Photograph should a white/tabby cat curled up sleeping in what appears to be a metal bucket.
Photography credit: Alex Pavlou

I have made some great progress in this past year in terms of my health. However, the main symptom that persists is fatigue. Though much improved (given I was essentially bed bound at one point), I am still limited in how much I can do each day as my stamina remains quite poor. I also suffer from post-exertional malaise should I push myself out with my energy envelope. Try as I might, this is one aspect of my recovery where I feel I have plateaued. As I am sure you can imagine, I have had an endless list of tests, which have always came back as within normal range. However, after reading quite a lot about adrenal fatigue, I decided to have yet another test done- an adrenocortex stress profile test.

What is adrenal fatigue?

Adrenal fatigue is a collection of signs and symptoms that occur when the adrenal glands are performing sub-optimally. It is associated with periods of intense stress or illness. It is not a widely recognised medical condition and many doctors can be dismissive of it. However, it has to be said that the same can be true of fibromyalgia! The symptoms of adrenal fatigue include high levels of fatigue, difficulty waking each morning, an inability to cope with stress, a weakened immune system and poor memory/concentration. You can read more about adrenal fatigue here, where there is a wealth of information on the subject.

Testing adrenal function

I have read a lot about how fibromyalgia and adrenal fatigue can often go hand-in-hand. Given my symptoms, it made sense for me to rule this out– if only to put my mind at rest. I therefore decided to have my adrenal function tested, which I did privately. I should note that this was not because of resistance from my GP, I just saw this as the quickest and easiest route. This was done through an adrenocortex stress profile via Genova Diagnostics. I believe the test cost £79. You cannot order tests as a patient and therefore need to find a practitioner who can order the test for you. I believe if you are based in the US there are labs that you can order the tests from yourself.

The test involves collecting four saliva samples throughout the day, which are then tested for cortisol and DHEA levels (hormones produced by the adrenal glands). It is simple to do and you are given a set of instructions to follow. You basically spit into the collection tubes at the specified times during the day and then freeze the samples afterwards. You need to ensure that you label the collection tubes correctly with your name, date of birth and the date and time of collection. There is also a requisition form that needs to be completed and returned with your samples. The morning after collection, you arrange for a courier to collect your samples so that they can be delivered to the lab via overnight delivery.

Photograph shows a specimen pathology bag and the instructions for the adrenal stress profile test kit.

My results

I had anticipated that perhaps my cortisol levels would be lower than normal. However, my results were the complete opposite of what I expected. My cortisol levels were normal/high first thing in the morning, abnormally high at noon, normal/high at tea time and abnormally high in the evening. My DHEA was low normal. Unfortunately, the practitioner that ordered the test for me was unable to consult with me. However, I was fortunate that Courtney from Vital Plan kindly took the time to go through my results with me. It was a relief knowing my adrenals are clearly working and are able to produce cortisol and the most significant result was the high levels of cortisol in the evenings. I do wonder though, if the noon reading was the result of pushing myself to go out for walk prior to this sample being taken. I am working hard on pacing this activity better now as, at the point when I had the test, I would be left feeling awful and completely drained of energy afterwards. Sometimes, even when you aren’t doing much, you have to break an activity down even further.

Since having the test done, I have added Vital Plan’s Pure Calm supplement into my health care regime to try and bring down my cortisol levels in the evening. I hope this will help to improve the quality of my sleep. I will continue to practise relaxation techniques, as I do now, too. I do believe the results shows that my body is under a degree of stress– most likely a combination of mental, physiological and emotional stress. I know what the main cause of stress is for me– being on long-term sick leave from work. I do put pressure on myself because of that and it understandably causes me stress knowing that I am now in a position where I face losing my job. I am trying to let go of that and just face what comes but it’s hard. Being ill, of course, is also bound to place a lot of physiological stress on my body too.

Should you get tested?

I think only you can answer that. If you read about adrenal fatigue and can relate to the symptoms, I believe that there is no harm in getting tested, especially given how non-invasive the test it. Of course, you should always consult your GP but if you find resistance from them, know that there are other ways to have the test done.

Let me know your thoughts in the comments below.


Hello, I'm Donna. I was diagnosed with Fibromyalgia in 2013 and started this blog shortly after. After my health declined significantly the following year, I decided to become my own advocate and searched for answers. It took two years but, in 2016, I finally discovered I had Lyme Disease. On February Stars, I share my personal journey back to better health; discussing what has helped me and the mistakes I've made along the way. I also cover topics on self-improvement, managing symptoms and living life to the fullest with chronic illness.


  1. There are several places in the US where you can order your own lab tests. I think there are only a few states don’t allow lab tests without a doctor’s order. There a few that I am going to have done when my budget allows it. Sometimes it’s not just the doctor. For instance the basic thyroid test. It’s not really that accurate but if your results come back in the normal range, most of the time insurance companies won’t pay to have a full thyroid panel done. You would think that they would do away with the test that doesn’t give the full picture and just run the one that does. I don’t know how it is in Scotland, but the healthcare system in the US is not about health it’s about profit which is really a shame.

    • I thought that was the case Sue but wasn’t 100% sure. It’s great you are able to do that. It seems to be the same with thyroid here. They test for tsh and t4 but don’t routinely test t3. Thyroid UK advise testing levels of free t3 too. I’m guessing with the nhs it’s a cost-saving exercise and maybe it’s only a small % who would have normal tsh and t4 but abnormal t3?

      • I’m supposed to have a load of things tested because I’m hypothyroid, but until recently my doctor was only testing T4 – which in essence is completely useless. I had to push to have my free T3 tested, but they still won’t test reverse T3 or T4, Calcium, Vit D or antibodies. As for my adrenals, which I do think need testing, they’d definitely argue against it.

        • That must be really frustrating for you. Adrenal fatigue is something that often isn’t acknowledged by traditional doctors but spit tests can be ordered privately if you definitely wanted to pursue it.

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