Adrenal Stress Tests (Stress & Fatigue)

Adrenal Fatigue Testing and health information

Adrenal glands are quite small but play a crucial role in your life. These glands produce several hormones, including the most notable cortisol hormone, which handles the fight-or-flight response. Early adrenal disease tests help track your hormonal levels and see if they are out of balance. Adrenal disease tests are quite convenient and provide you with the necessary health information you require. 

Our tests are highly accurate and reliable so that you can make informed decisions about your health. We also guarantee confidential and secure results. With Ulta Lab Tests, you don't need a doctor's referral or insurance to order lab tests. We offer affordable pricing as well as a 100% satisfaction guarantee. 

Order your Adrenal fatigue tests now. You can view the results online in 24 to 48 hours for most tests. 


Name Matches

17-Hydroxypregnenolone, LC/MS/MS

Clinical Significance

17-Hydroxypregnenolone is useful in the diagnosis of 3-Beta-Hydroxylase enzyme deficiency, a rare cause of congenital adrenal hyperplasia, and 17-Hydroxylase (P450c17) enzyme deficiency.

 


Description: 17-hydroxyprogesterone is a test that is measuring the levels of 17-OHP in the blood. 17-OHP is used to detect and monitor the treatment processes for congenital adrenal hyperplasia.

Also Known As: 17-OHP Test, 17-OH Progesterone Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a 17-Hydroxyprogesterone test ordered?

The 17-OHP test is regularly ordered as part of a newborn screening and may be repeated if the screening test results are elevated to confirm the initial findings.

When an infant or young kid exhibits signs and symptoms of adrenal insufficiency or CAH, a 17-OHP test may be administered.

When the milder type of CAH is suspected, this test may be ordered in older children or adults. When a girl or woman is having symptoms that could be caused by CAH or another illness, such as PCOS, the 17-OHP test can be used.

Boys and men may be tested if they are experiencing early puberty or infertility.

When a person is diagnosed with 21-hydroxylase deficiency, a 17-OHP test may be ordered on a regular basis to assess treatment effectiveness.

What does a 17-Hydroxyprogesterone blood test check for?

17-hydroxyprogesterone is a steroid hormone that is created during the cortisol production process. This test detects and/or evaluates congenital adrenal hyperplasia, a hereditary disorder characterized by decreased adrenal cortisol and aldosterone production and increased male sex hormone production.

Cholesterol is the source of 17-OHP. It is a precursor of active steroid hormones, rather than an active steroid hormone.

Cortisol is a hormone produced by the adrenal glands that aids in the breakdown of protein, carbohydrates, and fats, regulates the immune system, and maintains blood pressure. Other steroid hormones produced by the adrenal glands include aldosterone, which helps regulate salt levels and blood pressure, and androgens, which, like testosterone, cause male sexual characteristics and other consequences.

The processes in the synthesis of cortisol necessitate the use of several enzymes. Inadequate levels of cortisol are produced when one or more of these enzymes are insufficient or malfunctioning, as is the case with CAH. CAH is caused by a partial or total loss of the enzyme 21-hydroxylase, which accounts for around 90% of cases.

The adrenal gland grows in size because a low level of cortisol induces an increase in the level of a specific pituitary hormone that drives adrenal growth and hormone production. The increased size and activity, however, are insufficient to overcome the cortisol production bottleneck. Other chemicals that do not require the faulty enzyme, such as 17-hydroxyprogesterone and androgens, are created in excess. This is why 17-OHP testing can aid in the detection of CAH.

CAH is a set of hereditary illnesses characterized by cortisol-related enzyme deficits and caused by particular gene mutations. A mutation in the 21-hydroxylase gene causes around 90% of CAH cases, which can be diagnosed by an increase in 17-OHP in the blood. When both genes, one from each parent, contain mutations that reduce or cease the activity of the enzyme for which the gene codes, the disease is caused. Parents could be carriers, and carriers could not show any symptoms.

CAH with 21-hydroxylase deficiency can be inherited in two forms: severe and mild.

Severe forms can result in kids being born with severe aldosterone and cortisol deficits, necessitating medical treatment. This severe variant is most commonly found in infancy or early childhood through regular newborn screening. It may manifest in early childhood with signs and symptoms such as vomiting, listlessness, lack of energy, not eating properly, failure to thrive, dehydration, and low blood pressure if it is not found through screening, especially with severe sickness.

Excess male sex hormones can cause the development of male characteristics in females. Female babies' sex organs may not be obviously male or female, making it difficult to tell their gender at first. During childhood and adolescence, females may have excessive hair development on the face and body, as well as other male secondary sexual traits such as irregular menstruation. Men with this disorder may not appear different at birth, but they might develop sexual traits early in life, putting them at risk for fertility problems later in life.

Only partial lack of the enzyme may be present in the milder, though more prevalent type of CAH caused by 21-hydroxylase deficiency. This kind of CAH, also known as late-onset or non-classical CAH, can manifest symptoms at any age during childhood, adolescence, or adulthood. Symptoms might be nonspecific, develop slowly over time, and differ from one person to the next. Though this type of CAH is rarely life-threatening, it can cause growth, development, and puberty issues in children, as well as infertility in adults.

Lab tests often ordered with a 17-Hydroxyprogesterone test:

  • Cortisol
  • ACTH
  • Testosterone
  • Androstenedione
  • Pregnenolone

Conditions where a 17-Hydroxyprogesterone test is recommended:

  • Congenital Adrenal Hyperplasia
  • Polycystic Ovary Syndrome
  • Adrenal Insufficiency
  • Addison Disease
  • Endocrine Syndromes
  • Infertility

How does my health care provider use a 17-Hydroxyprogesterone test?

The 17-hydroxyprogesterone test is used to detect congenital adrenal hyperplasia and can be used in the conjunction with other tests to diagnose and track CAH.

In the United States, the 17-OHP test is frequently ordered as part of newborn screening to detect CAH caused by a lack of 21-hydroxylase.

The 17-OHP test can be used to screen for CAH in older children and adults before symptoms develop, or to confirm a CAH diagnosis in persons who are already experiencing symptoms.

Diagnosis

The presence of 17-OHP in the blood can help doctors diagnose CAH in older children and people who have a milder, "late-onset" variant of the disease.

A 17-OHP test, along with plasma renin activity, androstenedione, and testosterone assays, may be used to evaluate the success of treatment if someone is diagnosed with 21-hydroxylase insufficiency.

In women with symptoms such as abundant face and body hair and irregular periods, a 17-OHP test, along with other hormone testing, may be done to help rule out CAH. Women with probable polycystic ovarian syndrome and infertility, as well as those with suspected adrenal or ovarian malignancies, fall under this category.

False-positive results have been reported with 17-OHP testing, particularly the newborn screening test. Other tests may be performed if the level is higher but not to the point where it is indicative of CAH.

As a follow-up test, an ACTH test may be ordered. ACTH stimulation causes a significant increase in 17-OHP levels in CAH.

CYP21A2 gene mutations that cause the disorder may be detected by genetic testing.

A karyotype test may be ordered as a follow-up test to discover chromosome problems and to assist in determining the gender of a newborn.

Electrolytes may be ordered to determine the sodium and potassium levels of a person.

What do my 17 Hydroxyprogesterone test results mean?

If a newborn or infant has highly elevated 17-OHP levels, he or she is most likely suffering from CAH. If a person's levels are somewhat elevated, he or she may have a milder case of CAH or an 11-beta-hydroxylase deficiency.

The absence of CAH due to a 21-hydroxylase deficit is most often shown by normal 17-OHP findings.

In a person with CAH, low or declining amounts suggest a positive response to treatment. High or rising levels may suggest that treatment has to be changed.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Clinical Significance

21- Hydroxylase Antibody - 21-Hydroxylase Antibody is present in patients with autoimmune destruction of the adrenal glands, leading to Addison's disease. Antibody is also seen in autoimmune polyglandular syndrome.


Determination of ACTH is useful in differentiating between primary and secondary adrenocortical hypo- and hyperfunctional disorders: Addison's disease, Cushing's syndrome, adrenal carcinoma, ectopic ACTH syndrome, and adrenal nodular hyperplasia.

Determination of aldosterone is useful in the diagnosis and evaluation of primary aldosteronism, selective hypoaldosteronism, edematous states, and other conditions of electrolyte imbalance

Description: An antinuclear antibody screening is a blood test that is going to look for a positive or negative result. If the result comes back as positive further test will be done to look for ANA Titer and Pattern. Antinuclear antibodies are associated with Lupus.

Also Known As: ANA Test, ANA Screen IFA with Reflex to Titer and pattern IFA Test, ANA with Reflex Test, Antinuclear Antibody Screen Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

IMPORTANT Reflex Information: If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00

When is an ANA Screen test ordered?

When someone exhibits signs and symptoms of a systemic autoimmune illness, the ANA test is requested. Symptoms of autoimmune illnesses can be vague and non-specific, and they can fluctuate over time, steadily deteriorate, or oscillate between periods of flare-ups and remissions.

What does an ANA Screen blood test check for?

Antinuclear antibodies are a type of antibody produced by the immune system when it is unable to differentiate between its own cells and foreign cells. Autoantibodies are antibodies that attack the body's own healthy cells, causing symptoms like tissue and organ inflammation, joint and muscle discomfort, and weariness. The moniker "antinuclear" comes from the fact that ANA specifically targets chemicals located in a cell's nucleus. The presence of these autoantibodies in the blood is detected by the ANA test.

The presence of ANA may be a sign of an autoimmune process, and it has been linked to a variety of autoimmune illnesses, the most common of which being systemic lupus erythematosus.

One of the most common tests used to detect an autoimmune disorder or rule out other conditions with comparable signs and symptoms is the ANA test. As a result, it's frequently followed by other autoantibody tests that can help establish a diagnosis. An ENA panel, anti-dsDNA, anti-centromere, and/or anti-histone test are examples of these.

Lab tests often ordered with an ANA Screen test:

  • ENA Panel
  • Sed Rate (ESR)
  • C-Reactive Protein
  • Complement
  • AMA
  • Centromere antibody
  • Histone Antibody

Conditions where an ANA Screen test is recommended:

  • Autoimmune Disorders
  • Lupus
  • Rheumatoid Arthritis
  • Sjogren Syndrome
  • Scleroderma

How does my health care provider use an ANA Screen test?

One of the most often performed tests to diagnose systemic lupus erythematosus is the antinuclear antibody test. It serves as the first step in the evaluation process for autoimmune diseases that might impact various body tissues and organs.

When a person's immune system fails to discriminate between their own cells and foreign cells, autoantibodies called ANA are created. They attack chemicals found in a cell's nucleus, causing organ and tissue damage.

ANA testing may be utilized in conjunction with or after other autoantibody tests, depending on a person's indications and symptoms and the suspected condition. Antibodies that target specific compounds within cell nuclei, such as anti-dsDNA, anti-centromere, anti-nucleolar, anti-histone, and anti-RNA antibodies, are detected by some of these tests, which are considered subsets of the general ANA test. In addition, an ENA panel can be utilized as a follow-up to an ANA.

These further tests are performed in addition to a person's clinical history to assist diagnose or rule out other autoimmune conditions such Sjögren syndrome, polymyositis, and scleroderma.

To detect ANA, various laboratories may employ different test procedures. Immunoassay and indirect fluorescent antibody are two typical approaches. The IFA is regarded as the gold standard. Some labs will test for ANA using immunoassay and then employ IFA to confirm positive or equivocal results.

An indirect fluorescent antibody is created by mixing a person's blood sample with cells attached to a slide. Autoantibodies in the blood bind to the cells and cause them to react. A fluorescent antibody reagent is used to treat the slide, which is then inspected under a microscope. The existence of fluorescence is observed, as well as the pattern of fluorescence.

Immunoassays—these procedures are frequently carried out using automated equipment, however they are less sensitive than IFA in identifying ANA.

Other laboratory tests linked to inflammation, such as the erythrocyte sedimentation rate and/or C-reactive protein, can be used to assess a person's risk of SLE or another autoimmune disease.

What do my ANA test results mean?

A positive ANA test indicates the presence of autoantibodies. This shows the presence of an autoimmune disease in someone who has signs and symptoms, but more testing is needed to make a definitive diagnosis.

Because ANA test results can be positive in persons who have no known autoimmune disease, they must be carefully assessed in conjunction with a person's indications and symptoms.

Because an ANA test can become positive before signs and symptoms of an autoimmune disease appear, determining the meaning of a positive ANA in a person who has no symptoms can take some time.

SLE is unlikely to be diagnosed with a negative ANA result. It is normally not required to repeat a negative ANA test right away; however, because autoimmune illnesses are episodic, it may be desirable to repeat the ANA test at a later date if symptoms persist.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Includes

  • ANA Screen,IFA, with Reflex to Titer and Pattern
  • DNA (ds) Antibodies
  • Scleroderma Antibodies (SCL-70)
  • Sm and Sm/RNP Antibodies
  • Sjogren's Antibodies (SSA, SSB)

If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge - $13.00

 


Androstenedione is useful when evaluating patients with androgen excess and managing patients with Congenital Adrenal Hyperplasia (CAH).

Antiadrenal Antibody Screen With Reflex To Titer

This is a reflex test that may require additional tests to be run at additional cost to the patient.

If  Adrenal Antibody Screen is positive, Adrenal Antibody Titer will be performed at an additional charge (CPT code(s): 86256).


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Serum calcium is involved in the regulation of neuromuscular and enzyme activity, bone metabolism and blood coagulation. Calcium blood levels are controlled by a complex interaction of parathyroid hormone, vitamin D, calcitonin and adrenal cortical steroids. Calcium measurements are useful in the diagnosis of parathyroid disease, some bone disorders and chronic renal disease. A low level of calcium may result in tetany.



Cortisol, LC/MS/MS, Saliva Collection Kit

  1. Pick up the Cortisol, LC/MS/MS, Saliva Collection Kit from the Patient Service Center that is selected when placing the order.

Collection Instructions

  1.  Remove the swab from the Salivette.

  2. Follow times to collect as told by your physician
    a. Place the swab in the mouth, e.g. in your cheek, where it should remain for 2 minutes without chewing. If an extremely small amount of saliva is produced, leave the swab in the mouth for longer.

    b. Return the swab with the absorbed saliva to the Salivette.
    c. Replace the stopper.

  3. Label each saliva collection tube with the following information

              a. patient name

              b. date of birth (DOB)

              c. date and time of collection

Refrigerate the Salivette immediately after collection

Return Collected Samples & Patient Requisition Directly to Patient Service Center within 48hrs of collection

Storage instructions

  1. Specimen should be stored at refrigerated temperature prior to returning to the Patient Service Center .

  2. Do not use this kit on children under 3 years of age or any patient with increased risk of swallowing or choking.


Cortisol is increased in Cushing's disease and decreased in Addison's disease (adrenal insufficiency).

Cortisol is increased in Cushing's disease and decreased in Addison's disease (adrenal insufficiency).

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Description: A cortisol test measures the amount of cortisol in the blood. These levels will start off high in the morning and throughout the say they become lower. At midnight they are typically at their lowest level. Someone who works a night shift or has an irregular sleep schedule may have a different pattern. This test can be used to determine Cushing's or Addison's Disease.

Also Known As: Cortisol AM Test, Cortisol Total Test, Cortisol Test, Cortisol Blood Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Specimen must be drawn between 7 a.m. and 9 a.m. Test is not recommended for patients receiving prednisone/prednisolone therapy due to cross reactivity with the antibody used in this test.

When is a Cortisol AM test ordered?

When a person has symptoms that point to a high level of cortisol and Cushing syndrome, a cortisol test may be recommended.

Women with irregular menstrual periods and increased facial hair may be tested, and children with delayed development and small stature may also be tested.

When someone exhibits symptoms that point to a low cortisol level, adrenal insufficiency, or Addison disease, this test may be ordered.

What does a Cortisol AM blood test check for?

Cortisol is a hormone that plays a function in protein, lipid, and carbohydrate metabolism. It has an effect on blood glucose levels, blood pressure, and immune system regulation. Only a small fraction of cortisol in the blood is "free" and biologically active; the majority is attached to a protein. Cortisol is a hormone that is produced into the urine and found in the saliva. This test determines how much cortisol is present in the blood, urine, or saliva.

Cortisol levels in the blood usually rise and fall in a pattern known as "diurnal variation." It reaches its highest point early in the morning, then gradually decreases over the day, reaching its lowest point around midnight. When a person works irregular shifts and sleeps at different times of the day, this rhythm might fluctuate, and it can be disrupted when a disease or condition inhibits or stimulates cortisol production.

The adrenal glands, two triangle organs that sit on top of the kidneys, generate and emit cortisol. The hypothalamus in the brain and the pituitary gland, a small organ below the brain, control the hormone's production. The hypothalamus produces corticotropin-releasing hormone when blood cortisol levels drop, which tells the pituitary gland to create ACTH. The adrenal glands are stimulated by ACTH to generate and release cortisol. A certain amount of cortisol must be produced for normal adrenal, pituitary gland, and brain function.

Cushing syndrome is a collection of signs and symptoms associated with an unusually high cortisol level. Cortisol production may be increased as a result of:

  • Large doses of glucocorticosteroid hormones are given to treat a range of ailments, including autoimmune illness and certain cancers.
  • Tumors that produce ACTH in the pituitary gland and/or other regions of the body.
  • Cortisol production by the adrenal glands is increased as a result of a tumor or abnormal expansion of adrenal tissues.

Rarely, CRH-producing malignancies in various regions of the body.

Cortisol production may be reduced as a result of:

  • Secondary adrenal insufficiency is caused by an underactive pituitary gland or a pituitary gland tumor that prevents ACTH production.
  • Primary adrenal insufficiency, often known as Addison disease, is characterized by underactive or injured adrenal glands that limit cortisol production.

After quitting glucocorticosteroid hormone medication, especially if it was abruptly stopped after a long time of use.

Lab tests often ordered with a Cortisol AM test:

  • Cortisol PM
  • ACTH
  • Aldosterone
  • 17-Hydroxyprogesterone
  • Growth Hormone

Conditions where a Cortisol AM test is recommended:

  • Addison’s Disease
  • Cushing’s Syndrome
  • Endocrine Syndromes
  • Hypertension
  • Pituitary Disorders

How does my health care provider use a Cortisol AM test?

A cortisol test can be used to detect Cushing syndrome, which is characterized by an excess of cortisol, as well as adrenal insufficiency or Addison disease, which are characterized by a deficiency of cortisol. Among other things, the hormone cortisol controls how proteins, lipids, and carbohydrates are metabolized. Cortisol levels in the blood normally increase and fall in a "diurnal variation" pattern, rising early in the morning, dropping during the day, and reaching their lowest point around midnight.

The adrenal glands generate and excrete cortisol. The hypothalamus in the brain and the pituitary gland, a small organ below the brain, control the hormone's production. The hypothalamus produces corticotropin-releasing hormone when blood cortisol levels drop, which tells the pituitary gland to create ACTH. Cortisol production and release are triggered by ACTH in the adrenal glands. A certain amount of cortisol must be produced for normal brain, pituitary, and adrenal gland function.

Only a small fraction of cortisol in the blood is "free" and biologically active; the majority is attached to a protein. Blood cortisol testing assesses both protein-bound and free cortisol, but urine and saliva cortisol testing assesses only free cortisol, which should be in line with blood cortisol levels. Multiple blood and/or saliva cortisol levels collected at various times, such as 8 a.m. and 4 p.m., can be used to assess cortisol levels and diurnal variation. A 24-hour urine cortisol sample will not reveal diurnal variations; instead, it will assess the total quantity of unbound cortisol voided over the course of 24 hours.

If an elevated amount of cortisol is found, a health professional will conduct additional tests to confirm the results and discover the cause.

If a person's blood cortisol level is abnormally high, a doctor may order additional tests to be sure the high cortisol is indeed abnormal. Additional testing could involve monitoring 24-hour urinary cortisol, doing an overnight dexamethasone suppression test, and/or obtaining a salivary sample before sleep to detect cortisol at its lowest level. Urinary cortisol testing necessitates collecting urine over a set length of time, usually 24 hours. Because ACTH is released in pulses by the pituitary gland, this test can assist evaluate whether a raised blood cortisol level is a true rise.

An ACTH stimulation test may be ordered if a health practitioner feels that the adrenal glands are not releasing enough cortisol or if initial blood tests reveal insufficient cortisol production.

The purpose of ACTH stimulation is to compare the levels of cortisol in a person's blood before and after receiving an injection of synthetic ACTH. If the adrenal glands are healthy, the reaction to ACTH stimulation will be an increase in cortisol levels. Low amounts of cortisol will result if they are broken or not functioning properly. To distinguish between adrenal and pituitary insufficiency, a lengthier variant of this test can be used.

What do my Cortisol AM test results mean?

Cortisol levels are typically lowest before bedtime and highest shortly after awakening, though this pattern can be disrupted if a person works rotating shifts and sleeps at various times on separate days.

Excess cortisol and Cushing syndrome are indicated by an increased or normal cortisol level shortly after awakening, as well as a level that does not diminish by bedtime. If the excess cortisol is not suppressed after an overnight dexamethasone suppression test, the 24-hour urine cortisol is elevated, or the late-night salivary cortisol level is elevated, the excess cortisol is likely due to abnormal increased ACTH production by the pituitary or a tumor outside of the pituitary, or abnormal production by the adrenal glands. Additional tests will aid in determining the root of the problem.

If the subject of the examination reacts to an ACTH stimulation test and has insufficient cortisol levels, the issue is most likely brought on by the pituitary's insufficient production of ACTH. The adrenal glands are most likely the source of the issue if the subject does not react to the ACTH stimulation test.

 

An additional test, like as a CT scan, may be used by the medical professional to evaluate the degree of any gland damage once an irregularity has been identified and related to the pituitary gland, the adrenal glands, or another cause.

Important: Patient needs to have the specimen collected between 7 a.m.-9 a.m.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Urinary Free Cortisol is useful in the detection of patients with Cushing's syndrome for whom Free Cortisol concentrations are elevated.

Free cortisol is useful in the detection of patients with Cushing's syndrome for whom free cortisol concentrations are elevated.

Reference Range(s)

Adult    
8:00 A.M.-10:00 A.M. 0.07-0.93 µg/dL
4:00 P.M.-6:00 P.M. 0.04-0.45 µg/dL
10:00 P.M.-11:00 P.M. 0.04-0.35 µg/dL

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Cortisol is increased in Cushing's Disease and decreased in Addison's Disease (adrenal insufficiency). Patient needs to have the specimen collected between 3 p.m - 5 p.m.


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Description: A cortisol test measures the amount of cortisol in the blood. These levels will start off high in the morning and throughout the say they become lower. At midnight they are typically at their lowest level. Someone who works a night shift or has an irregular sleep schedule may have a different pattern. This test can be used to determine Cushing's or Addison's Disease.

Also Known As: Cortisol Total Test, Cortisol Test, Cortisol Blood Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Test not recommended when patient is on prednisone/prednisolone therapy due to cross reactivity with the antibody used in this test

When is a Cortisol Total test ordered?

When a person has symptoms that point to a high level of cortisol and Cushing syndrome, a cortisol test may be recommended.

Women with irregular menstrual periods and increased facial hair may be tested, and children with delayed development and small stature may also be tested.

When someone exhibits symptoms that point to a low cortisol level, adrenal insufficiency, or Addison disease, this test may be ordered.

What does a Cortisol Total blood test check for?

Cortisol is a hormone that plays a function in protein, lipid, and carbohydrate metabolism. It has an effect on blood glucose levels, blood pressure, and immune system regulation. Only a small fraction of cortisol in the blood is "free" and biologically active; the majority is attached to a protein. Cortisol is a hormone that is produced into the urine and found in the saliva. This test determines how much cortisol is present in the blood, urine, or saliva.

Cortisol levels in the blood usually rise and fall in a pattern known as "diurnal variation." It reaches its highest point early in the morning, then gradually decreases over the day, reaching its lowest point around midnight. When a person works irregular shifts and sleeps at different times of the day, this rhythm might fluctuate, and it can be disrupted when a disease or condition inhibits or stimulates cortisol production.

The adrenal glands, two triangle organs that sit on top of the kidneys, generate and emit cortisol. The hypothalamus in the brain and the pituitary gland, a small organ below the brain, control the hormone's production. The hypothalamus produces corticotropin-releasing hormone when blood cortisol levels drop, which tells the pituitary gland to create ACTH. The adrenal glands are stimulated by ACTH to generate and release cortisol. The brain, pituitary, and adrenal glands must all be operating properly in order to produce enough levels of cortisol.

Cushing syndrome is a collection of signs and symptoms associated with an unusually high cortisol level. Cortisol production may be increased as a result of:

  • Large doses of glucocorticosteroid hormones are given to treat a range of ailments, including autoimmune illness and certain cancers.
  • Tumors that produce ACTH in the pituitary gland and/or other regions of the body.
  • Cortisol production by the adrenal glands is increased as a result of a tumor or abnormal expansion of adrenal tissues.

Rarely, CRH-producing malignancies in various regions of the body.

Cortisol production may be reduced as a result of:

  • Secondary adrenal insufficiency is caused by an underactive pituitary gland or a pituitary gland tumor that prevents ACTH production.
  • Primary adrenal insufficiency, often known as Addison disease, is characterized by underactive or injured adrenal glands that limit cortisol production.

After quitting glucocorticosteroid hormone medication, especially if it was abruptly stopped after a long time of use.

Lab tests often ordered with a Cortisol Total test:

  • Cortisol PM
  • Cortisol AM
  • Cortisol Saliva
  • ACTH
  • Aldosterone
  • 17-Hydroxyprogesterone
  • Growth Hormone

Conditions where a Cortisol Test is recommended:

  • Addison’s Disease
  • Cushing’s Syndrome
  • Endocrine Syndromes
  • Hypertension
  • Pituitary Disorders

How does my health care provider use a Cortisol Total test?

A cortisol test can be used to detect Cushing syndrome, which is characterized by an excess of cortisol, as well as adrenal insufficiency or Addison disease, which are characterized by a deficiency of cortisol. Cortisol is a hormone that regulates protein, lipid, and carbohydrate metabolism, among other functions. Cortisol levels in the blood normally increase and fall in a "diurnal variation" pattern, rising early in the morning, dropping during the day, and reaching their lowest point around midnight.

The adrenal glands generate and excrete cortisol. The hypothalamus in the brain and the pituitary gland, a small organ below the brain, control the hormone's production. The hypothalamus produces corticotropin-releasing hormone when blood cortisol levels drop, which tells the pituitary gland to create ACTH. The adrenal glands are stimulated by ACTH to generate and release cortisol. The brain, pituitary, and adrenal glands must all be operating properly in order to produce enough levels of cortisol.

Only a small fraction of cortisol in the blood is "free" and biologically active; the majority is attached to a protein. Blood cortisol testing assesses both protein-bound and free cortisol, but urine and saliva cortisol testing assesses only free cortisol, which should be in line with blood cortisol levels. Multiple blood and/or saliva cortisol levels collected at various times, such as 8 a.m. and 4 p.m., can be used to assess cortisol levels and diurnal variation. A 24-hour urine cortisol sample will not reveal diurnal variations; instead, it will assess the total quantity of unbound cortisol voided over the course of 24 hours.

If an elevated amount of cortisol is found, a health professional will conduct additional tests to confirm the results and discover the cause.

If a person's blood cortisol level is abnormally high, a doctor may order additional tests to be sure the high cortisol is indeed abnormal. Additional testing could involve monitoring 24-hour urinary cortisol, doing an overnight dexamethasone suppression test, and/or obtaining a salivary sample before sleep to detect cortisol at its lowest level. Urinary cortisol testing necessitates collecting urine over a set length of time, usually 24 hours. Because ACTH is released in pulses by the pituitary gland, this test can assist evaluate whether a raised blood cortisol level is a true rise.

An ACTH stimulation test may be ordered if a health practitioner feels that the adrenal glands are not releasing enough cortisol or if initial blood tests reveal insufficient cortisol production.

ACTH stimulation is a test that measures the amount of cortisol in a person's blood before and after a synthetic ACTH injection. Cortisol levels will rise in response to ACTH stimulation if the adrenal glands are functioning normally. Cortisol levels will be low if they are damaged or not working properly. To distinguish between adrenal and pituitary insufficiency, a lengthier variant of this test can be used.

What do my Cortisol Total test results mean?

Cortisol levels are typically lowest before bedtime and highest shortly after awakening, though this pattern can be disrupted if a person works rotating shifts and sleeps at various times on separate days.

Excess cortisol and Cushing syndrome are indicated by an increased or normal cortisol level shortly after awakening, as well as a level that does not diminish by bedtime. If the excess cortisol is not suppressed after an overnight dexamethasone suppression test, the 24-hour urine cortisol is elevated, or the late-night salivary cortisol level is elevated, the excess cortisol is likely due to abnormal increased ACTH production by the pituitary or a tumor outside of the pituitary, or abnormal production by the adrenal glands. Additional tests will aid in determining the root of the problem.

If the person examined responds to an ACTH stimulation test and has insufficient cortisol, the problem is most likely due to insufficient ACTH production by the pituitary. If the person does not respond to the ACTH stimulation test, the problem is most likely to be with the adrenal glands. Secondary adrenal insufficiency occurs when the adrenal glands are underactive as a result of pituitary dysfunction and/or insufficient ACTH synthesis. Adrenal injury causes decreased cortisol production, which is referred to as primary adrenal insufficiency or Addison disease.

Once an irregularity has been found and linked to the pituitary gland, adrenal glands, or another source, the health practitioner may utilize additional testing, such as a CT scan, to determine the extent of any gland damage.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Deoxycorticosterone (DOC) is a weak mineralocorticoid derived from 21-hydroxylation of progesterone in the adrenal cortex.

Dexamethasone

 

Clinical Significance

Test used in the differential diagnosis of Cushing's syndrome.


DHEA is a weakly androgenic steroid that is useful when congenital adrenal hyperplasia is suspected. It is also useful in determining the source of androgens in hyperandrogenic conditions, such as polycystic ovarian syndrome and adrenal tumors.

DHEA-S is the sulfated form of DHEA and is the major androgen produced by the adrenal glands. This test is used in the differential diagnosis of hirsute or virilized female patients and for the diagnosis of isolated premature adrenarche and adrenal tumors. About 10% of hirsute women with polycystic ovarian syndrome (PCOS) have elevated DHEA-S but normal levels of other androgens.

Brief Description: DHEA Sulfate is a blood test that is measuring the levels of Dehydroepiandrosterone Sulfate in the blood. It is often used to diagnose any problems in the adrenal glands such as cancer or a tumor. It can also be used to evaluate the cause of early puberty in young boys and male characteristics or appearance in women.

Also Known As: DHEA-SO4 Test, DHEAS Test, DHES1 Test, Dehydroepiandrosterone Sulfate Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a DHEA Sulfate test ordered?

When excess androgen production is suspected and/or a health practitioner wants to analyze a person's adrenal gland function, a DHEAS test, along with other hormone testing, may be requested.

It can be assessed when a woman exhibits signs and symptoms of amenorrhea, infertility, and/or virilization. The intensity of these alterations varies, but they may include:

  • A huskier voice
  • Hair on the face or on the body that is excessive
  • Baldness in men
  • Muscularity
  • Acne
  • The Adam's apple has been enlarged
  • Breast size has shrunk

It may also be ordered if a young girl exhibits evidence of virilization or if a female infant's external genitalia are not clearly male or female.

When young males show indicators of premature puberty, such as a deeper voice, pubic hair, muscularity, and an enlarged penis before the age of typical puberty, DHEAS may be evaluated.

What does a DHEA Sulfate blood test check for?

Male sex hormone dehydroepiandrosterone sulfate is found in both men and women. This test determines the amount of DHEAS in your blood.

DHEAS:

  • At puberty, it aids in the development of male secondary sexual traits.
  • Can be transformed into more strong androgens like testosterone and androstenedione by the body.
  • It has the ability to transform into estrogen.

DHEAS is almost entirely produced by the adrenal glands, with minor contributions from a woman's ovaries and a man's testicles.

It's a good indicator of how well the adrenal glands are working. Overproduction of DHEAS can be caused by malignant and non-cancerous adrenal tumors, as well as adrenal hyperplasia. DHEAS can be produced by an ovarian tumor in rare cases.

DHEAS excess:

  • In adult men, it may go unnoticed.
  • In young boys, it can cause early puberty.
  • Menstrual irregularities and the development of masculine physical traits in girls and women, such as excess body and facial hair
  • Can result in a female infant being born with genitals that aren't clearly male or female

Lab tests often ordered with a DHEA Sulfate test:

  • Testosterone
  • ACTH
  • FSH
  • LH
  • Prolactin
  • Estrogen
  • Estradiol
  • Sex Hormone Binding Globulin
  • 17-Hydroxyprogesterone
  • Androstenedione

Conditions where a DHEA Sulfate test is recommended:

  • PCOS
  • Infertility
  • Endocrine Syndromes
  • Adrenal Insufficiency
  • Congenital Adrenal Hyperplasia

How does my health care provider use a DHEA Sulfate test?

The dehydroepiandrosterone sulfate test is ordered in conjunction with testosterone and other male hormones assays to:

  • Examine the adrenal glands' performance.
  • Differentiate DHEAS-secreting disorders produced by the adrenal glands from those caused by the testicles or, in rare cases, the ovaries
  • Adrenocortical tumors and adrenal malignancies can be diagnosed with this test.
  • Assist in the diagnosis of congenital and adult-onset adrenal hyperplasia.

DHEAS levels are frequently examined in women, along with other hormones like FSH, LH, prolactin, estrogen, and testosterone, to help diagnose polycystic ovarian syndrome and rule out other reasons of infertility, lack of monthly cycle, and excess facial and body hair.

DHEAS levels, along with other hormones, may be requested to examine and diagnose the cause of young females developing masculine physical traits and young boys developing early puberty.

What do my DHEA-S test results mean?

A normal DHEAS level, together with other normal male hormone levels, suggests that the adrenal gland is working properly. When an adrenal tumor or cancer is present but not secreting hormones, DHEAS may be normal.

A high DHEAS blood level could indicate that the person's symptoms are caused or exacerbated by excessive DHEAS production. An elevated level of DHEAS, on the other hand, is not used to make a diagnosis of any particular condition; rather, it usually signals that further testing is required to determine the source of the hormone imbalance. An adrenocortical tumor, Cushing illness, adrenal cancer, or adrenal hyperplasia, as well as a DHEAS-producing ovarian tumor, can all cause high DHEAS.

DHEAS levels may be high in polycystic ovary syndrome, but they may also be normal, as PCOS is usually associated with ovarian androgen production.

Adrenal insufficiency, adrenal dysfunction, Addison disease, or hypopituitarism, a disorder characterized by low levels of pituitary hormones that govern the generation and secretion of adrenal hormones, can all produce low DHEAS levels.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.



Adrenal glands are quite small but play a crucial role in your life. These glands produce several hormones, including the most notable cortisol hormone, which handles the fight-or-flight response. Early adrenal disease tests help track your hormonal levels and see if they are out of balance. Adrenal disease tests are quite convenient and provide you with the necessary health information you require. 

The Adrenal Glands

The adrenal glands are located on top of the kidneys in the midsection of the body. There are two parts of each gland (medulla and cortex) responsible for producing a different set of hormones. The hormones produced by these glands include: 

  • Aldosterone
  • Cortisol
  • Epinephrine
  • Androgenic steroids
  • DHEA
  • Norepinephrine. 

Adrenal Inefficiency

Various health issues may arise when your adrenal glands are not functioning properly, including: 

  • Congenital adrenal hyperplasia
  • Adrenal insufficiency 
  • Hyperaldosteronism
  • Cushing disease
  • Adrenal cancer
  • Pheochromocytoma. 

Addison's disease or adrenal insufficiency is the result of low hormone levels produced by the adrenal glands. But when a person develops Addison's disease, it never goes away. That is why proactive lab testing is so important. There is a better chance of treating a condition if you catch it before it gets serious. 

Symptoms Of Adrenal Insufficiency

Some of the most common signs and symptoms of adrenal insufficiency include:

  • Weight loss
  • Loss of appetite
  • Exhaustion
  • Nausea & Vomiting
  • Skin darkening
  • Pain near the adrenal glands

This rare condition can be onset by:

  • Infections
  • Cancer
  • Genetics
  • Autoimmune diseases

Lab Tests for Adrenal Insufficiency

Ulta Lab Tests offers several Addison's disease test panels that cover a wide range of biomarkers. These tests will help you get a better understanding of your hormone health.

Adrenal Complete

Adrenal Complete includes eight tests that cover 41 biomarkers. It helps measure several factors such as cortisol levels, a metabolic panel, iron levels, DHEA sulfate, and magnesium. The panel is performed using both blood and saliva samples.

ULTA Adrenal Function Panel

The Adrenal Function Panel has a combination of 16 tests to review 77 biomarkers. The test is done using both blood specimens and saliva. The patient should fast for at least 9 hours before taking the test. This test measures: 

  • Blood count
  • C-reactive protein
  • Cortisol levels
  • Metabolic health
  • DHEA sulfate
  • Vitamins D
  • Uric acid
  • Lipid health
  • Insulin level
  • Homocysteine
  • Hemoglobin A1c
  • Gamma-glutamyl transferase
  • Lactate dehydrogenase
  • Magnesium level
  • Phosphate level 

STTM Adrenal Panel Total

This is a combination of 3 tests that review 23 biomarkers. The test will cover a comprehensive metabolic panel (CMP), aldosterone levels, and magnesium levels. The biomarkers that are reviewed in the CMP include:

  • Albumin 
  • Globulin
  • Alanine transaminase
  • Alkaline phosphatase
  • Aspartate aminotransferase
  • Total bilirubin
  • Carbon dioxide levels
  • Calcium level
  • Creatinine level
  • Chloride level
  • Glomerular filtration rate
  • Total protein level
  • Potassium level
  • Sodium level
  • Blood urea nitrogen levels (BUN)

Benefits Of Adrenal Insufficiency Tests

Adrenal insufficiency tests help you take full control of your health and life. These tests are quite easy to perform and provide a wealth of knowledge about your current adrenal health status.

Better Understanding of Your Body

Adrenal insufficiency covers a multitude of factors in your body. You should understand these levels and how they affect the body to make the necessary changes and regain optimal health.

Catching Other Health Issues Early On

Once you get the results of your adrenal health tests, the results can surprise you. The levels you thought were on track could be high, and those you thought were off-track may be on track. It may reveal other issues that could be affecting your health and quality of life. 

Prevention Of Addison's Disease

When you know that you are on the path towards Addison's disease, you can take action to get things under control. For example, simple lifestyle changes can easily help improve levels and resolve any health issues. If you have a genetic cause for Addison's disease, these tests will reveal which biomarkers should be closely monitored and tested more often.

Treatments

If the tests reveal that you have Addison's disease, there are many treatment options for you. You can treat the issue with hormone therapy to make up for the hormones that are not being produced by the adrenal glands. Lifestyle changes can dramatically alter the side effects of the condition. It can also help manage your stress and blood pressure levels. Addisonian Crisis is the result of untreated Addison's disease. It causes low blood sugar, low blood pressure, as well as high levels of potassium in the blood. These issues need immediate treatment since they can be life-threatening. 

Feel More Confident About Your Health

Understanding what is going on in your body and adopting lifestyle changes can impact your health and well-being in a big way. The information provided by Ulta Lab Tests helps you make the correct decisions about your health and well-being.

Testing With Ulta Lab Tests

Our tests are highly accurate and reliable so that you can make informed decisions about your health. We also guarantee confidential and secure results. With Ulta Lab Tests, you don't need a doctor's referral or insurance to order lab tests. We offer affordable pricing as well as a 100% satisfaction guarantee. 

Order your Adrenal Insufficiency lab tests now. You can view the results online in 24 to 48 hours for most tests. 

Take charge of your health today with Ulta Lab Tests.