Under normal conditions, feeling stressed can be a healthy and helpful bodily reaction, giving us a heightened sense of awareness and the extra energy needed to help us cope with a given situation. However, an extended stressful situation or the constant pressure to perform can sometimes be crippling, overwhelming the nervous system and leading to adrenal exhaustion, especially acute or chronic illnesses. Chronic inflammatory conditions such as inflammatory bowel diseases (Crohn’s, IBS), arthritis (rheumatoid or osteoarthritis), diabetes, weight gain, and many others will put constant demands on cortisol production and eventually exhaust the adrenal stress response system.

Because cortisol levels are a good predictor of the stress response in most individuals, measuring cortisol levels is a common tool to assess what level and type of stress you are experiencing. When cortisol levels are very low, it is a sign of adrenal exhaustion or burnout. When cortisol levels are very high it may mean there is an uncontrolled acute stressor present (chronic inflammation) or that the feedback loops that should be lowering cortisol are not functioning properly.

adrenal stress testingCortisol can be measured from blood, urine or saliva samples.  At Whole Body Health, salivary testing is commonly used and an extremely accurate method of testing function of the hormonal system. The saliva test measures the active hormones only, rather than the inactive hormones. The active hormones can also be measured by a blood test but this test is extremely expensive.  In a saliva test, samples are collected 4 times throughout a “normal” day: once upon rising, once in the mid-late morning, once in the afternoon and once before bedtime. The lab will evaluate total levels of active cortisol and the proper diurnal rhythm. The lab will also measure additional hormones such as DHEA, melatonin (in the bedtime sample) and sometimes even testosterone and estrogens.  These other hormone levels can help define certain related conditions to help us define a better approach to care.

There are three stages of adrenal exhaustion: early/acute adrenal stress (stage 1), mid-phase adrenal fatigue (stage 2), and late phase (stage 3) adrenal fatigue. Each of these stages affects the body in different ways by creating an imbalance in hormone production, blood sugar handling, disruption of sleep/wake cycles, increased frequency in muscle and joint injuries, and the likelihood of illness in varying degrees. 

3 Adrenal Stress Levels

Early/Acute Adrenal Stress

Sometimes called “The Alarm Reaction” or being “wired,” this is a response to current demanding stressful situations that are causing high amounts of cortisol production without adequate feedback reduction. These individuals may lack an adequate diurnal rhythm as well. Acute adrenal stress will eventually suppress important immune functions and will often result in increased risk of sickness.

Mid-Phase Adrenal Fatigue

This condition can be the result of adjustments to an ongoing acute adrenal stress condition or the accumulation of years of mild stress without adequate relaxation and recuperation. These individuals may have cortisol levels within the normal range but either lacks proper circadian rhythm or have reduced levels of DHEA.

Late Phase Adrenal Fatigue

This is often called “burnout” or adrenal exhaustion. This condition typically has low or very low cortisol levels (Addison’s disease is the complete loss of cortisol production). These individuals are easily overwhelmed by any stress and find that even simple tasks become burdensome.

Through a process of physical examination, health history, lifestyle assessment and functional testing, Dr. Jeff Ulery can find out what level of stress or fatigue you are currently experiencing and develop recommendations so you can experience renewal and a healthy, balanced, more fulfilling life!

For more on understanding the science behind adrenal stress response, click HERE.