Guest Author - Jim Lowrance

Many Doctors pronounce patients "normal" when a patient passes the tests they feel are the only ones needed to diagnose low adrenal function. These will usually be an "ACTH Stimulation test" and/or a snapshot blood cortisol reading. The problem is, adrenal fatigue is a disruption of "cortisol rhythm" and not necessarily because cortisol is low all of the time and not because the adrenals can't be stimulated. Adrenal fatigue is not usually found until a multi-reading test is performed to gauge a patient's readings of cortisol, over a 24 hour period. Even a test that takes two readings one at morning upon waking when cortisol levels are suppossed to be highest and one at midnight when levels are supposed to be lowest can help give a cortisol average, rather than just a snapshot level.

What really convinced me years ago, that mild adrenal dysfunction does exist and has been proven in medical research, are those medical research articles published in regard to syndromes like CFS, Fibromyalgia and PTSD (Post Traumatic Stress disorder). These articles clearly state that people with these type syndromes suffer low cortisol levels and they have also found strong association of these syndromes to chronic stress, either prolonged or sudden events.

Here are example research article quotes:

"Several years ago, Dr. Straus and his colleagues found that CFS patients had slightly lower levels of circulating cortisol, the major glucose-regulating stress hormone, than did healthy individuals. Doctors have long believed that even subtle deficiencies in cortisol can result in lethargy and fatigue."
Research Link

"Both fibromyalgia and CFS are often viewed as being stress-response related, and abnormalities of the HPA axis have been found in both disorders.
...
In our study, morning cortisol levels were lower in women with CFS than in healthy controls. Some studies of the HPA axis in CFS show a mild hypocortisolism of central origin, in contrast to hypercortisolism of major depression.
...
Cortisol levels peak in early morning and need to be collected before patients rise in the morning; and determining single levels of hormones that are secreted in a pulsatile fashion may not be representative of normal functioning."
Research Link
("Cortisol and Hypothalamic-Pituitary-Gonadal Axis Hormones" © 2004 BioMed Central, Ltd. verbatim copying and redistribution permitted)

"Post-traumatic stress disorder is often associated with low production of cortisol."
Research Link

While research articles do not use the term "adrenal fatigue", this is exactly what is being described by them. They will instead use terms such as "mild adrenal insufficiency", "Blunted HPA axis", "hypocortisolism" and simply "low cortisol".

These type research articles are out there in significant numbers, so doctors who still do not believe that sub-clinical adrenal insufficiency exists, need to take a look at a few of these.

Adrenal fatigue by whatever other name they wish to call it does exist and is found in a variety of stress-related syndromes.