Adrenal insufficiency is a serious hormonal disorder where the adrenal glands fail to produce adequate amounts of essential hormones including cortisol, aldosterone, and DHEA. It is caused by damage to the adrenal glands themselves (primary adrenal insufficiency or Addison disease) or by pituitary gland dysfunction affecting ACTH production (secondary adrenal insufficiency). The Cortisol AM test is the most important test for diagnosis because it measures morning cortisol levels when they should be at their highest, and low values are a key indicator of this condition.
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Adrenal insufficiency is caused by either damage to the adrenal glands themselves or problems with the pituitary gland that controls them. Primary adrenal insufficiency, also called Addison disease, occurs when autoimmune disease destroys the adrenal cortex, infections like tuberculosis damage the glands, or genetic disorders affect adrenal development. Secondary adrenal insufficiency is caused by pituitary tumors, pituitary surgery, radiation therapy, or long-term use of corticosteroid medications like prednisone that suppress natural hormone production. Both types result in dangerously low levels of cortisol, aldosterone, and other essential steroid hormones your body needs to regulate blood pressure, metabolism, and stress response.
The Cortisol AM test is the most important test for adrenal insufficiency because it measures your cortisol levels in the morning when they should naturally be at their highest point. Low morning cortisol is a key indicator that your adrenal glands are not producing enough of this critical hormone. For a comprehensive diagnosis, your healthcare provider will likely recommend the Cortisol Total test to measure overall cortisol production throughout the day, and the Adrenal Antibody Screen to determine if an autoimmune response is attacking your adrenal glands. The Aldosterone/Plasma Renin Activity Ratio test is also essential because it measures aldosterone, another vital hormone that regulates blood pressure and electrolyte balance. Testing DHEA-S and unconjugated DHEA levels provides additional confirmation of adrenal function since these hormones are produced exclusively by the adrenal glands.
You should get tested if you experience persistent fatigue that does not improve with rest, unexplained weight loss, low blood pressure or frequent dizziness when standing up, darkening of your skin especially in areas like skin folds and scars, or salt cravings. Testing is especially important if you have chronic muscle weakness, loss of appetite, nausea, or vomiting that cannot be explained by other conditions. If you have been taking corticosteroid medications like prednisone for an extended period and are experiencing these symptoms, immediate testing is crucial. People with autoimmune diseases like type 1 diabetes or thyroid disorders should also consider testing since they have a higher risk of developing autoimmune adrenal insufficiency.
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What this means
Your testosterone levels are slightly below the optimal range. While this is not necessarily cause for concern, it may contribute to occasional fatigue, reduced motivation, or lower muscle mass over time.
Recommended actions
Increase resistance or strength training
Prioritize 7–8 hours of quality sleep per night, try to reduce stress
Include more zinc- and magnesium-rich foods (like shellfish, beef, pumpkin seeds, spinach)
Consider retesting in 3–6 months
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