Adrenal Testing in Greenville, SC
Adrenal Testing at IHP Greenville. Dr. Hendry, DAOM — functional medicine, root-cause diagnostics, personalized care. Call (864) 365-6156.
"I have been going to Dr. Hendry for 2 months now, for Acupuncture and Supplements. After 2 months, this is the best I have felt in over 2 years. My energy is so much better, my gut and digestion is back to normal."
— Danny Pyatt · March 2026 · Google Review
Conventional blood cortisol testing is designed to detect Addison's disease — complete adrenal failure. It cannot detect the far more common pattern of functional HPA axis dysregulation where cortisol production is present but the diurnal rhythm has collapsed. I use 4-point salivary cortisol because it maps the full daily arc: the morning awakening response that should spike within 30 minutes of waking, the midday regulation, the afternoon decline, and the evening suppression. Each point in that curve corresponds to a different clinical presentation and a different treatment target. A single morning blood cortisol tells you almost nothing about which one is abnormal.
How Adrenal Testing Works
The salivary cortisol curve is collected at home: morning (30 minutes after waking, before caffeine), noon, afternoon (4 PM), and evening (before bed). Saliva samples are collected on a defined test day and mailed to the lab. Results reveal the cortisol awakening response, midday regulation, afternoon decline, and evening suppression — the full daily rhythm of HPA axis function.
Conditions Treated with Adrenal Testing
4-Point Salivary Cortisol Curve vs. Single Morning Blood Cortisol
A patient presents with exhaustion, difficulty waking in the morning, an energy crash by 2 PM, and paradoxical alertness at 11 PM that prevents sleep. Her conventional physician orders a morning serum cortisol — it returns at 14 mcg/dL, technically within the reference range. She is told her adrenal function is normal. The clinical problem is that a single morning blood cortisol measures only the peak of the cortisol awakening response and captures only total cortisol — not the biologically active free fraction. It cannot reveal whether her cortisol fails to peak adequately upon waking, crashes prematurely midday, or remains inappropriately elevated at night — precisely the patterns driving her symptom profile. The 4-point salivary cortisol curve Dr. Hendry uses measures free cortisol at morning, noon, late afternoon, and evening, mapping the full diurnal rhythm against validated reference ranges at each time point. In this patient's case, the curve reveals a blunted morning awakening response (explaining the difficulty waking), a significant midday drop (explaining the 2 PM crash), and an elevated evening reading (explaining the night-owl alertness). Each data point corresponds to a specific intervention target. A single normal morning cortisol obscured all of this. The curve reveals it completely.
Research & Evidence
HPA axis dysregulation after chronic stress is well documented in the endocrinology literature. Fries et al. (2005) in Annals of the New York Academy of Sciences characterized the pattern of blunted cortisol response following prolonged psychosocial stress, describing the mechanism by which sustained HPA axis activation transitions to hypocortisolism — the physiological signature of what is clinically described as adrenal fatigue. Research on adaptogens used in HPA recovery protocols includes a 2012 review in Pharmaceuticals documenting rhodiola rosea's effects on the cortisol stress response and a 2009 Indian Journal of Pharmaceutical Sciences review of ashwagandha showing significant HPA axis normalization compared to placebo. The 4-point salivary cortisol curve used in IHP's adrenal assessment is validated in the peer-reviewed literature for identifying diurnal cortisol dysregulation patterns that single-point blood tests cannot capture.
Your First Appointment
Adrenal testing is ordered at your functional medicine or integrative medicine consultation. Dr. Hendry will provide the test kit and collection instructions. Results are typically available in 7–10 business days and are reviewed at a follow-up appointment.
Why Dr. Hendry for Adrenal Testing
Dr. Hendry's research in HRV biofeedback — which measures autonomic regulatory capacity closely linked to cortisol dynamics — gives him a deep understanding of how to interpret and treat HPA axis dysfunction.