Thyroid UK
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Advice on Adrenal Testing Please

I first wrote the main body of this blog as a comment, earlier today, then thought it might be more appropriate as a blog.

Over many years I have begged my GP for such tests, to no avail.

I have been long convinced that adrenal function is closely linked to thyroid levels but I have never been in the situation where I could act on proving this. I have no medical qualification, just a knowlege of how my body reacts to situations, and some ability to read and study those medical articles available on the internet.

I have often thought of having such tests done privately but when you are in the situation of having only enough energy to survive, of knowing which tasks are musts, then adding the task of organising another blood test to the mix which is such a simple task for 'normals' becomes too much.

Yesterday, my daughter asked me to make an appointment for her with her doctor. Her reasons for seeing him were very important. But when it came to arranging which day. Well! Other chores related to family which should be much lower on her list of priorities, but were 'must do s' for her, made it virtually impossible.

Anyway, I believe that all the hormones are connected, like gear wheels. Each responds to the levels of the others. There is an ebb and flow in each one related to the state of the body at any given time. When one of the hormones is fixed artificially, it no longer 'ebbs and flows', the other hormones react accordingly.

Daily life for my daughter, is made up of repeatedly having to use energy she hasn't got, then crashing. It used to be for me, and still is when I have to do too much. A prime example is over the T3 shortage: too many phone calls, too many visits and jumping on buses. I couldn't do anything for days after.

I must admit my main aim is to secure more help for my daughter, so apart from not knowing how to access an adrenal function test privately, help here please, I do wonder if there is an optimal time when to have the test within the cycle of energy expenditure-crashing-burning. Any thoughts?

11 Replies

Information on private testing is available here:

I am not the right person to answer on adrenal issues.



Hi All the hormonal and autoimmune diseases are linked, ie Thyroid, Diabetes, B12 and Ferritin /iron and vit D. all need testing. There are lots of other tests too. The most important one is tSH T4 and Free T3 for a proper diagnosis. An Endo would do all these normally and possibly more. A GP not automatically. My Endo did my Pituitary and adrenal glands , first visit and repeated the tests too. She says that the only good test, which would need to be through a doctor. Is 24 hour urine collection, a cortisone tablet prescribed for mid night, exactly, and a blood test at exactly 9am. I hope this helps. I know she does not think any other test reliable although I do know a lot of TUK members use them.

Best wishes,



They certainly are connected, and if your doctor is refusing to acknowledge that then I would change doctor. When I wasn't getting any better on medication, one of the first things my gp did was to refer me to the endo to get my adrenals checked out. Sometimes a problem in your adrenals will cause your thyroid to tank out, OR your thyroid problem will overstretch your adrenals. HOWEVER, the tests readily available on the NHS aren't too hot. There's either the 9am cortisol test or the Synacthen test. If your 9am cortisol is under 400 they will send you for a synacthen test to see if the problem is originating in your adrenals or pituitary. If that synacthen test is "normal" then hey-ho, you're back on the scrap heap again. I think there is a 24 hour cortisol test they do, but again that will be to check if the problem originates in your adrenals. After I failed my cortisol test, but passed my synacthen test, I decided to do the Genova saliva test which is very very simple. And you can find details on the Thyroid UK website on how to get this done without hassling your GP for authorisation. It was purely for me to see what really was going on, and it all made sense with how I was feeling. So, although I now agree with the endo that supplementing my adrenals isn't a good plan, at least I know what I need to do to get them back on track


Hi. I really feel for you, are you on thyroid meds and how long, have you ever seen an nhs endo, please just insist on a referral as gps have no knowledge on these issues at all, my doctor like all put all my symptons down to stress, depression and the menopause, after 7 years of feeling like a zombie and not functioning I insisted for a referral and passed initial tests that led on to mri and insulin tolerance test, turns out I have hypopituritism with low basal cortisll, abnormal low growth hormone and endo agrees to treat thyroid by symptons now as tsh level will not change and I am now dependant on steroids and fighting now for the red listed growth hormone injections to see if it raises my very poor quality of life, I feel very angry that we are constantly ignored, labelled as hypochondriacs and treated so poorly by gps if they listened to our complaints seroiusly I am sure I would not be in this awful position now as this take years to get to hypopituritism, tests for me are ongoing and endo say will take about 1 year to get axis back in sync but at least I now have been properly diagnosed how many people have to suffer for years to get this, please dont give up and maybe get more sympathetic gp (easier said than done) I know but thanks to this forum I have learnt so much and we can empathise ans support each other cos we get nothing elsewhere.


You can have your adrenal test done privately from Genova. You don't need to leave your house. The pack gets sent out, you do the 4 saliva samples at 4/5 hourly intervals tthroughout the day and freeze them, then courier them off.


You are 100% right in your thoughts, I like the comparison too of gear wheels. I have just completed the adrenal saliva test in my home door to door collection- which is the most accurate way to test adrenals according to Dr C- this is still used by endo's should your ACT bloods highlight an issue. I have been having the ACT cortisol bloods done over 4yrs now with an increase every time- with no action from GP/endo- only on going to Dr C did he want to investigate further- as to why there was a major increase. Thank god he has as I have a very abnormal result at the midnight saliva test- as being mega mega high. I am £600 lighter in fees and now Dr C has referred my back to GP/endo as he says I urgently need to have bloods again and further testing with regards to CUSHINGS. I also had thyroid Urine tests and full Thryroid profile- but I can not address these issues until this is sorted. I am worrying lots..but now have got to the point of at least something has been highlighted and for 4years of jumping up and down... hoping it is not 4yrs too late. wishing you all the best for your results and moving forward with a simple and accurate test.


There's a lot of disagreement on adrenal exhaustion. Several medical papers indicate no provable correlation between cortisol measurements across individuals and chronic stress. They postulate this is because of the large psychological component in how individuals deal with stress - ie. differently. I think this is why a large proportion of the UK medical community seem skeptical.

References: Grossi G, Perski A, Ekstedt M, Johansson T, Lindström M, Holm K. (2005). The morning salivary cortisol response in burnout. J Psychosom Res. 59(2):103–11. PMID 16186006

De Vente W, Olff M, Van Amsterdam JG, Kamphuis JH, Emmelkamp PM. (2003). Physiological differences between burnout patients and healthy controls: blood pressure, heart rate, and cortisol responses. Occup Environ Med. 60 Suppl 1:i54–61. PMID 12782748

Pruessner JC, Hellhammer DH, Kirschbaum C. (1999). Burnout, perceived stress, and cortisol responses to awakening. Psychosom Med. 61(2):197–204. PMID 10204973)

On the flipside in the US the 24 hour saliva tests are taken more seriously than they are here.

Again though - the reliance on test results to explain symptoms seems to me to be a problem. If you have the symptoms then there IS something wrong. You know your own body. I suffer chronic stress. I am treating this but it's not the only problem - it's caused a bunch more systems than thryoid to jump out of whack. So regardless of what test results tell you you need to address the stress at a primary level. This means lifestyle change and time to heal properly. This book lays it out - Adrenal Fatigue - The 21st Century Stress Syndrome By: Jim Wilson. It's hard though because there's no quick pill fix for this one or test that can necessarily get you all the help you need.


I had a saliva test 2yrs ago. Not accepted by the NHS. Revealed adrenal deficiency, low progesterone and aldosterone. So am no further forward.

You can do some tests yourself which cost nothing.

7 day temperature chart (1st two taken before rising - Ist taken under the arm then mouth these are for thyroid) the remainder are for the adrenals 12noon, teatime, before bed.

Eye sensitivity test

Sergent's white line

Dr Wilson's questionnaire - on the internet and in his book Adrenal fatigue the 21st Cent'y syndrome. In this book he has other tests:

The Raglin Test (blood pressure)

The Romberg Test (balance).

I did several of them inc questionnaire --- didn't answer all sections and still came put moderate to severe adrenal fatigue. ALL cortisol tests inc synatchen's came back normal.

To be honest, until NHS accept tests we have done ourselves and act on them, we can only do them for personnel reasons. Bit doomy and gloomy. But there we go.


Could u tell me where i find info about the tests u menrion(how tthankso do them).?


Hello Cloud, the following are all in Dr Wilson's book (& you can find him on internet)

Raglan, Romberg, eye sensitivity, sergent's white line and of course his questionnaire. I found his book invaluable, well worth buying - good reference once read. Also might pay you to purchase Dr Peatfields book Your Thyroid and How to Keep it Healthy. I won't tell you how I felt after reading that.


Find a Nutritional Therapist - they will help you through doing the adrenal test and the supplements after the test.


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