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Why Run the Adrenal Stress Test?

The adrenal glands are located near the kidneys and produce hormones responsible for a variety of functions in the body. Among those produced are the steroid hormones cortisol and DHEA (dehydroepiandrosterone), which contribute to metabolism and the immune response. The production of these hormones can be altered by internal and external stressors, and this can result in a wide variety of disorders.

What is Measured on the Adrenal Stress Test?

Dunwoody Labs™ offers a comprehensive test that evaluates two antibodies, secretory IgA and anti-gliadin IgA, to determine how well the adrenal glands are functioning and the cause of any fatigue or inflammation that may be associated with adrenal dysfunction. The Adrenal Stress Test: Profile 1600 is a non-invasive saliva test that provides a clinical “snapshot” of hormone function and immune function.

Cortisol

Cortisol is known as the “stress hormone” due to its role in the stress response. Cortisol helps regulate blood pressure, metabolism of fats and carbohydrates, anti-inflammatory response, blood sugar level (through gluconeogenesis), and the immune response (1,2). Normal cortisol production peaks in the early morning and gradually decreases throughout the day. However, stress and damage to the adrenal or pituitary glands have been shown to alter this production (3, 4, 5). Dunwoody Labs™ uses an accurate and non-invasive method for testing cortisol levels using saliva. Cortisol has been found unbound in saliva samples, indicating a strong correlation to cortisol concentrations in blood plasma (6). Four samples are collected from each patient in a 24-hour time frame: one early morning sample (within 30 minutes of waking), one noon sample (11 a.m.-1 p.m.), one afternoon sample (4 p.m.- 6 p.m.), and a final evening sample (10 p.m.-12 a.m.). The results are analyzed and available online in 10-14 days.

Symptoms of Cortisol Imbalance:

Common disorders of adrenal fatigue include:

    • Addison’s disease
    • Cushing’s syndrome, Cushing’s disease
    • Sheehan’s syndrome
    • Nelson’s syndrome

Low Cortisol levels can result in a range of symptoms which may include:

    • Hypertension or hypotension
    • Chronic fatigue and muscle weakness
    • Nausea and vomiting
    • Abnormal blood sugar
    • Blotchy skin
    • Weight gain
    • Irritability, anxiety or depression.

DHEA

DHEA, or dehydroepiandrosterone, is another steroid hormone produced predominately in the adrenal glands. It is the most abundant circulating steroid and best known as a metabolic intermediate for the production of androgens and estrogens (7, 8). DHEA is also involved in anti-oxidant, anti-inflammatory and other immune system functions. For this reason, DHEA production is measured alongside cortisol production (9, 10). Unfavorable ratios of DHEA to cortisol have been linked to depression, anxiety, and other psycho-emotional disorders. They can even have an effect on HIV infection due to the immunocompromised state of the body (15, 16, 17). Like cortisol production, DHEA production is linked with the stress response and peaks in the early morning, gradually decreasing throughout the day (11).  Tests for DHEA concentration are done on the saliva samples taken in the morning after the patient wakes up. Results typically take 10-14 days to be analyzed and uploaded. 

Disorders Associated with DHEA Imbalance

Low DHEA production has been correlated with several disorders including:

  • Depression
  • Alzheimer’s disease
  • Colitis
  • Parkinson’s disease
  • Lupus
  • Osteoporosis
  • Cardiovascular disease

High DHEA levels can result in several symptoms which may include:

  • High blood pressure
  • Weight gain
  • Hair loss
  • Fatigue
  • Insomnia
  • Abdominal pain
  • Irregular heartbeats and heart palpitations
  • Increased risk of developing certain kinds of Cancer

Secretory Immunoglobulin A

Secretory immunoglobulin A (sIgA) acts as the body’s first line of defense against enteric pathogens and toxins at the mucosal surfaces (18). It is a major player in mucosal immunity and is secreted in tear ducts, salivary glands, mammary glands, and gastrointestinal and respiratory systems (19). High sIgA has been seen in celiac disease, acute stress, heavy smoking, alcoholism, periodontal disease, and oropharyngeal carcinoma. Low levels have been detected in allergy and airway infections, asthma, recurrent infections, chronic stress, dental caries, repeated antibiotic treatments, bronchial hyperreactivity, and inflammatory bowel disease.

Associated Disorders

These disorders are strongly associated with abnormal sIgA:

  • Celiac disease
  • IgA nephropathy
  •  Recurring GI and respiratory tract infections

Anti-gliadin Immunoglobulin A

The Adrenal Stress Test by Dunwoody Labs measures anti-gliadin IgA, the immunological reaction to gliadin, in saliva. Gliadin is one of the two main components of wheat gluten and is similar to the proteins of rye and barley. Approximately 1 in 100 people have celiac disease worldwide, an autoimmune disease triggered by eating gliadin. There is growing awareness of non-celiac gluten sensitivity which shows similar symptoms to celiac disease but cannot be easily identified with diagnostic testing. Salivary anti-gliadin IgA can detect gluten sensitivity in a non-invasive manner, without a blood draw.

Associated Symptoms

One in 5 people suffers from some level of gluten intolerance which may lead to:

  • Nausea
  • Fatigue
  • Joint pain
  • Depression
  • Diarrhea

Gluten sensitivity can cause brain fog and general inflammation. More inflammation can contribute to the progression of almost any pathology or condition. When anti-gliadin antibody is positive, further testing for celiac disease may be warranted.

Adrenal Stress Test Instructional Video


We've prepared a video detailing this process for you:

References

  1. Migeon, C.J., & Lanes, R.L. (1990). Adrenal cortex: hypo- and hyperfunction. In F. Lifshitz (ed.), Pediatric endocrinology, a clinical guide (2nd ed.), (pp. 333-52). New York: Marcel Dekker.
  2. Drucker, S., New, M.I. (1987). Disorders of adrenal steroidogenesis. Pediatr Clin North Am, 34(4), 1055-66.
  3. Dorn, L.D., Lucke, J.F., Loucks, T.L., Berga, S.L. (2007). Salivary cortisol reflects serum cortisol: analysis of circadian profiles. Ann Clin Biochem, 44(pt 3), 281-84.
  4. Chernow, B., Alexander, H.R., Smallridge, R.C., et al. (1987). Hormonal responses to graded surgical stress.Arch Intern Med, 147(7), 1273-78.
  5. Kreiger, D.T. (1975). Rhythms of ACTH and corticosteroid secretion in health and disease and their experimental modification. J Steroid Biochem, 6(5), 758-91.
  6. Vining, R.F., McGinley, R.A., Symons, R.G. (1983). Hormones in saliva: mode of entry and consequent implications for clinical interpretation. Clin Chem, 29(10), 1752-56
  7. Mo Q, Lu SF, Simon NG (April 2006).“Dehydroepiandrosterone and its metabolites: differential effects on androgen receptor trafficking and transcriptional activity”J. Steroid Biochem. Mol. Biol. 99 (1): 50–8.doi:10.1016/j.jsbmb.2005.11.011PMID 16524719
  8. William F Ganong MD, ‘Review of Medical Physiology’, 22nd Ed, McGraw Hill, 2005, page 362.
  9. Kroboth, P.D., Salek, F.S., Pittenger, A.L., et al. (1999). DHEA and DHEA-S: A review. J Clin Pharmacol, 39(4), 327-48.
  10. Maninger, N., Wolkowitz, O.M., Reus, V.I., et al. (2009). Neurobiological and neuropsychiatric effects of dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS). Front Neuroendocrinol, 30(1), 65-91.
  11. Rosenfeld, R.S., Rosenberg, B.J., Fukushima, D.K., Hellman, L. (1975). 24-Hour secretory pattern of dehydroisoandrosterone and dehydroisoandrosterone sulfate.   J Clin Endocrinol Metab, 40(5), 850-5.
  12.  Friess E, Schiffelholz T, Steckler T, Steiger A (December 2000). “Dehydroepiandrosterone–a neurosteroid”European Journal of Clinical Investigation. 30 Suppl 3: 46–50.doi:10.1046/j.1365-2362.2000.0300s3046.x.PMID 11281367
  13.  Tworoger, S. S.; Missmer, S. A.; Eliassen, A. H. et al. (2006). “The association of plasma DHEA and DHEA sulfate with breast cancer risk in predominantly premenopausal women”.Cancer Epidemiol. Biomarkers Prev. 15 (5): 967–71.doi:10.1158/1055-9965.EPI-05-0976PMID 16702378
  14.  Key, T.; Appleby, P.; Barnes, I.; Reeves, G. (2002). “Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies”. J. Natl. Cancer Inst. 94 (8): 606–16.doi:10.1093/jnci/94.8.606PMID 11959894
  15.  Goodyer, I.M., Herbert, J., Altham, P.M., et al. (1996). Adrenal secretion during major depression in 8- to 16-year-olds, I. Altered diurnal rhythms in salivary cortisol and dehydroepiandrosterone (DHEA) at presentation.Psychol Med, 26(2), 245-56.
  16. Young, A.H., Gallagher, P., Porter, R. (2002). Elevation of the cortisol-dehydroepiandrosterone ratio in drug-free depressed patients. Am J Psychiatry, 159(7), 1237-39.
  17.  Christeff, N., Gherbi, N., Mammes, O., et al. (1997). Serum cortisol and DHEA concentrations during HIV infection. Psychoneuroendocrinology, 22 (Suppl. 1), S11-18.
  18. N J Mantis, N Rol, and B Corthésy(2011) Mucosal Immunology 4, 603–611; doi:10.1038/mi.2011.41; published online 5 October 2011.

Holmgren, J., Czerkinsky, C. (2005). Mucosal immunity and vaccines. Nature Medicine11(4 Suppl), s45-53.