That ain't good!
Saliva testing (which is probably cheaper than blood work/doctor visit) is the only way to test for adrenal gland hormones on a cellular level. Blood testing for adrenal function is absolutely useless.
I don't know what Lam says...I think he says he doesn't need to use saliva tests because he can diagnose AF by hearing your symptoms over the phone, and that he doesn't think there is a firm clinical understanding among other alt-doctors on how to interpret the tests.
If I were you, I would find out what my cortisol curve is via a saliva test. If it's low in the morning and high at night, you are lining yourself up for some very, very, very serious health issues. Cancer being among them. This is serious stuff.
Once you get your saliva test back, call Lam (you are a patient of his, right?) AND that Walsh guy in Maryland, or e-mail if that works better, and get them to interpret the saliva test to figure out exactly what is going on with you. If you've continued to get worse over a period of years, I wouldn't delay a single day, either.
(If you're not a patient of Lam, give me your saliva tests results when they come in, I'll call and say that they're mine, and get the interpretation.)