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Adrenal Fatigue: How can I know for sure?

If you haven’t had a chance to read my blog post on Adrenal Fatigue yet go back and read that first.

Adrenal Fatigue – The Silent Epidemic


Disclaimer: I am not a healthcare professional.  I am sharing what I have learned but you need to make your own decisions about your own health care.  Consult with a health care professional that you trust for guidance in any changes that you are interested in making.

I’m going to remind you of the list I shared in the last post of symptoms of Adrenal Fatigue.  This is not an exhaustive list and you only need one symptom from it to suspect adrenal fatigue.  Obviously the more symptoms you have the more likely it is.

  • Being tired all the time no matter how much sleep you get.
  • Trouble getting up in the morning, “needing” a cup of coffee to get going
  • craving salty and/or sweet foods
  • mild depression
  • increased respiratory infections/difficulty recovering from sickness
  • allergies both food and airborne
  • asthma
  • hypoglycemia
  • brain fog
  • insomnia esp between 3-5 am
  • IBS
  • Low Blood pressure
  • sensitivity to light and/or cold
  • irritability, anger, impatience
  • panic/anxiety attacks
  • burst of energy in the evening after dragging all day

Adrenal fatigue may be one aspect of another illness. That doesn’t mean that your adrenal fatigue doesn’t need to be addressed as well. The stress of that illness can wear out your adrenals quite quickly! For example,

“during the Spanish flu epidemic in 1919, according to the Archives of Internal Medicine, doctors autopsied 126 patients who had died in the flu epidemic. Of these, 103 showed adrenal gland atrophy and shriveling consistent with adrenal exhaustion, and another 3 cases had adrenal hypertrophy and swelling consistent with a state of extreme stress. The adrenals were exhausted in their effort to restore balance to the body during overwhelming infection, to the point that their depleted state was physically detectable upon autopsy and significantly contributed to their death.” (from here)

Adrenal exhaustion cannot be ignored!

If you have identified yourself in this list but you still aren’t convinced here are 3 tests that you can do yourself at home to confirm your suspicions.

Test #1: Iris Contraction Test – In a darkened room, sit in a chair in front of a mirror. Holding the flashlight at the side of your head, shine it across one eye (not into the eye). Watch what happens in the mirror.  You should see your pupil contract immediately after the light hits the eye. The pupil will normally stay contracted, but if you have adrenal fatigue, the pupil won’t be able to hold its contraction and will dilate. This dilation will take place within 2 minutes and last for about 30-45 seconds before it contracts again. Time how long the dilation lasts and record it along with the date. Retest monthly as it serves as an indicator of recovery.

Test #2: Blood Pressure Test – If your blood pressure drops when you stand up from a lying position, this almost always indicates low adrenals. This can be measured with a blood pressure gauge (a sphygmomanometer), which you can buy at a drug store. Make sure to purchase the type that doesn’t require a stethoscope to take your blood pressure.  Make sure to do this test when you are well hydrated or it could give you a false positive. Lie down quietly for about 10 minutes, then take your blood pressure (while still lying down). Then stand up and measure your blood pressure immediately upon standing. Normally blood pressure will rise 10-20mmHg from standing up. If your blood pressure drops, you likely have adrenal fatigue. The more severe the drop, the more severe the adrenal fatigue.
Test #3: Sergent’s White Line – This is only present in about 40% of people with Adrenal Fatigue, but if the test is positive, it’s a “slam dunk” confirmation. With a ballpoint pen, take the cap end of the pen and lightly stroke the skin on your abdomen, making a mark about 6″ long. Within a few seconds, a line should appear. In a normal reaction, the mark is initially white, but reddens within a few seconds. If you have Adrenal Fatigue, the line will stay white for about 2 minutes and will also widen.

Now that you feel confident that adrenal fatigue is likely an issue for you, you need to do one more test.  This absolutely must happen before you can start treating your adrenal fatigue with herbs or drugs. No, you can’t figure this out some other way. The kind of test you want is a diurnal saliva test. That is you will take samples of your saliva 4 or 6 times in a 24 hour period and send them off to be tested. (You could also do a blood test at the right intervals but who wants to do that?  Plus finding a lab to draw it after 10 pm could be tricky). My family sees a Dr who will order this test but many Dr’s don’t know about this kind of testing and will not order it.  If your Dr won’t order it it is possible to order it yourself. You can do that at Canary Club. The cost is $109.

If you have not done this test it is very difficult to know how to treat your adrenals effectively although there are some general things you can do no matter what your cortisol pattern looks like. It is important that you not be taking anything that will effect your cortisol levels for 2-3 weeks before you take the test.  Getting an exhaustive list of things that effect cortisol is difficult since there are so many. The most common substances are hydrocortisone, anti-anxiety meds, some anti-depressants, herbal adrenals supplements, asthma inhalers, melatonin, zinc, and prednisone.  What I did was go off of most supplements for those 2 weeks and researched anything I felt would be difficult to live without (google the supplement name and cortisol together).  Foods also can effect cortisol but changing your diet is not necessary for accurate testing.  If you usually consume coffee it is ok to do so on the day of the testing at your normal rate but do follow the instructions for fasting.

You should get your test results in 1-2 weeks.   My next post will be about what you can do to help your adrenals to heal.  In the meantime get more sleep and avoid stress as much as possible!

Do you have any questions about testing your adrenals?  Did you do any of the self tests?  What were your results?  Share in the comments.

Adrenal Fatigue: What Can I Do About it?


  1. My husband did the diurnal saliva testing through Mercola’s clinic. Then he took DHEA abd pregnenolone for 9 months, if I remember correctly. This was back in 2007. I think we need to have him tested again as he has been under intense physical and emotional stress again. He also uses EFT at times and that is very helpful.

    • Yes he needs to be tested again. Your adrenal status can change much faster than that and he needs to know where he is at right now before treating.

  2. Patty, can you explain this pen cap a little more? Is it the point of the ball point pen, or the round side of the cap, or the stick part off of the lid? I guess I’m wondering what kind of scratch to make to test.

    • It just needs to be a small blunt hard object. I have done it with my fingernail but a pen cap is an easy to find object for most people. You aren’t drawing on yourself with ink, just scratching your skin firmly (but not enough to leave a scratch, hence the blunt object). Make sense?

  3. I’ve been feeling extremely fatigued recently, and have had many of these symptoms. When I tried the Iris Contraction test I got mixed results. For two minutes my Iris remained mostly contracted. It only got a little bigger for a few seconds. It did not go anywhere near fully dilated.

    I tried the Sergent’s White Line test, and the white line went away within seconds.

    After I’ve been laying down and I suddenly stand up I do occasionally get dizzy for a few seconds, but then I quickly normalize. I had heard that was normal though, so I’ve never thought anything of it. I’m uncertain if that’s a positive hit for the blood pressure test.

    What do you think?

    • I think it would be a good idea for you to get your adrenals tested with a saliva test. Those two self tests are only indicators and not necessary for adrenal fatigue. I flunk the pupil test but haven’t ever had the Sergents white line test come up positive despite having severe adrenal fatigue at one time. It is the symptoms that you need to pay attention to the most and just one is necessary to suspect adrenal fatigue. The more symptoms, the more likely it is.

  4. Hi Patty
    I have known I have adrenal exhaustion for a long time now. I have had the saliva test done and it confirms. Almost a year ago I changed my diet to a traditional diet and have eliminated all junk foods, processed foods and do a lot of fermentation of foods & beverages, cooking from scratch, soaking, raw milk & cheeses. A total change of life. I have not seen much change to the adrenal symptoms list as I still have ALL but one on your list above. I am sure my thyroid is affected too. I don’t have a physician or health insurance. Are there things, ways I can help my body to be stronger ? Things I can take? I know eating right is a plus but I do notice that when my immune is down even eating right isn’t enough. I have always wondered what am I missing during these times my body is stressing out!! Am I making sense!! Thanks for your articles and sharing your experiences. I am learning from you and don’t feel so alone!! I want to feel better and help my body to be strong!! Thanks.

    • Diet alone was not enough for me either. One thing I don’t notice you mentioning is sleep. With adrenal fatigue you must go to bed by 10 pm every night and get as much sleep as possible. Sleeping 12 hours a night for 6 months straight is not unreasonable.
      Some other things can help like eating more saturated fat, more salt, and for me I needed to take hydrocortisone. If your cortisol level is low (it can be high with af also) then you might try taking isocort. Do not follow the bottle instructions for it. Join the yahoo group that is linked on the adrenals website for information about using it. Also you should probably get another test done to see if you have had any improvements over the past year just with diet. Yes you should also get your thyroid tested and treat it if necessary. My experience was that both needed to be treated simultaneously to see healing for me and my dd.

  5. Hi Patty
    Yes, sleep is an issue for me. I’m tired all day but by 9-9:30p. I am in bed. If I get to bed later than 10p. I miss that window and tend to be awake instead of sleeping. I do not get a lot of sleep during the night as tired as I am, I am awake by 3-4a. and have trouble falling back to sleep. Some nights I can sleep thru but I’m up by 6:30a. to get my son out the door for school. No matter how much sleep I get and usually not more than 8 I am still extremely fatigued in the morning like I didn’t even sleep. Never enough and always tired. Have been this way all of my life even as a teenager. I’m 49 years old now and a lot of years to help correct in bad health. I crave saturated fat and Celtic sea salt!!!!! I have heard of isocort and have been afraid to try it. Do you need a prescription for the hydrocortisone? Are these things I can use to treat on my own? Did you have to treat your thyroid too? I have heard that most people with adrenal issues usually have thyroid issues as well since they work together to produce harmones your body needs.

  6. When I finished reading your last post and this one (up till the sudden blood pressure drop thing) a light WENT OFF IN MY HEAD. I’ve had the dizziness thing since 5th grade, and it really peaked in high school (I was at a high-stress magnet school) when I often complained about not feeling well, to the point that when it would snow (in Alabama, where we get snow once, sometimes twice a year, sometimes not at all), my brother would get really angry at me because I wouldn’t even want to go outside. I still have the dizzy spells when I get up to do something. Once I got one when I turned my head. The thing is, it almost completely disappeared during the second half of my pregnancy! Poor baby. I was walking miles a day at her expense (you would have too, she was 41 weeks and 3 days. Had to get her out.) As soon as the pregnancy was over and things got back to normal, bam. Dizzy. Guess I better work on my salt and sleep.

  7. Read the work by Dr. Lam. If you suffer from Adrenal Fatigue, which most people do, typically not in an incapacitating way as they are only in stages I or II, you should buy his book. He is an MD who is not of the western mindset in treating and diagnosing disease. He approaches treatment based on ways in which work with your body in a natural manner, only relying on synthetic pharma drugs when absolutely necessary. If you look him up, you will find his website. As an ND medical student, I don’t care to listen to anyone else on the subject after reading his book.

  8. I have been really tired and
    Sick feeling with my bp dropping really low. I had know idea about an adrenal gland til i went to the Dr . He is running test that should be in in a week. I wanted to know more about and found this blog thru google . I just tried the abdoman scratch test and u were right!!! I was amazed!! It stayed white for along time . Most of it is red now but theyre still some white at the end of the line. How long does it take u to feel better and does it feel something like a kidney infection? My back is so sore and tender right where the kidneys are.

  9. hi,

    i’ve read your post and tried the iris test as the most accurate one. but i have a question? by dilatating you mean the pupil going back to full size (like when you are in a dark room?) … and if the pupil stays small but contracts with nano-micro-milimeter that is really hard to catch is it still a valid test that the adrenal function is okay?

    • I’m not sure I’m understanding what you say. The eye test you are watching the pupils and if they don’t stay small when a light is shined on the eye that is a sign of adrenal fatigue. I have seen it where the pupil seems to almost flutter bigger and smaller. That would also be considered a sign of adrenal fatigue.


  1. Adrenal Fatigue: How can I know for sure? | Loving Our Guts | Adrenal Diet Weight Loss - [...] post: Adrenal Fatigue: How can I know for sure? | Loving Our GutsRelated [...]
  2. Adrenal Fatigue- The silent epidemic | Loving Our Guts - [...] For part 2 see Adrenal Fatigue: How can I know for sure? [...]

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