Adrenal Insufficiency Testing. Because the condition is often difficult to diagnose, testing for adrenal insufficiency can help detect the condition at an early stage. After gathering a medical history and performing a physical exam, the doctor may recommend certain tests, including ACTH stimulation tests, CRH stimulation tests, abdominal x-rays, and CT scans.
A diagnosis of adrenal insufficiency is confirmed through hormonal blood and urine tests. A health care provider uses these tests first to determine whether cortisol levels are too low and then to establish the cause. Imaging studies of the adrenal and pituitary glands can be useful in helping to establish the cause.
Adrenal Insufficiency Diagnosis. During this test, blood is drawn to measure the blood glucose and cortisol levels, followed by an injection of fast-acting insulin. Blood glucose and cortisol levels are measured again 30, 45 and 90 minutes after the insulin injection. The normal response is for blood glucose levels to fall (this represents the stress) and cortisol levels to rise.
Adrenal Insufficiency and Addison Disease. The outer layer produces aldosterone, a salt-balancing hormone that has effects on blood pressure. The middle layer produces cortisol, a hormone with effects on blood sugar, blood pressure and inflammatory responses. The deepest layer produces hormones called androgens,
Cortisol Tests. The major lab test used to diagnose Adrenal Fatigue is, as you might have guessed, the cortisol test. But there is more than one type of cortisol testing, and the correct interpretation of results is also important. Depending on his or her preference, your doctor may order a saliva, blood or urine test to measure your cortisol.
The clinical presentation of adrenal insufficiency is variable, depending on whether the onset is acute, leading to adrenal crisis, or chronic, with symptoms that are more insidious and vague. Therefore, the diagnosis of adrenal insufficiency depends upon a critical level of clinical suspicion.