How to Test Adrenal Function? | PYHP 067

In our last episode we talked about the differences between PCOS and Adrenal Dysfunction, which is often called Adrenal Fatigue.  Adrenal Fatigue or Adrenal Dysfunction is not a ICD10 diagnosis. There is an actual ICD10 billable code called: unspecified adrenocortical insufficiency (E27.40).  But there is controversy in using this code for patients. It is technically meant for conditions where the adrenal glands do not produce enough steroid hormones such as cortisol and aldosterone.  You might be saying, but this sounds exactly like Adrenal Fatigue/Dysfunction! Most people with Adrenal Dysfunction have normal labs, so their doctor cannot code for Adrenocortical Insufficiency (E27.4).  And because their labs and testing look normal people are told they are fine and dismissed.
In this episode, we are going to talk about the testing for Adrenal Dysfunction.  There are some testing that can show Adrenal Dysfunction such as saliva and urine testing.  But most conventional docs are mainly familiar with blood testing. Typical blood testing for adrenals usually will show that a person doesn't have adrenal dysfunction, when in reality, they do. 
We are going to talk about the different methods for testing Adrenal Dysfunction. 
 Let's start by talking about the most common testing method that most docs use, blood testing.
Adrenal Blood Testing:
Cortisol: Blood testing for cortisol is not accurate.  Most, if not all people with Adrenal Dysfunction will test normal for cortisol blood testing.  The reference ranges are vast and a blood test is only done once or twice in one day. And when you have a needle coming to stab you, automatically the body raises the stress hormones.  So cortisol can be falsely elevated in a blood test.
DHEA: DHEA is secreted mainly from the adrenal glands.  In adrenal dysfunction, you will see lower levels of DHEA.  DHEA reference ranges are vast and everyone falls in normal when doing a DHEA total blood test.  But a DHEA-sulfate blood test is fairly accurate for evaluating levels of DHEA in the body. But again, those lab reference ranges are still pretty broad.  But in general, terms, if the DHEA is low or low normal range then you can start to consider that a person has Adrenal Dysfunction.
Testosterone: DHEA is secreted mainly from the adrenal glands and will convert to testosterone for females.  In adrenal dysfunction, you will see lower levels of testosterone in women because of the reduced DHEA levels.  In men with adrenal dysfunction, you will also see lower levels of total testosterone. Testosterone reference ranges are very vast.  Quest has a reference of 2-45 for females and for males the reference range is 250-1100 ng/dL. These are pretty big reference ranges.  But if someone has a low normal testosterone level you can consider that person has Adrenal Dysfunction. 
Pregnenolone: Pregnenolone is secreted from the adrenal glands and there is a small amount made in the spinal cord and brain making it very neuroprotective.  Pregnenolone is accurate as a blood test. But like DHEA and Testosterone, the reference ranges for pregnenolone is huge. For Labcorp the reference range is anything less than 150 is norma