All Stress and Fatigue Tests

All Stress and Fatigue Tests brings together the labs most often used to investigate low energy, burnout, and stress-related symptoms. Because tiredness is multifactorial, we pair HPA-axis checks (cortisol patterns, DHEA-S) with common “look-alikes,” including thyroid imbalanceanemia/iron or B12 deficiencyblood sugar issuesinflammationelectrolyte or liver/kidney problems, and selected hormone markers.

A proactive plan often starts with 8–9 a.m. serum cortisol (± ACTH) alongside TSH/free T4CBCferritin/iron/TIBCCMPA1c/fasting glucose, and vitamin D. Add late-night salivary cortisol or 24-hour urinary free cortisol when high cortisol is suspected, plus DHEA-S for longer-term adrenal output. Based on history, consider B12 ± MMAfolateCRP/ESRmagnesium, and sex hormones (e.g., testosterone in men, prolactin, or perimenopause context). These tests support screeningdiagnostic triage, and monitoring, but they do not replace a clinician’s evaluation, sleep assessment, or mental-health care.

Signs, Symptoms & Related Situations

  • Energy & sleep: persistent fatigue, afternoon slump, non-restorative sleep, early awakening, snoring or witnessed apneas

  • Stress & mood: brain fog, low motivation, irritability, anxiety under stress, low mood

  • Physical cues: lightheadedness when standing, headaches, muscle cramps, sugar/salt cravings, cold intolerance

  • Metabolic hints: central weight gain, elevated blood pressure, high triglycerides, impaired fasting glucose

  • Medication/lifestyle flags: recent or chronic steroid use, opioids, oral estrogens, shift work, overtraining, heavy alcohol

  • Urgent care now: fainting, severe weakness, vomiting with dehydration, chest pain, severe shortness of breath, confusion, high fever

Symptoms are nonspecific and should be reviewed by a qualified clinician.

Why These Tests Matter

What testing can do

  • Map cortisol patterns (morning peak, late-evening nadir) to guide next steps

  • Differentiate common mimics of fatigue (thyroid, iron/B12, glucose, inflammation, organ function)

  • Quantify risks and trends so you can measure progress after clinical or lifestyle changes

What testing cannot do

  • Diagnose “adrenal fatigue” (not a formal medical diagnosis)

  • Replace confirmatory testing for adrenal insufficiency or Cushing syndrome when indicated

  • Provide treatment or dosing advice without clinician oversight

What These Tests Measure (at a glance)

  • Cortisol & HPA-axis

    • 8–9 a.m. Serum Cortisol (± ACTH) for low-output screens

    • Late-Night Salivary Cortisol (LNSC) or 24-hr Urinary Free Cortisol (UFC) for high-output screens

    • DHEA-S for longer-term adrenal output context

    • Caveat: oral estrogens/pregnancy raise CBG, inflating total serum cortisol; free cortisol tests (LNSC/UFC) are less affected

  • Thyroid: TSH ± free T4 (± free T3 when directed)

  • Blood count & iron: CBCferritiniron/TIBCtransferrin saturation

  • Metabolic health: A1cfasting glucoseCMP (electrolytes, kidney/liver enzymes)

  • Nutrients: Vitamin B12 ± MMAfolatevitamin Dmagnesium (± RBC)

  • Inflammation: CRP (or hs-CRP steady state), ESR

  • Selected hormones (history-based): Testosterone (men—morning), prolactin, perimenopause context (clinician-directed)

Quick Build Guide

Goal / Scenario Start with Add if needed
First-line fatigue screen AM cortisol ± ACTH • TSH/free T4 • CBC • Ferritin/Iron/TIBC • CMP • A1c • Vitamin D B12 ± MMA • Folate • CRP
“Wired at night,” weight gain, HTN/glucose issues LNSC (×2) or 24-hr UFC 1-mg dex suppression test(clinician-directed)
Dizziness/low BP, steroid taper history AM cortisol ± ACTH ACTH stimulation test(clinician-directed)
Shift work/insomnia AM cortisol aligned to wake time • TSH LNSC aligned to habitual bedtime
Overtraining/athlete burnout AM cortisol • DHEA-S • CBC/CMP • Ferritin • TSH CRP • Magnesium • Vitamin D
Brain fog/neuropathy clues B12 ± MMA • Folate • TSH Iron panel • Vitamin D
Post-viral or inflammation concern CRP/ESR • CBC • CMP Targeted viral serologies(clinician-directed)

How the Testing Process Works

  1. Choose your starting bundle: match the Quick Build Guide to your symptoms and history.

  2. Prepare for accuracy: fast only if ordered (fasting glucose/lipids). Avoid vigorous exercise, nicotine, and alcohol before salivary cortisol; time AM cortisol within an hour of your usual wake time. List medicines/supplements (biotin can interfere with some assays).

  3. Provide samples: blood draw for most tests; saliva for LNSC; 24-hour urine for UFC.

  4. Review secure results: most panels post in a few days.

  5. Plan next steps: share results with your clinician to decide on confirmatory testing, sleep or mental-health evaluation, and a monitoring cadence.

Interpreting Results (General Guidance)

  • Clearly low AM cortisol with compatible symptoms → evaluate for adrenal insufficiency (confirmatory testing is clinician-directed).

  • High LNSC or UFC on repeat → consider hypercortisolism pathways (dex suppression, imaging per guidance).

  • Abnormal TSH/free T4 → thyroid imbalance can drive fatigue, mood, and weight changes.

  • Low ferritin or iron indices → iron deficiency pattern; correlate with CBC and history.

  • B12 low or MMA high → functional B12 deficiency.

  • Elevated CRP/ESR → systemic inflammation; interpret with symptoms and exam.
    Trends over time matter more than a single number; always interpret with a qualified healthcare professional.

Choosing Panels vs. Individual Tests

  • Core stress & fatigue panel: AM Cortisol ± ACTH • TSH/free T4 • CBC • Ferritin/Iron/TIBC • CMP • A1c • Vitamin D

  • HPA-axis expansion: LNSC (×2) or 24-hr UFC • DHEA-S

  • Nutrient add-ons: B12 ± MMA • Folate • Magnesium (± RBC)

  • Inflammation add-ons: CRP/hs-CRP • ESR

  • History-based hormones: Testosterone (men—AM) • Prolactin
    Choose bundled panels for efficient screening; add individual markers to answer targeted questions or monitor progress.

FAQs

Do I need to fast for these tests?
Only if your order includes fasting glucose (or lipids). Most other tests do not require fasting.

Blood, saliva, or urine—what’s the difference for cortisol?
AM serum cortisol screens low output; late-night saliva and 24-hr urine assess high output and daily pattern.

Can stress alone raise cortisol?
Yes—acute stress, poor sleep, nicotine, and intense exercise can elevate salivary cortisol. Follow prep instructions.

I’m on birth control or pregnant—does that change cortisol?
Oral estrogens/pregnancy raise CBG, increasing total serum cortisol; free cortisol tests (LNSC/UFC) are less affected.

How long after stopping steroids should I test?
Timing is individualized; recent steroid use can suppress cortisol. Ask your clinician before testing.

Will supplements affect my labs?
Some do (e.g., high-dose biotin interfering with select assays). List all products on your order and follow any washout guidance.

How often should I recheck?
Commonly 6–12 weeks after changes, then as advised by your clinician.

Related Categories & Key Tests

  • Stress & Fatigue Tests Hub

  • Adrenal Stress Tests • Thyroid Tests • Men’s Hormone Health Tests • Women’s Hormone Health Tests • Metabolism Tests • Sleep & Wellness Panels

  • Key Tests: AM Cortisol • ACTH • Late-Night Salivary Cortisol • 24-hr Urinary Free Cortisol • DHEA-S • TSH • Free T4 • CBC • Ferritin • Iron/TIBC • Transferrin Saturation • CMP • A1c • Fasting Glucose • Vitamin B12 • MMA • Folate • Vitamin D • Magnesium (± RBC) • CRP/hs-CRP • ESR • Testosterone (AM, men) • Prolactin

References

  • Endocrine Society — Guidelines on Primary Adrenal Insufficiency and Cushing Syndrome.
  • American Association of Clinical Endocrinology — Adrenal disorder and fatigue evaluation guidance.
  • American Thyroid Association — Thyroid function testing recommendations.
  • American Society of Hematology — Evaluation of anemia and iron deficiency.
  • American Diabetes Association — Standards of Care in Diabetes (A1c/glucose interpretation).
  • NIH Office of Dietary Supplements — Vitamin B12, vitamin D, iron fact sheets.
  • Clinical reviews on cortisol-binding globulin effects, salivary cortisol collection, and fatigue differentials.

Available Tests & Panels

Your All Stress and Fatigue Tests menu is pre-populated in the Ulta Lab Tests system. Start with a core stress & fatigue panel, then use filters to add HPA-axis testing (LNSC/UFC, DHEA-S), nutrient checks (B12/MMA, folate, vitamin D, magnesium), and inflammation markers (CRP/ESR). Follow any timing and collection instructions, and review results with your clinician to confirm findings and set a monitoring plan.

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The Thyroid Stimulating Hormone (TSH) Test measures TSH levels in blood to assess thyroid function and diagnose hypothyroidism or hyperthyroidism. It evaluates how the thyroid controls metabolism, energy, weight, and heart rate. Doctors use the TSH test to investigate symptoms such as fatigue, hair loss, or mood changes. Frequently included in routine health exams, it is also key for monitoring thyroid disease treatment and overall endocrine balance.

Blood
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Also Known As: Thyroid Stimulating Hormone Test, Thyrotropin Test

The Urinalysis Complete Test evaluates urine for physical, chemical, and microscopic properties to assess kidney health, urinary tract infections, diabetes, and metabolic disorders. It measures appearance, concentration, pH, protein, glucose, ketones, blood, bilirubin, nitrites, leukocyte esterase, and microscopic cells or crystals. Doctors use this test in routine exams, to diagnose urinary symptoms, and to monitor chronic kidney or metabolic disease.

Urine
Urine Collection
Also Known As: Urine Analysis Test, UA Test, Complete Urinalysis Test

The Vitamin A Micronutrient Test measures blood levels of vitamin A (retinol) to assess nutritional status and detect deficiencies or excesses. Adequate vitamin A is essential for vision, immune defense, reproduction, and cellular health. This test helps evaluate malnutrition, absorption issues, or toxicity from supplements, supporting diagnosis and monitoring of overall health.

Patient must be 18 years of age or older.
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Also Known As: Retinol Test

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The Vitamin A Test measures blood levels of vitamin A, a nutrient essential for vision, immune function, reproduction, and skin health. Low levels may indicate malnutrition, fat malabsorption, or liver disease, while high levels may suggest toxicity from over-supplementation. Doctors use this test to investigate night blindness, frequent infections, or poor wound healing. Results provide vital insight into nutritional status, metabolic function, and overall wellness.

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Also Known As: Retinol Test

The Vitamin B1 Blood Test measures thiamine levels to assess nutritional status and detect deficiency. Vitamin B1 is essential for energy metabolism, nerve function, and muscle health. Low levels may cause weakness, fatigue, irritability, or serious conditions such as beriberi or Wernicke-Korsakoff syndrome. Doctors order this test for patients with poor diet, alcoholism, or unexplained neurological symptoms. Results provide key insight into vitamin balance and metabolic health.

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Also Known As: Thiamine Blood Test

The Vitamin B1 Blood Micronutrient Test measures thiamine levels in the blood to assess nutritional status and detect deficiencies. Thiamine is essential for energy production, nerve function, and carbohydrate metabolism. This test helps identify malnutrition, absorption disorders, or risk from poor diet or alcohol use, supporting diagnosis and management of overall health.

Patient must be 18 years of age or older.
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Also Known As: Thiamine Blood Test

The Vitamin B12 and Folate Panel Test measures blood levels of vitamin B12 and folate to evaluate nutritional status, red blood cell production, and nervous system health. Deficiencies may cause anemia, fatigue, weakness, neuropathy, or cognitive decline, while elevated levels can indicate liver or kidney disease. Doctors use this panel to diagnose deficiency, monitor therapy, and assess absorption disorders such as pernicious anemia, Crohn’s disease, or celiac disease.

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Also Known As: Cobalamin and Folic Acid Test, Vitamin B12 and Vitamin B9 Test

The Vitamin B2 Micronutrient Test measures riboflavin levels in the blood to evaluate nutritional status and detect deficiencies. Riboflavin is vital for energy production, red blood cell function, and the metabolism of fats, carbohydrates, and proteins. This test helps identify dietary insufficiency, malabsorption issues, or increased nutrient needs, supporting overall health assessment and management.

Patient must be 18 years of age or older.
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The Vitamin B2 Test measures riboflavin levels in the blood to assess nutritional status. Riboflavin is essential for energy metabolism, red blood cell production, and maintaining healthy skin, eyes, and nerves. Low levels may result from poor diet, malabsorption, or chronic illness, leading to fatigue, mouth sores, or anemia. Doctors use this test to detect deficiency, monitor supplementation, and support overall metabolic and nutritional health.

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Also Known As: Riboflavin Test

The QuestAssureD™ Vitamin D 25-Hydroxy Total Test measures Vitamin D2, Vitamin D3, and total 25-hydroxy vitamin D to assess overall vitamin D status. Adequate vitamin D supports bone strength, calcium absorption, immune health, and muscle function. Low levels may cause osteoporosis, weakness, or increased disease risk, while high levels can indicate toxicity. Doctors use this test to diagnose deficiency, monitor supplementation, and evaluate metabolic and endocrine health.

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Also Known As: Vitamin D Test, Ergocalciferol Test, Vitamin D2 Test, Cholecalciferol Test, Vitamin D3 Test, Calcidiol Test, 25-hydroxyvitamin D Test, Calcifidiol Test, 25-hydroxy-vitamin D Test, Vitamin D Total Test

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The Zinc Micronutrient Test measures blood zinc levels to evaluate nutritional status and detect deficiencies or excess. Zinc is vital for immune function, wound healing, growth, reproduction, and enzyme activity. This test helps identify poor intake, malabsorption, or excessive supplementation, supporting diagnosis and management of overall health, immune balance, and metabolic function.

Patient must be 18 years of age or older.
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The Zinc Test measures zinc levels in blood to evaluate nutritional status and overall health. Zinc is essential for immune function, wound healing, growth, taste, and reproductive health. Abnormal levels may cause fatigue, hair loss, delayed healing, or increased infection risk. Doctors use this test to detect zinc deficiency or excess, monitor supplementation, and guide treatment for conditions linked to immune, metabolic, or endocrine imbalance.

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Also Known As:  Zinc Plasma Test, Zn Test

The Zinc Protoporphyrin (ZPP) Test measures ZPP levels in red blood cells to detect iron deficiency and lead exposure. When iron is low or lead interferes with hemoglobin production, ZPP accumulates, making it a sensitive early marker. Doctors use this test to screen for iron-deficiency anemia, monitor occupational lead exposure, and evaluate unexplained anemia, helping guide diagnosis, prevention, and treatment strategies.

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Also Known As: ZPP Test, ZP Test, Free Erythrocyte Protoporphyrin Test, FEP Test

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 The Fatigue Test Panel is a comprehensive set of laboratory tests designed to investigate common causes of fatigue, a pervasive and often challenging symptom to diagnose due to its nonspecific nature and multiple potential causes.
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A shocking statistic you may not know is that 55 percent of Americans experience stress during the day. That’s about one in two people! 

It’s a statistic that should get one concerned, considering what stress can do to our bodies. 

If you feel overwhelmed by stress in your day-to-day life, you should consider a stress lab test. A lab test can check various biomarkers that can help establish whether or not your well-being is taking a hit from your level of stress. 

Let’s start by learning more about stress.

What is Stress? 

Stress is the body’s reaction upon being put under pressure by internal or external stimuli. Whenever your body responds to stressful stimuli, you may have a physical, emotional, or mental response. 

It is normal for every person to deal with stress at a point in their life. It may have come about due to the loss of a loved one, dismissal from your job, or any other occurrence that made your body trigger a stress response. 

Then again, stress shouldn’t always be considered a negative thing. You could have experienced stress because you landed a new job, had your first child, or due to any other positive occurrence. Such stressors open up your mind, making you more conscious about your surroundings. 

Despite that, stress significantly affects our bodies. Whenever we’re subjected to positive or negative stressors, stress can shift the normal levels of our bodily hormones. 

Risk Factors for Stress 

We’ve already mentioned that stress is a normal part of life. As such, everyone is bound to experience it at one point in life. 

Keeping that in mind, researchers and scientists have been studying the main stressors in the patients’ lives. Below, we’ve listed the most prevalent stressors that may trigger the development of stress-related conditions: 

  • Loss of a partner 
  • Divorce 
  • Separation in marriage 
  • Incarceration 
  • Loss of a close relative 
  • Injury or sickness 
  • Marriage 
  • Dismissal from your job 
  • Marriage reunion 
  • Retirement 

If any of these has recently occurred or you’re currently going through any of these scenarios, you have to be mindful of the stress levels that are piling up. If you’re experiencing an abnormal level of stress, this could adversely affect your health. 

Ensure that you keep a keen eye on the common indicators of high stress levels. We’ll get to the details of that later on. 

Causes of Stress 

There are differences in how everyone experiences stress. When subjected to a stressor, some people may develop long-term illnesses. Some people may not experience any change even when subjected to several stressors. 

Typically, the stress you’re feeling is usually due to a significant occurrence in your life. However, what causes stress is how your body responds to such an occurrence. 

Our bodies convey a signal when subjected to stress. The signal travels throughout the body, alerting every cell of the occurrence that you’re experiencing or already went through. 

As a result, all the body systems react to the signal: your circulatory system, hormonal system, nervous system, respiratory system, and others. The response your body gives can be likened to what is experienced with the ‘flight-or-fight response.’ 

Whenever you experience stress, there’s a chain of chemical reactions that occurs. Again, how you respond to the various changes in your life is nothing out of the ordinary. 

Your body’s reaction is an adjustment to the stressor(s), and what you’re experiencing is the outcome of the changes. 

It’s possible to experience more severe symptoms and even develop sicknesses if your body doesn’t move on from this state. 

What are the signs and symptoms of Stress? 

We’ve already mentioned that stress affects all of the body’s systems. As such, numerous signs may show up whenever you’re stressed: 

  • Mood swings 
  • Feeling of being overburdened 
  • Struggling to relax 
  • Feeling lonely and/or low 
  • Keeping off family and friends 
  • Fatigue 
  • Nausea 
  • Headaches 
  • Chest pain 
  • Sleeping disorders 
  • Constant anxiety 
  • Recurrent sickness 
  • Low libido 
  • Dry mouth 
  • Constricted jaw 
  • Constant uneasiness 
  • Lapse of memory 
  • Inability to concentrate 
  • Negativity 
  • Appetite loss or gain 
  • Misjudgment 
  • Procrastination 
  • Excessive use of alcohol or drugs 

Every system in the body contributes to the symptoms of stress. This list is just the tip of the iceberg when it comes to how people feel due to stress. It is not uncommon for stress to culminate in strokes and heart attacks in some people. 

To avoid compromising your immune system or triggering other health problems, you need to suppress your stress levels. 

Diagnosing Stress 

You should see a medical professional if you’re experiencing a heightened level of stress. With their help, you can avoid being overwhelmed by stress. 

A common way to diagnose excessive stress is by evaluating your present social life. They’ll want to know if there have been recent changes or tough spells in your life. 

Another way is by running lab tests to identify any strong stress response by your body. 

Lab Tests to Observe the Effect of Stress on an Individual’s Health 

Cortisol is the most common test ordered when checking for chronic stress. Cortisol is also called the stress hormone. Your body releases cortisol when subjected to more stressors than it can handle.   

A health professional may also want to measure your testosterone and DHEA sulfate levels. Both males and females produce these sex hormones, and their levels can significantly go up when the body experiences too much stress. Such an increase can, in turn, result in other problems in the body. 

Get a Stress Lab Test with Ulta Labs Today! 

If you want to know your body’s stress level, consider a stress test from Ulta Lab Tests. We look for various biomarkers that are common indicators of stress and its effects on your health. Here’s why you should try Ulta Lab Test: 

  • Precise and dependable results that are out in 1 or 2 days for most tests 
  • Secure and confidential results 
  • No need for a doctor’s referral or insurance 
  • Affordable prices for all tests 
  • 100% guaranteed satisfaction 

Keep in mind that if the body experiences stress for too long, your well-being will likely suffer. Your body could be immunodeficient, and you could suffer acute and long-term diseases. 

Ulta Lab Tests helps you take the wheel when it comes to your health. Let us provide you with the answers you need so you can keep off stress.