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Five-marker adrenal panel assessing the HPA axis through cortisol, dehydroepiandrosterone sulphate (DHEA-S), dehydroepiandrosterone (DHEA), aldosterone, and ACTH.
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A five-marker adrenal and stress hormone panel measuring cortisol, DHEAS, DHEA, aldosterone, and ACTH — designed for those investigating HPA axis function.
The adrenal glands sit atop the kidneys and produce several hormones critical to stress response, energy regulation, fluid balance, and immune function. When the hypothalamic-pituitary-adrenal (HPA) axis is chronically over- or under-stimulated, the effects are wide-ranging: persistent fatigue, sleep disruption, weight changes, blood pressure fluctuations, mood instability, and impaired immunity.
The Adrenal and Stress Hormone Panel measures the five key adrenal markers: cortisol (the primary stress hormone), dehydroepiandrosterone sulphate (DHEA-S) and DHEA (precursor androgens that decline with adrenal dysfunction), aldosterone (which regulates sodium, potassium, and blood pressure), and ACTH (the pituitary signal that drives cortisol production).
The ACTH-to-cortisol relationship is particularly informative: elevated ACTH with low cortisol suggests adrenal insufficiency (Addison’s-type pattern), while suppressed ACTH with high cortisol points to adrenal or ectopic cortisol excess. This panel requires a venous draw collected in the early morning (8 to 9 am) for accurate cortisol and ACTH values. GMC-physician reviewed results within 5 to 7 working days.
Understand what each marker measures, why it matters, and what the science says — not just a list of numbers.
Primary adrenal stress hormone; morning peak value essential for assessing diurnal rhythm and adrenal reserve.
Pituitary signal that drives cortisol production; the ACTH-to-cortisol relationship distinguishes primary from secondary adrenal dysfunction.
Stable, long-circulating adrenal androgen precursor; low levels reflect reduced adrenal reserve and chronic stress burden.
Immediate precursor to sex hormones; declines with age and adrenal dysfunction, often reflecting overall adrenal vitality.
Adrenal hormone that regulates sodium and potassium balance and blood pressure; assessed in the context of hypertension or low blood pressure.
This panel is designed for adults who want a comprehensive, evidence-based picture of their metabolic health — not a GP referral panel.
People with persistent unexplained fatigue and poor stress resilience
Those investigating possible adrenal insufficiency or Addison's disease
Individuals with blood pressure abnormalities (high or low)
Those with chronic stress, burnout, or post-viral fatigue syndromes
Cortisol is extremely sensitive to physical and psychological stress, time of day, acute illness, exercise, and medication. A single morning blood value provides a useful snapshot but cannot replace dynamic testing (such as a Short Synacthen Test) for confirming adrenal insufficiency. ACTH is highly labile and degrades rapidly at room temperature; samples must be processed quickly, which is why clinic-based or early morning phlebotomist collection is required. This panel does not substitute for specialist endocrine assessment if adrenal insufficiency, Cushing's syndrome, Conn's syndrome, or congenital adrenal hyperplasia is suspected. All results should be discussed with a physician before any adrenal-related medication adjustments.
From order to physician-reviewed report in as little as three working days.
Three options designed to fit your schedule, location, and preference — all producing a laboratory-standard sample.
Adults 18+ in mainland UK. Not suitable if you have had a transfusion in the last 3 months.
Order anytime; kit dispatched within 24 hours Mon–Fri.
Allow 24–48 hours for sample transit on top of lab processing time.
Adults 18+ within 20 miles of a serviced city centre.
Mon–Sun, 06:00–20:00. Next-day booking typical.
Sample reaches the lab within 24 hours of collection.
Adults 16+ with photo ID. Paediatric draws by appointment at selected sites.
Mon–Fri, with Saturday hours at most metropolitan locations.
Samples processed same-day at the receiving clinic.
Every test is processed in a UKAS ISO 15189-accredited laboratory, overseen by GMC-registered physicians, and governed by UK GDPR. No overseas processing, no offshore data.
Follow these guidelines to ensure accurate, reproducible results. Most markers are sensitive to recent food, exercise, and sleep.
Can't find your answer? Our clinical support team is available Monday to Friday, 9am–5pm.
Contact supportThe hypothalamic-pituitary-adrenal (HPA) axis is the hormonal cascade that controls your stress response. The hypothalamus releases CRH (corticotrophin-releasing hormone), which signals the pituitary to release ACTH, which in turn stimulates the adrenal glands to produce cortisol. When cortisol levels are adequate, they feed back to suppress CRH and ACTH — a self-regulating loop. Disruption at any point in this axis — whether due to chronic stress, adrenal disease, pituitary tumours, or long-term corticosteroid use — alters the entire cascade and produces wide-ranging symptoms.
The term ‘adrenal fatigue’ is not a recognised medical diagnosis and is not validated by endocrinological or regulatory bodies. What is recognised are: adrenal insufficiency (primary or secondary), subclinical adrenal dysfunction, and HPA axis dysregulation associated with chronic stress or illness. This panel assesses cortisol, ACTH, and adrenal androgens to provide an objective biochemical picture of adrenal function. Your physician report will interpret results using validated reference ranges and clinical criteria, not the adrenal fatigue framework, and will recommend appropriate next steps.
Cortisol follows a strong circadian pattern, peaking within 30 to 60 minutes of waking — a phenomenon called the cortisol awakening response — and then declining throughout the day to reach its lowest point around midnight. Standardised morning testing (8 to 9 am) is essential because reference ranges for cortisol are derived from samples taken during this window. A normal afternoon cortisol value would appear falsely low if compared against morning reference ranges. Morning timing also provides the most clinically sensitive window for detecting both low cortisol (insufficiency) and high cortisol (excess).
dehydroepiandrosterone (DHEA) (dehydroepiandrosterone) is a short-acting adrenal androgen that is rapidly converted to dehydroepiandrosterone sulphate (DHEA-S) (its sulphate ester form) in the adrenal glands. dehydroepiandrosterone sulphate (DHEA-S) has a much longer half-life in the circulation, making it a more stable and reliable measure of adrenal androgen output. dehydroepiandrosterone (DHEA) reflects more immediate production and fluctuates more. Including both provides a fuller picture: dehydroepiandrosterone sulphate (DHEA-S) reflects cumulative adrenal androgen capacity, while dehydroepiandrosterone (DHEA) captures shorter-term fluctuations. Both decline with age and with reduced adrenal reserve.
Yes, significantly. All corticosteroids — including oral prednisolone, dexamethasone, inhaled budesonide or fluticasone, and topical hydrocortisone creams used on large areas of skin — can suppress adrenal cortisol production and alter your test results. Oestrogen-containing medications (including the combined oral contraceptive pill and HRT) can raise cortisol-binding globulin and falsely elevate total cortisol measurements. Please list all medications when registering your sample, and inform the phlebotomist at your appointment. Your physician will adjust their interpretation accordingly.
Your physician report will explain the clinical significance of any out-of-range values. In general: a very low morning cortisol (below 100 nmol/L) with elevated ACTH suggests primary adrenal insufficiency (Addison’s disease) and requires urgent medical review. Low cortisol with low ACTH suggests secondary adrenal insufficiency, often related to pituitary disease or long-term corticosteroid use. High cortisol with suppressed ACTH may point to adrenal cortisol excess. Mildly abnormal values in the context of chronic stress require clinical interpretation alongside symptoms. The report will clearly indicate whether urgent GP contact or specialist referral is recommended.
