Stressed? How to Test Your Adrenal Gland Function

Tuesday Aug 19 | BY |
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Stress Adrenals

Too much stress can throw off your adrenal glands, leading to other health problems.

Did you know that your adrenal glands can be the source of abundant health or the source of abundant health challenges? The choice is yours!

I want you to make an intelligent choice, but first you must acquire some knowledge. Let’s start with a primer on the adrenal glands.

Adrenals 101

The adrenal glands are small, triangular shaped glands that sit atop your kidneys. They regulate our body’s response to stress in a number of ways.

There are two main sections of the adrenal glands: the outer adrenal cortex and the inner adrenal medulla.

The adrenal cortex is further divided into three layers.

  1. Zona glomerulosa: the site of mineralcorticoid production (i.e. aldosterone), which helps to regulate sodium/potassium balance in the body.
  2. Zona fasciculate: the site of glucocorticoid production (i.e. cortisol), which helps regulate blood sugar balance.
  3. Zona reticularis: the site of sex hormone production (i.e. DHEA, androstenedione).

A doctor I spoke with told me that in medical school, one way they learned to remember these three layers is: “Salt, sugar, sex.” Not important, but catchy.

Connected Directly to the Brain

The adrenal glands are unique in that part of them, the inner adrenal medulla, has a direct connection to the brain. In virtually all of the other hormone-producing glands in the body, the message to secrete a hormone is transmitted via a chemical messenger traveling through the blood stream.

Not so with the adrenal medulla. There is a nerve that goes directly from the brain to the adrenal glands. This is a good thing because when you are in an acute stress situation, you want your body to respond quickly.

What happens when your adrenal glands go awry?

For simplicity’s sake, let’s break down adrenal function into two categories:

  1. Overactive
  2. Underactive

Overactive adrenal glands usually produce too much cortisol and possibly other adrenal hormones (i.e. epinephrine, aldosterone). Since cortisol plays a role in elevating blood sugar, this is often accompanied by an increased blood sugar level. Over time, this might lead to conditions like insulin resistance and metabolic syndrome.

Underactive adrenal glands, on the other hand, produce inadequate amounts of hormones, especially cortisol, to maintain homeostasis in the body.

A common clinical problem with underactive adrenal glands is hypoglycemic symptoms due to fluctuations in blood sugar. Normal, healthy bodies release cortisol to help liberate glucose, which maintains brain, organ and cell functions when blood sugar levels decline between meals, or overnight during sleep.

When cortisol is unavailable, glucose levels get too low. The adrenal glands release epinephrine (a.k.a. adrenaline) as a back-up plan. This causes the light-headedness, shakiness, and irritability that people with low blood sugar experience, and is why people with low blood sugar commonly wake up during the night.

When Adrenal Glands Malfunction

What can cause dysfunctional adrenal glands? Unfortunately, a lot of things:

  • mental/emotional stress
  • food sensitivities
  • blood sugar imbalances
  • infections (i.e. parasitic, bacterial)
  • excessive exercise
  • anything that is a perceived stress on the body

We know that under the influence of certain biochemical processes, the adrenal glands can go straight into a state of overactivity or underactivity.

For instance, through a series of biochemical processes, a viral infection can throw the adrenal glands into a state of adrenal underactivity. On the other hand, food sensitivities seem to encourage the body’s physiology to promote a state of adrenal hyperactivity.

How Are You Adrenals Doing?

Want to test your adrenal gland function? Try this at home!

Here’s one relatively easy test to do if you have a blood pressure monitor. It’s called the orthostatic hypotension test. After lying down for approximately five minutes, take your blood pressure and make note of the systolic pressure (the top number). Then stand up and take your blood pressure again.

If your systolic pressure remained the same or if it decreased, there is a chance you do not have optimal adrenal medulla function, or epinephrine secretion. When we stand, epinephrine is normally secreted to increase our blood pressure to help prevent gravity from pulling blood away from our brain. If your blood pressure drops, it might mean that epinephrine isn’t there to do its job.

Here’s another test you can do at home.

When in the dark, your pupil should be dilated (open). When you shine a light it should constrict. The duration of constriction can indicate adrenal function, though there are other causes for a positive finding on this test. Wait 30 seconds in the dark before repeating with the other eye.

Healthy adrenal function would have your pupil constricting for at least 20 seconds.

There are a few ways of assessing adrenal gland function using laboratory testing. By far the most popular is the adrenal salivary test. It takes four salivary samples throughout the day and uses them to assess levels of salivary cortisol and DHEA. Along with patient history, symptomatology, and clinical observation, the adrenal salivary test is one of the most effective ways of assessing adrenal gland function and determining a course of treatment.

As an aside, particularly for women who are considering using hormone replacement treatments, make sure these three things are functioning properly:

  1. adrenal gland function
  2. blood sugar balance; and
  3. gastrointestinal function.

Of course, now you want to know how to manage the adrenal glands and keep them healthy.

Help Your Adrenal Glands Recover

If you’re concerned about your adrenal glands, the first thing you must do is remove or address the source of stress. This may mean removing food sensitivities, addressing an infection, resolving mental/emotional stress, or whatever it may be that is negatively impacting adrenal gland physiology.

Once you address the source of stress, these are some therapeutic options depending on the findings of the adrenal salivary test:

  • Adaptogenic herbs: There are a number of botanicals called “adaptogens” because of their amazing ability to help the body respond to stress. They can help dampen the stress response in overactive adrenal glands, and increase the response in underactive adrenal glands.
  • Licorice root: This herb is used primarily in the case of underactive adrenal glands and can help with increasing circulating cortisol levels until the adrenal glands restore function. Due to its effects on aldosterone, it is not recommended for people with high blood pressure, so check with your health care provider about this.
  • Phosphytidylserine (PS): This compound is best known for its ability to lower cortisol. But its effects are understated. PS should be used in both overactive adrenal glands and underactive adrenal glands because of its profound effects on the hypothalamus, which is a key regulator in the feedback loop between the pituitary and adrenal glands. Though 600-800 mg taken orally seems to be effective, some people like using a topical application.
  • Hormones: There are two hormones that are sometimes indicated when rehabilitating the adrenal glands: pregnenolone and DHEA. However, please don’t use them without the supervision of a qualified health professional.

To summarize, the adrenal glands and their hormones have major physiological impacts on our body, affecting bone metabolism, hormonal balance, gastrointestinal function, thyroid function, brain health, blood sugar balance, inflammation, and immune system function.

Today, supporting one’s adrenal glands is far more complicated than it used to be in the past. It requires proper testing, looking at many different physiological systems in the body, and proper nutritional support to help our body deal with stress.

The healthier you function internally, the healthier your life will be in general, and your adrenal health plays a huge role.

Shelli Stein

Shelli Stein

Shelli Stein holds a Master’s degree in exercise physiology and has completed over 12 advanced certifications in the field of health and fitness. She coaches and teaches from her home base in San Diego, California. Her specialties include hormone health for women, run coaching, and helping her clients move from pain to performance. She offers free newsletters both weekly and monthly from her websites: and


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  1. Thanx for the good topic, but no idea what you mean by shine a light. You mean like a flashlite and directly into the eye, and how long do you shine it? Then do you just use regular daylight to count how long the construction lasts or are you still shining the light and counting?? Can you give a little more specific steps, that would be a little clearer to get a better reading, not clear

    • Shelli Stein Shelli Stein says:

      Great questions, Barbara.

      Yes, use a flashlight. From the side of your head shine it across your eye. Watch what happens. Your pupil should contract immediately after light hits the eye. Your pupil will normally stay contracted. If you have adrenal issues, it won’t stay contracted and will dilate. This will happen within 2 minutes and last for about 30-45 seconds before it starts to contract again.
      And you can retest monthly to see if you’ve made progress.

      Hope this clarification helps.

  2. ooops meant to say constriction.

  3. Danny says:

    One thing this article doesn’t mention is that heavy metal poisoning can also cause adrenal problems. Eating too much fish, having metal fillings, breathing the vapors from a broken CFL bulb… All of these can poison you.

  4. Deborah says:

    Very thorough, easy to understand. I have read a lot about adrenals but this was much more comprehensive than I’ve previously encountered.

    • Shelli Stein Shelli Stein says:

      Thanks, Deborah. Like you mentioned, it’s a big and often confusing topic so glad I was able to make it easier to understand.

  5. Lynn says:

    Wonderfully informative — really appreciate the comprehensive explanation of Adrenal function and tests. Awesome!

  6. arnie says:

    An excellent summation of a very complicated and often misunderstood component of the endocrine system. It is very disturbing to find out that most MD’s have little to no understanding of the importance of the adrenals and what to do about it when they malfunction. There is an article by the head of the endocrinology department at the Mayo Clinic entitled Adrenal Fatigue, Does It Really Exist? You know what the answer is – No! Protect your adrenals, they are your govenor.

    • Shelli Stein Shelli Stein says:

      Thanks for your comment, Arnie, and for pointing to another resource for people to look at.

  7. Joan says:

    I have a question about women who are thinking about hormone replacement therapy. You mentioned that they should have proper adrenal function, blood sugar balance and gastrointestinal function first. Why is this?

    • Shelli Stein Shelli Stein says:

      In general, I think it’s a good idea to make sure the basic functionality of our major systems are in place regardless of what else we might add to the equation. HRT is an addition. Adrenal function, balanced blood sugar, and gut health, are essential no matter what else may be going on.

  8. Hi…thank you for the article because I can forward it to friends whom I’ve been trying to explain this. I came across a book at our local health food store “Adrenal Fatigue – 21t Century Syndrome” and it was like a lightbulb coming on. It also explained to me why my doctor’s first line of “cure” for me was to prescribe Xanax, after I tried to explain my symptoms! Learned the medical world don’t have a code for adrenal fatigue so since it doesn’t “exist” they can’t treat it, nor claim it so they will be paid for it. Anyways, no wonder antidepressants are so widespread….we are a nation of adrenal fatigue! Since I can’t get my friends to read the book, I can forward on your report to them! Thank you so much for bringing credibility to me! Lol!

    By the way, your article explains why my fasting sugar has dropped – I don’t take meds and only control it by what I eat and exercise, but it is easy to manage now that I am taking adrenal support. Keep the reports coming in!

    • Shelli Stein Shelli Stein says:

      Thanks for your comments, Linda, and glad you are having success managing your blood sugar levels.

  9. Annette says:

    Great article! I am a naturopath and you explained it all really well.


  10. Perry says:

    This is covered in “Adrenal Fatigue: The 21st Century Stress Syndrome” by Dr. WIlson…which is basically the “Bible” of adrenal info. Amazon link here:

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