Adrenal Fatigue

[CoQ10]

Hey Everybody,

Is anybody familiar with the basics of "adrenal fatigue" or "adrenal exhaustion syndrome"? How might these relate to SSRIs?

Thanks,
C10

[Emma-Leigh]

Hey Everybody,

Is anybody familiar with the basics of "adrenal fatigue" or "adrenal exhaustion syndrome"? How might these relate to SSRIs?

Thanks,
C10

Mostly pseudoscience. See -- >>
http://forum.bodybuilding.com/showth...#post289859421

Depends on what is happening for you (whom ever you are asking for) - but symptoms of MANY things (stress, panic, overtraining, depression etc) can often present as what people call ‘adrenal fatigue’ –
http://www.diagnose-me.com/cond/C17669.html
http://www.mayoclinic.com/health/adr...atigue/AN01583
^
And although many people suggest it is ‘real’ (and indeed there are states where you DO have pictures of chronic stress which are muchly like what is called 'adrenal fatigue') -- it is actually usually just CHRONIC STRESS this that is the cause!! Chronic stress/ anxiety/ depression or even chronic fatigue - >>
http://www.mayoclinic.com/health/chr...ndrome/DS00395
^^

And -> SSRI??? Well - if you have underlying depressive symptoms, anxiety/ panic issues or other neurochemical driven wacky.... then it would likely help to decrease these things and, as such, decrease some of the symptoms/signs of 'fatigue'.

But to say more - I would need to know more....

[CoQ10]

Mostly pseudoscience. See -- >>
http://forum.bodybuilding.com/showth...#post289859421

Depends on what is happening for you (whom ever you are asking for) - but symptoms of MANY things (stress, panic, overtraining, depression etc) can often present as what people call ?adrenal fatigue? ?
http://www.diagnose-me.com/cond/C17669.html
http://www.mayoclinic.com/health/adr...atigue/AN01583
^
And although many people suggest it is ?real? (and indeed there are states where you DO have pictures of chronic stress which are muchly like what is called 'adrenal fatigue') -- it is actually usually just CHRONIC STRESS this that is the cause!! Chronic stress/ anxiety/ depression or even chronic fatigue - >>
http://www.mayoclinic.com/health/chr...ndrome/DS00395
^^

And -> SSRI??? Well - if you have underlying depressive symptoms, anxiety/ panic issues or other neurochemical driven wacky.... then it would likely help to decrease these things and, as such, decrease some of the symptoms/signs of 'fatigue'.

But to say more - I would need to know more....

Emma-Leigh -

Thanks very much for the input. My understanding was that it was nonsense as well. However, one DC insisted that I have some "adrenal fatigue issues going on" after reviewing my blood test results. She wants me to get another, more comprehensive blood panel. I'm HIGHLY skeptical, but I have several clients who swear by her methods...

If you have a moment, would you mind taking a look at these numbers and letting me know what you think? Note that I was on a fairly high dose of SSRIs (Prozac, 80 mg/day) as a teenager.

Thanks again.

-C10

[Emma-Leigh]

Firstly - you should discuss all your results with your physician... k?

Secondly - your results need to be interpreted in light of everything:
- symptoms (you experience)
- signs (that you demonstrate on examination)
- other blood results (eg: the more extensive tests she should have done WITH the ones above) or other tests (eg: imaging)

But looking JUST at the numbers MOST show nothing:
* Thyroid function is good (TSH normal... then your T4/ T3 is also normal)... but essentially it means your hypo-pit-thyroid axis is good.

* Testosterone levels are good (both total, and the % free/free).... which tells you your hypo-pit-gonad axis is probably good - but to get more of a picture things like FSH/ LH should be done.

* Estrone levels are normal.... This is one of a few types of oestrogens found in the body (just before you hit oestrogen) and it is formed down the androgen pathway.... basically - it tells you that most of your enzyme pathways are intact in your adrenals... as when there are deficiencies of some of the enzymes blokes get higher levels of oestrogens forming

^^
Testing this really... And in a nut shell it tells you that your adrenals should be functioning well to convert things normally (both mineralocorticoid and steroid pathways).

* PSA normal.... which indicates bugger all (and why in all things holly they are even testing you for this is a mystery to me... PSA goes up in a bazillion things - trauma, sex, infection.... shouldn't be done on everyone and even when done in the right population results need to be taken with a good pinch of salt and weighed up with clinical evidence too)...


BUT ->> Low DHEA level.... DHEA is produced almost entirely in the adrenals... Whether or not this was an isolated finding (the reading looks like it was taken late arvo and DHEA is known to be slightly higher in the morning), or if it indicates something else (which would be odd... considering estrone levels are normal) needs to be further investigated..... The above tests (so far) show that nothing looks horrible... But I would go on to do / request other measurements - electrolytes, cortisol tests (either direct or via a dex suppression test), basic liver/kidney function etc.... And possibly consider some imaging as well (ultrasound)..


But, as mentioned, this is me throwing out ideas without any understanding of what is actually going on with signs/ symptoms and other body systems. So - could be missing a massive 'well d'uhhhh' moment due to not seeing the 'whole picture' thing...

[CoQ10]

Emma-Leigh -

First of all, a HUGE "thank you" for the rundown. I feel like I have a much better idea of what these results indicate.

As far as signs/symptoms go - I generally feel great. The reason I was interested in the thyroid test is because I gain weight on a very low caloric intake; 2,000 calories/day will have me gaining a pound or so per week. As an active male in his mid-twenties with an appreciable level of muscle mass and, I find this quite odd.

I spoke with my uncles (one is an immunologist and the other is an internist) and both felt that I have nothing to be concerned about if I'm asymptomatic. They thought that the evidence behind supplemental DHEA was "tenuous, at best."

Considering that my only symptom is rapid weight gain on minimal calories, would you still recommend cortisol, liver/kidney, and electrolyte testing, or should I just "let it be"?

Thanks again! You have been a tremendous help.

-C10

[Emma-Leigh]

Emma-Leigh -

First of all, a HUGE "thank you" for the rundown. I feel like I have a much better idea of what these results indicate.

As far as signs/symptoms go - I generally feel great. The reason I was interested in the thyroid test is because I gain weight on a very low caloric intake; 2,000 calories/day will have me gaining a pound or so per week. As an active male in his mid-twenties with an appreciable level of muscle mass and, I find this quite odd.

I spoke with my uncles (one is an immunologist and the other is an internist) and both felt that I have nothing to be concerned about if I'm asymptomatic. They thought that the evidence behind supplemental DHEA was "tenuous, at best."

Considering that my only symptom is rapid weight gain on minimal calories, would you still recommend cortisol, liver/kidney, and electrolyte testing, or should I just "let it be"?

Thanks again! You have been a tremendous help.

-C10

^
you are welcome.

Firstly - your family is correct with regards to the evidence behind DHEA... it is 'sparce'. There are SOME areas it is showing effectiveness in (eg: bone mass in menopausal females, sex drive in females, irritable bowel or gastrointestinal disease, and SLE/ autoimmune disease).... in other areas (eg: metabolism) it isn't shown to be effective in clinical trials.

With regards to your symptoms - - >> weight gain at a low calorie intake can be a few things.... In rough order:
1., 2., 3., 4., 5., 6., 7., 8., 9., and possibly 10., miscalculation of calorie intake/ expenditure (the most common cause... less likely with someone 'careful' but still happens and sometimes as much as 50%)
11. metabolic compensation for long term low calorie dieting or compensation for rapid / excessive weight loss in the past (not 'starvation mode' - but compensation ; ) ).
12. lack of patience

..... a few other things (namely part 1 through 10 again )....
10022. genetics (thrifty gene or other chromosome or genetic abnormality)
10023. hormone wackiness (thyroid, cushings/ excessive cortisol, pituatory/hypothalamus issues)

Another thing it could be is an initial glycogen/ water shift (which can result in initial weight gain) - - - > but if the weight gain continues after a few weeks this is unlikely.


Regardless... At 159#, and being a moderately active male (who I would assume doesn't suffer from issues 11, 12 or 10022), you would expect your metabolism to be be about 2200-2550 a day.... So it is odd that you would be gaining on 2000...

Whether or not the above tests would shed some light on the situation? Well - the cortisol/ dex stim test as well as the electrolytes would test your mineralocorticoid/ glucocorticoid pathways (cushings etc).... which would test the function of your adrenal glands (HPA axis), and rule out these as causes.... but you would generally be symptomatic if you were suffering from this... You could also test GH... but the other tests above suggest your Hypothal. and pit. are ok already....

I would suggest you go back to basics:
- recheck activity /output and cal intake
- recheck activity /output and cal intake
- assess if you may be stalled and if you feel a few weeks at 'high cal/ carb' would be of benefit
- assess family for what your genetics are likely to be (be realistic)
^
if the above all lead no where.... then go back to plan B (that is - get a FULL check over just to be sure...).


And... if NONE of that works....
- Eat clean
- Protein and fats only.
- No fruit, dairy, sugar, saturated fats, carbs, treat meals, processed foods, sodium or eating after 7pm
- 12-15 reps per set and make sure you do LOTS of drop sets, supersets and giant sets
- Don't train for more than 1 hr
- Don't train more than once/ week for each muscle
- Make sure you GRUNT a lot and yell 'come on', especially when training arms
- Do 1 hr of empty stomach low intensity cardio every morning while sipping on 'supplement x'

^

[CoQ10]

^
you are welcome.

Firstly - your family is correct with regards to the evidence behind DHEA... it is 'sparce'. There are SOME areas it is showing effectiveness in (eg: bone mass in menopausal females, sex drive in females, irritable bowel or gastrointestinal disease, and SLE/ autoimmune disease).... in other areas (eg: metabolism) it isn't shown to be effective in clinical trials.

With regards to your symptoms - - >> weight gain at a low calorie intake can be a few things.... In rough order:
1., 2., 3., 4., 5., 6., 7., 8., 9., and possibly 10., miscalculation of calorie intake/ expenditure (the most common cause... less likely with someone 'careful' but still happens and sometimes as much as 50%)
11. metabolic compensation for long term low calorie dieting or compensation for rapid / excessive weight loss in the past (not 'starvation mode' - but compensation ; ) ).
12. lack of patience

..... a few other things (namely part 1 through 10 again )....
10022. genetics (thrifty gene or other chromosome or genetic abnormality)
10023. hormone wackiness (thyroid, cushings/ excessive cortisol, pituatory/hypothalamus issues)

Another thing it could be is an initial glycogen/ water shift (which can result in initial weight gain) - - - > but if the weight gain continues after a few weeks this is unlikely.


Regardless... At 159#, and being a moderately active male (who I would assume doesn't suffer from issues 11, 12 or 10022), you would expect your metabolism to be be about 2200-2550 a day.... So it is odd that you would be gaining on 2000...

Whether or not the above tests would shed some light on the situation? Well - the cortisol/ dex stim test as well as the electrolytes would test your mineralocorticoid/ glucocorticoid pathways (cushings etc).... which would test the function of your adrenal glands (HPA axis), and rule out these as causes.... but you would generally be symptomatic if you were suffering from this... You could also test GH... but the other tests above suggest your Hypothal. and pit. are ok already....

I would suggest you go back to basics:
- recheck activity /output and cal intake
- recheck activity /output and cal intake
- assess if you may be stalled and if you feel a few weeks at 'high cal/ carb' would be of benefit
- assess family for what your genetics are likely to be (be realistic)
^
if the above all lead no where.... then go back to plan B (that is - get a FULL check over just to be sure...).


And... if NONE of that works....
- Eat clean
- Protein and fats only.
- No fruit, dairy, sugar, saturated fats, carbs, treat meals, processed foods, sodium or eating after 7pm
- 12-15 reps per set and make sure you do LOTS of drop sets, supersets and giant sets
- Don't train for more than 1 hr
- Don't train more than once/ week for each muscle
- Make sure you GRUNT a lot and yell 'come on', especially when training arms
- Do 1 hr of empty stomach low intensity cardio every morning while sipping on 'supplement x'

^

LOL, thanks Emma-Leigh .

Most of the time, I take in 1,200 - 1600 kcal/day just to maintain.

My initial thought is that the rapid weight gain that occurs when I eat "normally" (1800 - 2,000 kcal) is mostly water. This can amount to as much as 3 lbs/week for several weeks. Eventually, the weight gain seems to taper, but I'll still be putting on ~1-1.5 lbs/week with the same intake. Both my caloric intake and activity level is meticulously recorded, so I can only attribute this to:

A) Genetics
B) Metabolic issues due to long-term dieting
C) Thyroid

Since there's nothing I can do about A and the blood test results indicate that C is not the issue, I'll try to ease off of the dieting for a while and see how I do on 1,800 - 1,900 kcal/day with a moderate carbohydrate intake.

If that doesn't work, I'll go in for more testing. Or try megadosing "Xtend" whilst grunting and performing copious drop sets .

Anyway, thanks once again for the guidance. I'll likely post again in this thread in a month or so with an update.

Best,
C10

[reefpicker]

(I realize this post comes in ex post facto but....

^^

BUT ->> Low DHEA level.... DHEA is produced almost entirely in the adrenals... Whether or not this was an isolated finding (the reading looks like it was taken late arvo and DHEA is known to be slightly higher in the morning), or if it indicates something else (which would be odd... considering estrone levels are normal) needs to be further investigated..... The above tests (so far) show that nothing looks horrible... But I would go on to do / request other measurements - electrolytes, cortisol tests (either direct or via a dex suppression test), basic liver/kidney function etc.... And possibly consider some imaging as well (ultrasound)..

EL: Beautiful image of the steroidogenic pathway I might steal it for my presentations :O

OP:
From what I gathered by a quick look at some articles, DHEA is really not a hormone that you should be worried about. We know little about it and it seems that it is hard to detect in blood (because it is a precursor probably)...

I will tell you that the problem with precursors is that some serve no purpose at all even if they are biologically active (so that they can be used as supplements). This happens often because precursors can look a lot like what they are going to become, and can trick the receptor. Thus, they might have no real biological role at all.

Since downstream all seems well with your adrenal glands and you appear asymptomatic, it is safe to conclude that you have no adrenal fatigue (which IMO is a made-up disorder).

But if you have any questions, consult your physician (MD). I have nothing against DCs but if your physician/DC gives any credence to Adrenal Fatigue, maybe its time to reconsider moving to another DC or physician....

[CoQ10]

Thanks very much for the responses.

The DC ordered the following tests:

Complete Metabolic Panel
Lipid Panel
CBC (Completed Blood Count) with Platelets

My neutrophil count was a little bit low last time I was tested (December), but otherwise everything is pretty normal.

Worth the time, or is this information superfluous for someone who is ostensibly healthy?

-C10

[reefpicker]

Thanks very much for the responses.

The DC ordered the following tests:

Complete Metabolic Panel
Lipid Panel
CBC (Completed Blood Count) with Platelets

My neutrophil count was a little bit low last time I was tested (December), but otherwise everything is pretty normal.

Worth the time, or is this information superfluous for someone who is ostensibly healthy?

-C10

I think that physicians tend to favor testing for some of these once a year, even if you are healthy, as long as you have insurance. If you don't have insurance, and are young, healthy, asymptomatic, and have no other disease (such as high bp, diabetes, hypothyroids, etc), then there is no reason. But if its covered, by all means get it done.

That reminds me, I have to do the same... My last blood panel was like 2 or 3 yrs ago!

[CoQ10]

I think that physicians tend to favor testing for some of these once a year, even if you are healthy, as long as you have insurance. If you don't have insurance, and are young, healthy, asymptomatic, and have no other disease (such as high bp, diabetes, hypothyroids, etc), then there is no reason. But if its covered, by all means get it done.

That reminds me, I have to do the same... My last blood panel was like 2 or 3 yrs ago!

Thanks, Reefpicker. It is covered by insurance, so maybe I'll just go ahead and get it done. Now I just have to find a primary care physician!

Best of luck with your test .

-C10

[Dr. Horse]

Is the OP on any other meds?

[CoQ10]

Is the OP on any other meds?

No. I take a handful of supplements and took SSRIs as an adolescent, but currently I'm not taking any prescription medication.

-C10

[Dr. Horse]

Well, as above, adrenal fatigue isn't really a recognized entity. Adrenal insufficiency is, and we have specific tests for it. Although it sounds like you are not having any signs or symptoms, you can be worked up if your doctor feels it is appropriate.

[CoQ10]

Well, as above, adrenal fatigue isn't really a recognized entity. Adrenal insufficiency is, and we have specific tests for it. Although it sounds like you are not having any signs or symptoms, you can be worked up if your doctor feels it is appropriate.

Since I'm getting a blood test done anyway, would I want to look at anything besides the following?

Complete Metabolic Panel
Lipid Panel
CBC (Completed Blood Count) with Platelets
Antithyroglobulin Antibody

Thanks,
C10

[Dr. Horse]

Since I'm getting a blood test done anyway, would I want to look at anything besides the following?

Complete Metabolic Panel
Lipid Panel
CBC (Completed Blood Count) with Platelets
Antithyroglobulin Antibody

Thanks,
C10

Well none of those will be diagnostic for adrenal insufficiency. I'm surprised your doctor is barking up that tree but not testing for it. I don't know what to make of it. I may have missed it in this thread, but are you having any problems? i.e. symptoms?

[CoQ10]

Well none of those will be diagnostic for adrenal insufficiency. I'm surprised your doctor is barking up that tree but not testing for it. I don't know what to make of it. I may have missed it in this thread, but are you having any problems? i.e. symptoms?

To be honest, I think this DC is pretty terrible. I don't plan on working with her, but she ordered the tests so that insurance will cover it. After I get the results, I will find a good endocrinologist to go over things with me.

I'm pretty much asymptomatic. I have plenty of energy and am generally quite healthy. However, I'm young and carry an appreciable amount of muscle mass, yet maintain weight on a caloric intake in the 1,200 - 1,600 kcal range. I'm hoping to figure out what's going on, as it's difficult to live a normal lifestyle under the circumstances.

What might you recommend I have tested? Note the previous numbers (post #3 in this thread) are more or less normal.

Thanks,
C10

[Dr. Horse]

Are you absolutely certain of the calorie intake? And is this really consistent over a significant period of time? And why is it difficult to have a normal lifestyle? What is your appetite like? Do you have to limit your food intake and be hungry all the time to keep from gaining weight?

[CoQ10]

Are you absolutely certain of the calorie intake? And is this really consistent over a significant period of time?

Yes, I have meticulously logged my caloric intake for some time now (three years on and off, consistently for the past six months). I rarely eat out, so the numbers are all pretty accurate.

And why is it difficult to have a normal lifestyle? What is your appetite like? Do you have to limit your food intake and be hungry all the time to keep from gaining weight?

I can control my appetite with EC, but I'm still hungry pretty often. Eating out is difficult. It's nothing terrible - obviously it could be a lot worse - but I would just like some answers as to why I have to eat less than my much smaller sister just to maintain a reasonable weight. 1,500 calories really is not that much food. If there's something hormonal going on, it's probably better to find out sooner rather than later.

-C10

[Dr. Horse]

I can control my appetite with EC, but I'm still hungry pretty often. Eating out is difficult. It's nothing terrible - obviously it could be a lot worse - but I would just like some answers as to why I have to eat less than my much smaller sister just to maintain a reasonable weight. 1,500 calories really is not that much food. If there's something hormonal going on, it's probably better to find out sooner rather than later.

-C10

If you're taking ephedrine and caffeine regularly, stopping that would be the first thing I would do.

[CoQ10]

If you're taking ephedrine and caffeine regularly, stopping that would be the first thing I would do.

I've only been taking it for a few months, and usually take a week off every 3-4 weeks. I understand that this can cause some metabolic issues, but I don't think it's responsible in my situation. I had an extremely slow metabolism long before I was taking any stimulants.

-C10

[Dr. Horse]

I've only been taking it for a few months, and usually take a week off every 3-4 weeks. I understand that this can cause some metabolic issues, but I don't think it's responsible in my situation. I had an extremely slow metabolism long before I was taking any stimulants.

-C10

Interesting. Well, your thyroid studies are normal. You can repeat them to confrim i guess. I'd see an endocrinologist if you are having any symptoms or it is having negative effects on your life. Otherwise I would just live with it.

[CoQ10]

Interesting. Well, your thyroid studies are normal. You can repeat them to confrim i guess. I'd see an endocrinologist if you are having any symptoms or it is having negative effects on your life. Otherwise I would just live with it.

Thanks for the input, Dr. Horse. That's my intention as of now. Since I'm going in anyway to have iron levels tested, I figured I might as well take a second look at thyroid function. I'll post again if anything abnormal shows up.

-C10

[Dr. Horse]

Thanks for the input, Dr. Horse. That's my intention as of now. Since I'm going in anyway to have iron levels tested, I figured I might as well take a second look at thyroid function. I'll post again if anything abnormal shows up.

-C10

Sounds reasonable.

BTW, nice bench @ 159lbs. I'd say you are a pretty healthy guy. A lot of docs would laugh you out of their office...

[Emma-Leigh]

Well none of those will be diagnostic for adrenal insufficiency. I'm surprised your doctor is barking up that tree but not testing for it. I don't know what to make of it. I may have missed it in this thread, but are you having any problems? i.e. symptoms?

I already suggested these if he was symptomatic/ concerned:

....I would go on to do / request other measurements - electrolytes, cortisol tests (either direct or via a dex suppression test), basic liver/kidney function etc.... And possibly consider some imaging as well (ultrasound)..

[atticus_a]

To be honest, I think this DC is pretty terrible. I don't plan on working with her, but she ordered the tests so that insurance will cover it. After I get the results, I will find a good endocrinologist to go over things with me.

I'm pretty much asymptomatic. I have plenty of energy and am generally quite healthy. However, I'm young and carry an appreciable amount of muscle mass, yet maintain weight on a caloric intake in the 1,200 - 1,600 kcal range. I'm hoping to figure out what's going on, as it's difficult to live a normal lifestyle under the circumstances.

What might you recommend I have tested? Note the previous numbers (post #3 in this thread) are more or less normal.

Thanks,
C10

It seems that everyone has pretty much answered your questions but with that said there is a very limited reason to seek an endo for decreased DHEA-Sulfate. I have had low DHEA-Sulfate for years with high DHEA. My endo hasn't really made a deal out of it.

I believe the DC is using your DHEA-Sulfate to make a generalization about the functioning of your adrenal glands. Which I think is rather short sighted and probably not that accurate. Isn't DHEA the one that is produced in the adrenals?

It is my understanding that DHEA is converted to DHEA-Sulfate via Sult2a1 which if I recall is Vitamin D dependent. Perhaps, you don't have enough vitamin D. Or, perhaps you have low DHEA-Sulfate because your DHEA is being converted into androgens and there isn't much left over to be detoxicified into DHEA-Sulfate. Desulfured DHEA is the only one that can be converted into androgens.

[CoQ10]

Atticus -

Thanks for the input. I do take a vitamin D supplement and eat plenty of foods rich in vitamin D, so I don't think that's a problem.

A test error has crossed my mind, so I'm going to go in tomorrow and get some bloodwork done. I wanted to recheck my iron levels and cholesterol as well, so I figure I might as well.

I'll post the results of the following:

Complete Metabolic Panel
Electrolyte Panel
Hepatic Function Panel
Lipid Panel
Renal Function Panel
Complete Blood Count with Platelets
Antithyroglobulin Antibody

Thanks again.

-C10

[TaoistWarrior]

Atticus -

Thanks for the input. I do take a vitamin D supplement and eat plenty of foods rich in vitamin D, so I don't think that's a problem.

A test error has crossed my mind, so I'm going to go in tomorrow and get some bloodwork done. I wanted to recheck my iron levels and cholesterol as well, so I figure I might as well.

I'll post the results of the following:

Complete Metabolic Panel
Electrolyte Panel
Hepatic Function Panel
Lipid Panel
Renal Function Panel
Complete Blood Count with Platelets
Antithyroglobulin Antibody

Thanks again.

-C10

If you are operating under the assumption that adrenal fatigue is a real condition, you'll want to have tests that measure your levels of cortisol and DHEA. Those are the hormones mostly implicated in adrenal fatigue diagnoses (a good friend of mine is undergoing treatment for AF by a ND.) I'm not sure what exact labs to request; Dr. Horse can probably help you in that regard.

[CoQ10]

Thanks for the feedback, Taoist.

Would a saliva test be suitable? The following sites offer cortisol, DHEA, and a wide range of other hormonal tests:

http://www.johnleemd.com/store/prod_stest.html

http://www.salivatest.com/

Let me know what you think.

Thanks!

-C10

[atticus_a]

Thanks for the feedback, Taoist.

Would a saliva test be suitable? The following sites offer cortisol, DHEA, and a wide range of other hormonal tests:

http://www.johnleemd.com/store/prod_stest.html

http://www.salivatest.com/

Let me know what you think.

Thanks!

-C10

A ND that I saw used Great Smokies Diagnostic lab that measured salva for cortisol and DHEA. It measured cortisol and DHEA four times a day. I believe that DHEA-S is after its converted by your liver. But DHEA is highly variable that is why test DHEA-S. As Taoist said, cortisol is the hormone generally looked at by the alternative medicine community to measure it (Adrenal fatigue).

I have read the book by Dr James Wilson on adrenal fatigue. I think he is the guy that sorta the authority on it. Your only symptoms seems that you gain weight easy. Adrenal fatigue has lots of other symptoms that is associated with it more than a challenge with maintain weight. Chiefly, the afternoon crash generally associated with the diminished cortisol in the afternoon.

As for the suitability of the salva test, it really depends.
http://www.aetna.com/cpb/medical/data/600_699/0608.html
Its an insurance company's website but it might illustrate how the conventional medical industry views salva testing.

If you really are super concerned, request a 24 hour urine comprehensive hormone profile. If your doctor will not prescribe it or your insurance will not cover it, you can get it through your DC through Meridian Valley labs. Generally, most of the labs the alternative community uses do not accept insurance directly so you will have to submit them to your insurance company yourself.