glands alone.
While adrenal testing has its limitations as a single-day cortisol test reflecting levels for that particular day, and influenced by various factors such as age, sex, menstrual cycle, and even the day of the week, these tests can be incredibly useful tools in assessing patterns of dysregulation and developing strategies for support. In addition, they do not reveal the underlying sources of stress (physical or emotional), which is where clinical expertise becomes essential, and practitioners like myself must interpret these results in the context of overall health trends and patterns, rather than viewing them in isolation.
What makes the DUTCH adrenal test unique?
DUTCH is an acronym for Dried Urine Test for Comprehensive Hormones. While there are many versions of this test measuring various hormones, I performed the DUTCH Adrenal Test which looks specifically at cortisol and DHEA production. The DUTCH test stands out for its ability to measure creatinine, cortisol, cortisone, DHEA-S, and the cortisol and cortisone metabolites, along with a preference for on over the other. The inclusion of free cortisone— the deactivated form of cortisol—helps to validate the cortisol levels. This test also looks at DHEA-S, the sulfated form of DHEA, which gives us a better measurement of total DHEA since 97% of this hormone is in the sulfated form.
My personal DUTCH adrenal key findings:
Cortisol-Overall low and not following the appropriate pattern
DHEA-S-Low
See my test results here to follow along visually and for a look at a sample report
Cortisol, often known as the stress hormone, also plays a crucial role in inflammation and immune health. When cortisol is low, inflammation can go unchecked, which may explain why my recent illness hit me hard. The immune system often becomes suppressed when cortisol is low. In addition to levels of this hormone having significance, cortisol also follows a natural circadian rhythm, peaking in the morning and declining steadily throughout the day. With the DUTCH adrenal test, the highest value of cortisol should be the morning sample, an hour or so after waking. My test shows the highest value as the waking sample, but this is more accurately a reflection of what cortisol looks like during the night. At this level, sleep quality must be assessed.
DHEA-S is the sulfated form of DHEA. Produced mainly by the adrenals, DHEA is an anabolic hormone, vital for building the body, and is a precursor to our sex hormones. Low levels of DHEA can indicate greater hormone disruption, making the case for a more comprehensive hormone panel down the road that includes estrogen, progesterone, and testosterone. Imbalances in DHEA often result from prolonged stress demonstrating a breakdown in HPA signaling.
With both my DHEA and cortisol low, it is no wonder my blood sugar does not look stable. It is also no wonder recovery from this recent illness seemed prolonged. While evaluating cortisol and DHEA levels offers valuable insight, it does not pinpoint the root causes of hormonal imbalances. Instead, these results serve as a roadmap, guiding me to identify key areas that warrant further investigation. In addition, they help me decide which supports to apply that can help bring the HPA axis back into balance as I address the foundational pillars of health that are ultimately at the root of imbalance. These include:
Gut health-digestion, absorption, and the microbiome
Blood sugar regulation
Inflammation
Stress- both physical and emotional stressors
Sleep
Nutrient depletion
By examining the above aspects of health, I aim to develop a holistic approach to hormone health, applying targeted interventions that address the root cause rather than merely managing the symptoms. While adrenal testing can be a valuable asset to any health plan, there are specific circumstances in which it is particularly beneficial.
When you might consider adrenal testing?
Chronic fatigue, mood changes, or brain fog
Blood sugar dysregulation
Unexplained weight change
High stress or low stress resilience
Frequent illness
Other hormonal imbalances, infertility
Persistent inflammation
Sleep disturbance
Its important to understand that as a functional practitioner I don’t often start with adrenal testing, prioritizing instead the foundational pillars first, as this approach frequently corrects hormonal imbalance. Regardless, testing rather than guessing is an effective strategy for more rapidly identifying what drives our health challenges. If you're curious about how functional testing can elevate your health journey, I encourage you to book a FREE 30-minute consult with me! Let’s explore your path to wellness together.
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Carla Abate is a Board Certified Holistic Nutritionist in Lakewood, CO, specializing in functional nutritional strategies for women and families. She is a Restorative Wellness Solutions Practitioner, a Certified Nutrition Therapist Master, and a Postpartum Doula. She also holds a Master's degree in Counseling. Carla is dedicated to fostering health and wellness through evidence-based nutrition coaching. Contact her at Rebel Roots Nutrition.
References:
https://pmc.ncbi.nlm.nih.gov/articles/PMC4997656/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3181830/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8434839/
https://pmc.ncbi.nlm.nih.gov/articles/PMC10316519/
https://pmc.ncbi.nlm.nih.gov/articles/PMC6948931/