Adrenal Fatigue vs. Cortisol Imbalance -- Should You Test
Cortisol is a critical steroid hormone that controls your body’s response to stress. Your adrenal glands, one on top of each of your two kidneys, produce cortisol as part of your body’s fight-or-flight response. Stress can be psychological, as in what a high-pressure job can cause, or physical. For example, if you experience a serious injury, your body is under stress, and your cortisol levels might be high.
If your cortisol levels are too high or too low, it can also harm your health. Besides moderating your body’s stress response, cortisol is also involved in regulating your cortisol levels.
- Immune system
- Blood pressure
- Metabolism
In these stressful times, many people are talking about adrenal health, adrenal fatigue, and cortisol imbalance. What do these terms really mean, and should you test for them?
Are Adrenal Fatigue and Cortisol Imbalance the Same Thing?
No, they are not. Cortisol imbalance is a term used to describe when you have either too much or too little cortisol, outside of what is considered normal, healthy cortisol levels.
Adrenal fatigue is just one kind of cortisol imbalance. In adrenal fatigue, you may have lower levels of cortisol. Adrenal fatigue is not an official medical diagnosis. Instead, some health providers and wellness experts suggest that chronic stress depletes your adrenal glands’ ability to secrete enough cortisol. They suggest that people with adrenal fatigue who are under chronic stress may have the following symptoms:
- Tiredness
- Weakness
- Sleep problems
- Cravings for sugar and salt
Some health experts describe adrenal fatigue as a milder version of adrenal insufficiency. Medical health providers, nurse practitioners, and other licensed health professionals diagnose adrenal insufficiency when cortisol levels are extremely low.
People can also have too much cortisol. When cortisol levels are too high for long periods of time, it can lead to health issues such as:
- Weight gain
- High blood pressure
- A weakened immune system
- Anxiety and depression
Several medical conditions can cause higher-than-normal cortisol levels. The Cleveland Clinic reports that the symptoms of high cortisol levels can be:
- Weight gain, especially in your face and belly
- Fatty deposits between your shoulder blades
- Wide, purple stretch marks on your belly
- Muscle weakness in your upper arms and thighs
- High blood sugar, which can turn into Type 2 diabetes
- High blood pressure
- Excessive hair growth in people assigned female at birth
- Weak bones, called osteoporosis, and bone breaks
How Can You Test for Adrenal Fatigue and Cortisol Imbalance?
There is no official test for adrenal fatigue. There are tests (blood tests or saliva tests) that can measure your cortisol levels. Still, they are used to diagnose adrenal insufficiency, Cushing Syndrome, or problems with the other glands involved in cortisol hormone balance. These glands are:
- Your pituitary gland
- Your hypothalamus gland
Some providers believe that cortisol tests designed to diagnose Cushing Syndrome or other endocrine conditions are not sensitive enough to detect minor dips in cortisol levels, which may be caused by adrenal fatigue.
Medical providers may use a more specific test, the adrenocorticotropic hormone test, or the ACTH stimulation test, to diagnose either primary or secondary adrenal insufficiency. They may also consider testing for other conditions causing hormonal imbalances with similar symptoms, such as:
- Polycystic ovarian syndrome (PCOS)
- Metabolic syndrome
- Diabetes
- Thyroid conditions
Should You Test For Adrenal Fatigue and a Cortisol Imbalance?
If, overall, you are a healthy person without any other pre-existing medical conditions, such as diabetes or high blood pressure, then you do not need to test for adrenal fatigue or a cortisol imbalance. The US Preventive Services Task Force (USPSTF) does not have any recommendations for or against regular screening for adrenal conditions.
If, however, you have noticed a change in your health, weight, appetite, energy level, blood pressure, or sleep, you might want to start paying closer attention to your symptoms and whether they seem like those caused by either too high or too low cortisol levels.
Talking with a healthcare provider can help you sort through your symptoms, identify any potential causes of a cortisol imbalance, and determine which, if any, tests might provide more answers for why you aren’t feeling like your usual, healthy self.
Test Your Cortisol Levels at Home With Everlywell
Everlywell makes it easy and convenient for you to learn more about your hormonal health. There are several Everlywell tests that either measure cortisol alone or combine a cortisol test with other vital tests.
- The Women’s Health Test tests your cortisol levels, as well as levels of 10 other biomarkers, including estradiol, progesterone, and thyroid-stimulating hormone (TSH).
- The Men’s Health Test measures four hormones: cortisol, DHEA, Estradiol, and free testosterone.
- The Sleep and Stress Panel tests the amount of cortisol in your saliva.
- The Metabolism Panel tests cortisol, thyroid-stimulating hormone (TSH), and free testosterone.
Cortisol is a much bigger player in the game of your body’s health and well-being, besides just being the catcher for life’s stressors. Your ability to live a longer, healthier life may depend on your cortisol levels. Cortisol levels can impact how your body stores fat, your blood sugar, your risk of developing diabetes, and your body’s ability to fight off viruses, bacteria, and cancer — all significant risk factors for chronic diseases and earlier death.
Paying attention to whether you have any of the symptoms of adrenal insufficiency or a cortisol imbalance could save your life. Expert nurse practitioners at Everlywell are available to consult with you via fast and easy virtual visits. Everlywell is your partner on your journey to learning more about your hormonal health and how you can optimize it for the long haul.