Check out the Adrenal Fatigue factsheet here to see if you recognise yourself. OK, convinced you do? Let’s explore how to test effectively then…
My general advice is to do a Genova Adrenal Stress Test or Genova Comprehensive Adrenal Test, which includes SIgA. You can do the Comprehensive Adrenal Stress with CAR, which also includes SIgA and CAR. Here are the test instructions. If your results don’t seem to fit how you feel (ie. you feel fatigued yet your cortisol looks high rather than low), follow up using the DUTCH Adrenal Metabolism. Here is a sample report and test instructions. Or preferably – and better value for the sheer amount of info you get – use the DUTCH Complete Plus hormone test. If you want more info right off the bat, do the DUTCH Complete Plus.
Most people want to see what their cortisol and DHEA are up to during the day. You can do that using the Genova Adrenal Stress Test, which measures 4 salivary cortisols and total DHEA samples. This gives you the info you need to see what’s most likely going on, where issues in the day might be and when to take boosters or calmers etc.
However, I would always do the Genova Comprehensive Adrenal Test, which includes SIgA. The Comprehensive Adrenal Stress with CAR includes SIgA too, if that’s easier. Let’s explore why those markers are important…
In some cases, you can see an adrenal problem developing before it shows in the normal testing scores by measuring the CAR, cortisol awakening response, so it can be worth including that. The CAR essentially is the spike we experience on waking and within the first 30 minutes. If your CAR is below 50%, it shows you are not able to mount a wakening response and there is an adrenal issue, even if it isn’t showing on the main test parameters.
SIgA is extremely useful and not enough people check it. You can read my SIgA factsheet here, but essentially it is the marker for gut and mucosal immunity and it ‘tags’ food as ‘safe’ or not. If you don’t have enough, it can explain why you can’t get rid of infections or chronic symptoms and is an answer to why you are developing ever more food and chemical sensitivities. If it’s too high, it suggests inflammation or acute reaction somewhere to, eg. a parasite or allergen. SO useful.
The DUTCH test stands for Dried Urine Test for Complete Hormones.
Rather than the normal salivary test, they measure adrenal function using dried urine samples and include several metabolites which can give you more information, for example, on more hidden adrenal issues. I think the extra info you can get with it is quite useful, especially if you’ve done the standard testing and treatment and need to go a bit deeper. You can choose the DUTCH Adrenal Metabolism Test, but actually if doing a DUTCH test, the DUTCH Complete or the DUTCH Complete Plus which includes CAR will give you tons more info to work with. Check each out and see which gives you what you need.
You can read a blog post I wrote about the DUTCH tests here. You can see more info including collection instructions etc on DUTCH tests here. And here is a video overview of the DUTCH test here:
The Adrenal Plan
The Adrenal Plan is based around the Genova tests and shows you what to do with your results, the protocols to use etc. In over a decade of use in-clinic, I have found this a very useful test and the Plan sorts most people out. There are two versions of the Adrenal Plan: one normal and one TrulyGlutenFree version, which contains grain and dairy free supplement protocols.
My general advice is to do a Genova Adrenal Stress Test or Genova Comprehensive Adrenal Test, which includes SIgA. You can add CAR (PHC) onto that or do the Comprehensive Adrenal Stress with CAR which also includes SIgA and CAR. If your results don’t seem to fit how you feel (ie. you feel fatigued yet your cortisol looks high rather than low), follow up using the DUTCH Adrenal Metabolism (sample report & test instructions). Or preferably – and better value for the sheer amount of info you get – the DUTCH Complete Plus hormone test. If you want more info right off the bat, do the DUTCH Complete Plus.
Steroids like the pill, inhalers , creams etc and any adrenal or thyroid-boosting supplements might affect results. The lab advises you stop them 48 hours before taking the test unless monitoring yourself on them. Please be advised by your health professional before stopping anything.
Long term steroids may also affect cortisol levels and they can show artificially high. If you are on long term steroids, you may not get reliable results. If stopping a steroid medication (via your doctor), you are advised to wait 2 months before adrenal testing to allow them to come out of your system.
Always follow what the lab notes in your test kit tell you to do re avoidance of stuff before testing. There is a useful run-down of adrenal-affecting meds and foods etc here on STTM which might be useful too.
Freezing time. Genova advises that frozen saliva samples are stable at room temperature for 3 days and frozen for 1 month. In other words, you can freeze your samples for a good few days if you have to hang on a bit before sending.
CAR: With CAR we want to get the measurement from when you naturally wake, so if you wake up at 4am, for example, take the samples then and 30 minutes later. The best is to wake naturally at your normal time, not measure an ‘odd’ day where you wake early or something.
Children: DUTCH do not have reference ranges for children. You wouldn’t test certainly before they’ve gone through puberty and a bit beyond.