“Adrenal Fatigue” Testing

Quick Intro

Searching for answers about “adrenal fatigue”? At VEI Clinic Apgujeong, we offer an evidence-based adrenal function evaluation for travelers and Seoul residents with symptoms like low energy, brain fog, poor stress tolerance, and non-restorative sleep.

What We Actually Test (Doctor-Guided)

We tailor your workup to your symptoms, medication use, and any red flags:

• Morning serum cortisol (8–9 AM) ± ACTH
• Screens for primary/secondary adrenal insufficiency in the right context.
• ACTH stimulation test (cosyntropin), if indicated
• Confirms/clarifies adrenal insufficiency.
• Overnight dexamethasone suppression or late-night cortisol (if indicated)
• Screens for Cushing’s syndrome when clinical features are present.
• 4-point salivary cortisol (diurnal curve) (select cases)
• Evaluates circadian rhythm/stress patterns; useful adjunct for sleep/shift-work/jet-lag discussions—not a stand-alone diagnosis tool.
• DHEA-S (context-dependent)
• May help interpret adrenal androgen patterns.
• Electrolytes (Na/K), fasting glucose/A1C
• Supportive data for hypo- or hypercortisol states.
• Look-alike checks (chosen case-by-case)
• Thyroid panel, iron studies (ferritin), B12/folate, vitamin D, CRP, sleep risk screening, mental-health screeners, medication review (e.g., steroids, opioids, OCPs, herbals).

When an Adrenal Evaluation Is Useful (Examples)

• Persistent fatigue ± orthostatic lightheadedness, salt cravings, GI upset
• Sleep and stress rhythm complaints (shift work, jet lag, new parents)
• Features suggesting cortisol excess (easy bruising, central weight gain, purple striae, proximal muscle weakness)
• Autoimmune history or chronic steroid exposure
• Post-illness recovery planning where safe activity/lifestyle pacing is needed

Who Might Not Be a Candidate (Today)

• Emergencies: severe dehydration, collapse, high fever with confusion → call 119 or go to the ER
• On systemic steroids (pills/injections) without a weaning plan—tests may be uninterpretable; we’ll advise on timing
• Acute severe illness—defer non-urgent testing until stable

Preparing for Testing (Simple Checklist)

• Morning slot: many cortisol tests require 8–9 AM timing
• Steroids & hormones: tell us about any steroid use (oral, inhaled, topical, injections), DHEA, OCPs, HRT—timing matters
• Biotin: if you take high-dose biotin, you may need to pause it for 48–72 hours (some immunoassays are affected)
• Caffeine/exercise: keep your routine normal; avoid unusually intense workouts just before sampling
• Saliva kits: no food/drink (except water), brushing, flossing, gum, or smoking for 30 minutes before collection

Visit Flow (What to Expect)

• Brief consult → symptoms, sleep/work schedule, meds/supplements, red flags
• Plan → select appropriate tests (blood ± saliva; stimulation/suppression if indicated)
• Collection → on-site blood draw and/or take-home saliva kit with timed vials
• Results review → clear English summary with practical next steps
• Next steps → targeted lifestyle guidance (sleep, pacing, nutrition, stress tools), medication changes, or specialist referral if needed

Turnaround Time

• Standard blood tests: ~1–3 business days
• Salivary cortisol day-curve: 3–7 business days
• Stimulation/suppression testing: timing arranged with you; results typically 1–3 days after the test

What Improvement Can Look Like

• Clarifying (or ruling out) true adrenal disease
• Identifying treatable contributors (thyroid/iron/sleep/meds)
• A realistic plan for energy pacing, sleep anchors, jet-lag protocols, and gradual conditioning—plus follow-up metrics

Pricing & Insurance Notes

• Fees vary by panel complexity and special tests
• Most visitors pay upfront; many insurers reimburse with documentation
• Ask for an itemized English receipt (we can add diagnosis/procedure codes)

Safety Note (What This Page Is Not)

If you have chest pain, severe shortness of breath, heavy bleeding, confusion, stroke symptoms, or very high fever with dehydration, call 119 or go to an ER. Hormone testing is not an emergency service or a substitute for urgent care.

What to Bring

• Medication & supplement list (especially steroids, DHEA, OCPs/HRT)
• Prior labs/imaging, relevant clinic letters
• Payment method (card/cash); insurer details if you’ll file a claim