Unless you’ve been to a physician trained in natural therapies, you’ve probably never directly heard about the adrenal glands and their role in health. Essentially, adrenal gland problems, outside of pathology, don’t exist in conventional medicine, even in the eyes of endocrinologists. The main reason adrenal gland problems go unaddressed is because standard medical tests do not identify problems until hormonal levels are greatly altered, most often due to some pathology of the glands or reaction from a medication. There are a few reasons why medical tests are insufficient, and typically a waste of time and money, when it comes to evaluating the health of these hormones.
Testing For Adrenal Gland Problems
First, as discussed in Part I, is that the adrenal glands release their hormones in a circadian rhythm, which is a 24-hour cycle. The hormonal levels should normally be highest in the morning around 6-7am and lowest at night around 11pm-12am. So it’s normal for your hormonal levels to fluctuate throughout the day; actually if they don’t then you’ll have problems. When a person has their adrenal hormone levels checked (typically cortisol), and the results come back as “normal”, all that means is that the level was normal for that specific time of the day. It’s very common for someone with adrenal gland dysfunction to have certain times of their circadian rhythm impaired. Just because a blood test at noon says everything is fine doesn’t mean that they’re working well at 8am or 10pm.
The second reason that medical blood tests often miss adrenal gland problems is that the standard medical ranges for “normal” are expanded to such lengths that there has to be a great overproduction or under production of hormonal levels to be flagged as abnormal. So with such wide ranges, it’s hard to fail the test.
The third reason has to do with the actual blood tests when it comes to testing the hormonal levels, and this holds true for other hormonal levels too, particularly sex hormones such as testosterone, estrogen, and progesterone. Blood labs are testing for the total blood-bound hormone levels which do not have a significant influence on the body’s tissues as the unbound free hormone levels. This means that checking blood levels often does not reveal a problem because it is looking at the total amount of hormone in the bloodstream which again, isn’t often a factor until the patient is in dire health. The free hormone levels, which today can be easily and accurately (and affordably) measured through saliva, tend to be much more indicative of the individual’s true state of hormonal health as it is testing the free levels, (approximately 8-10% of the total), which are actually having an effect on the human body and overall health. And, due to the circadian rhythm of all hormones, saliva testing allows for testing multiple times at home to get a total picture of a gland’s function throughout the day, rather than a single spot-check.
Common Signs and Symptoms of Adrenal Problems
Recognizing various signs and symptoms of adrenal gland problems can help you not just realize that there is a health issue which needs to be addressed, but hopefully deal with the problem before it becomes more severe. Here are some common adrenal gland signs and symptoms alerting your body it is under more stress than it can handle.
- Allergies -> Both food and environmental allergies can be a sign that your adrenal glands are stressed. If you’re unable to go through normal seasonal changes without sneezing or getting sick or if you’re sensitive to certain foods, your adrenal glands may need a tune-up.
- Dizzy standing up quickly -> This problem, known as orthostatic hypotension, occurs when your blood pressure drops when you stand up too quickly. No, the way to alleviate this problem is not to stand up more slowly, but deal with the hormonal stress so your blood pressure can be regulated immediately no matter what your positional movement is.
- Bright lights and loud noises -> If you’re sensitive to bright lights, such as you can’t go from a dark space to a bright space without being temporarily blinded, then that’s an adrenal issue as your pupils are slow to constrict and stay constricted. If you often need to wear sunglasses especially on overcast days then that’s a sure sign of adrenal gland problems too. Ideally a healthy person should not need to wear sunglasses even on a sunny day unless the sun is directly in the eyes. If you’re overly startled by loud noises, such as if someone drops something on the ground creating a loud bang, most likely your adrenal glands are too stressed.
- Hangnails -> Getting hangnails or brittle fingernails can often be a sign of fatigued adrenal glands. They can be from thyroid problems too.
- Sleep issues -> Most sleep issues are at least somewhat tied into adrenal gland problems whether due to the adrenal-pineal link or due to the adrenal-pancreas-liver relationship in controlling blood sugar. Both of these will be discussed in Part III.
- Craving salt -> If you crave salt then your adrenal glands are most likely fatigued as you’re losing too much sodium in your sweat and urine. Yeah, if you crave potato chips and pretzels then it’s probably because of the salt.
- Low energy, especially in the evening -> Typically people with adrenal gland problems have lower energy as the day goes on and they crash around 4-7pm but then get their second wind later at night and tend to be night owls. Often they feel the need to drink coffee or some other caffeinated beverage throughout the morning to get them going and then they may need to resort to alcohol at night to calm them back down; it’s a classic adrenal-dysfunction pattern.
- Low Sex and Athletic Performance -> If your sex drive is low and if you can’t perform, then the adrenals may be to blame. The same goes for performance out of the bedroom, as in athletic performance. Athletes who are suffering performance problems, especially if they have chronic nagging injuries, often have adrenal gland problems.
- Sick often -> Those who seem to get sick often and catch multiple infections throughout the year may have a suppressed immune system from the adrenals constantly secreting high levels of cortisol. This is similar to when someone is prescribed a corticosteroid such as Prednisone to help lower inflammation via suppressing the immune system, as is often the treatment with auto-immune diseases.
- Pain – especially pelvis, knee, foot, and ankle -> The adrenal glands have a strong muscle relationship with the muscles which support the inside of the knee as well as the lower legs (calf muscles). Therefore, if you’re suffering from knee pain, especially on the inside or outside of the knee, or if you have problems with plantar fasciitis, shin splints, or Achilles tendonitis, then your adrenal glands may be partly or fully to blame. Back pain can also be due to adrenal gland problems due to the impact of the glands on the muscles which connect the pelvis to the knees. For more, see this article.
Next in Part III, I’ll discuss the many interactions of the adrenal glands with other hormones, and their influence on overall health.
SteveL says
Are you going to let us know in future articles where we can get tested?
drgangemi says
In regards to the saliva testing that would involve you finding a doc who utilizes such tests.
SteveL says
Are there any labs worth mentioning that we could use a mail in kit from home or is it always through a Doc?
drgangemi says
None that I use.
Pam E says
As I just woke up from the 2 hr nap I had to take, even though I had a ton of things to do, I saw your column.What is the treatment for this daily issue?
drgangemi says
General recommendations will be in Part IV. Past that I can’t give individual advice on-line.
Kelly says
Words cannot express how incredibly thankful I am to have found your website. I have always been a competitive distance runner. In recent years, I have also become a fitness instructor and a mother (two very difficult jobs!), all while continuing to run and train competitively (all while not sleeping enough and probably not eating enough calories). In April of 2014, I crashed. My body tightened up, I had injury after injury, I had a plethora of symptoms and until recently, I had to give up running. I went from doctor to doctor. I was finally put on synthroid by an endocrinologist due to my newly discovered hypothyroidism. Life was miserable and I had finally come to terms that his as hellish as it might be, was my new life. After researching, I honestly believe I suffered from adrenal fatigue thus causing my thyroid to be off balance. For the last few weeks, I cut out caffeine, dairy and anything artificial (sweetners and processed foods). I always thought I was a healthy eater before, but I had a coffee habit I could not kick (with sweet and low and creamer). I focused on good fats, meats, LOTS of vegetables, fruits and taking in lots of vitamin C. I tried to sleep more, reduce stress and live a better life. I am happy to report that on my low dose of thyroid meds, I feel “hyper.” I firmly believe that thanks to you, I am going to be able to reduce my dosage and eventually get off of them all together. Thanks! Wish you were in Texas! This might have been discovered 9 months ago!
Matt says
Can you point the readers into a general direction or lab / doctor website that could offer the salivary testing you recommended in the article?
Any info or direction here is appreciated.
Dr. Stephen Gangemi says
There are many but personally I use Diagnos-Techs Lab.
Susan Isaacson says
Thank you Dr. Gangemi! I have had more than one test showing that my adrenals are very stressed. The line chart looks almost straight across with a little fluctuation. I have nearly all of the adrenal gland signs listed for stressed adrenals. Especially my knees, feet (top + bottom) bottom the feet, heal and ankles. What kind of doctor do you recommend that I go to? Also is any of this covered by insurance? Any naturapathic and traditionally western trained doctors of medicine do not seem to take me serious. This is even when I bring in some of the articles authored by you describing the stressed adrenals. I don’t know which way to go and who to go to. I am also retired and my money is very limited as is my insurance coverage. Any suggestions because I really do not have much hope at this point that I can get the kind of help (tests + treatment) that you offer. Thank you for any help at all.
Dr. Stephen Gangemi says
You should look for a functional medicine physician or better yet, one of my trained practitioners: https://systemshealthcare.net/find-a-practitioner/