Private adrenal function blood test in London

A standard adrenal function panel measures morning cortisol (the body's main stress hormone, drawn 8 to 9 AM to capture the daily peak) and DHEA-sulfate (the most stable measure of adrenal androgen production). At WMG Health we add total testosterone and SHBG by default, because androgen excess work-up in women is the commonest reason for testing. ACTH is available as a bespoke add-on when a borderline cortisol result needs investigating further.

Cortisol follows a strong circadian rhythm: it peaks within the first hour of waking and falls steadily through the day, reaching a trough overnight. A draw at 8 to 9 AM captures the peak; by midday cortisol is already noticeably lower; by evening it is naturally low even in healthy patients. A "low" cortisol result at 2 PM might be entirely normal physiology, not adrenal disease. To give an interpretable result we draw bloods between 8 and 9 AM where possible, 10 AM as the absolute latest. We can sometimes arrange earlier draws by special arrangement.

No. "Adrenal fatigue" is not a recognised medical diagnosis, and there is no objective blood, saliva, or urine test that confirms it. What is real, and worth investigating, are the specific endocrine conditions adrenal testing can identify: primary adrenal insufficiency (Addison disease), secondary adrenal insufficiency (pituitary cause), Cushing syndrome (cortisol excess), and androgen excess from an adrenal source. Persistent unexplained fatigue is more commonly explained by anaemia, thyroid disease, vitamin D or B12 deficiency, sleep apnoea, or perimenopause: an adrenal panel sits within a broader work-up, not as a standalone answer.

Our Adrenal Function Panel is £299 and includes morning cortisol, DHEAS, total testosterone, and SHBG with full clinician interpretation and a written report. A bespoke adrenal-focused panel can be built around your specific question (for example cortisol + DHEAS only, or adding ACTH) and typically lands in the £180 to £399 range. We confirm the exact price in writing before booking.

Cortisol and DHEAS are clinician-reviewed within 4 hours of your appointment. Total testosterone, SHBG, and ACTH (when included) are usually back the same working day. Every result is interpreted against your symptoms, medication history, and the timing of the draw by a GMC-registered doctor and released through our secure patient portal with a written report.

Exogenous corticosteroids (prednisolone, hydrocortisone, dexamethasone, inhaled or topical steroids at high dose) suppress endogenous cortisol production and will give a misleadingly low result. We will discuss this at booking. If you are on long-term steroids and need adrenal axis assessment, a short Synacthen stimulation test (not a single morning cortisol) is the appropriate investigation, arranged via endocrinology referral. Hormonal contraceptives raise cortisol-binding globulin and therefore raise total cortisol; this is factored into the clinical interpretation.

A single early-morning cortisol within range is reassuring but does not rule out subtle HPA-axis dysfunction. Adding DHEAS gives a complementary view of adrenal output, and a paired morning result interpreted alongside symptoms (timing of fatigue, salt craving, postural symptoms, central weight gain, mood and sleep patterns) often surfaces information a single NHS cortisol cannot. We are happy to interpret an existing NHS result rather than repeat the cortisol in isolation.