Last week I took a deep dive into the physiology of our stress response. In short, when our bodies experience stress, there is a cascade of events that begin in the brain and ultimately lead to the release of cortisol from our adrenal glands. This system is an evolutionary tool that has allowed the human species to survive. Back in the day, this cortisol response is what allowed us to run from bears in the wild. Fast forward to modern times where we’re under constant stress; there are bears everywhere: sitting in traffic, listening to the news, at the office, in our relationships. Our bodies are not designed to have this constant cortisol exposure and so disease ensues. Our blood sugars are uncontrolled, we have high blood pressures, fat around our bellies, and we crave sugar. Even more, constant stress can cause communication between the brain and the adrenals to go haywire; some of us have too much cortisol and some of us not enough.
No need to wonder if this is a factor in your health, because testing your cortisol levels is easy. There are four ways that we can evaluate your cortisol levels. These include: blood, saliva, urine, and hair. Each of these methods have proven efficacy and the method of testing is based on your individual needs.
Salivary: I use this method the most in practice. Cortisol is a diurnal hormone, meaning there are fluctuations throughout the day. With this method, it’s easy to collect samples of your cortisol levels throughout the day. Ideally cortisol levels should be highest in the morning and lowest in the evening, but it’s common to see dysfunctional cortisol levels at night. Even more reason to get tested! For more about this method, check out this study.
Blood assessment: This is the second most common method I use in my clinic. If blood draws are a stressful event for you, I would recommend other testing methods, as cortisol could be falsely elevated because of the perceived stressful event. I use blood to measure cortisol when my patient has excellent lab coverage, otherwise I prefer salivary or urinary testing because we can gather the cortisol levels throughout the day.
Urine Analysis: I have yet to employ this method in my clinic, however my research in this area leads me wanting to offer this ASAP. In fact, at the time of this writing, I have joined forces with Precision Labs and am proud to be offering DUTCH (Dried Urine Test for Comprehensive Hormones). I like this method because it is easy to collect and we actually get more valuable information as compared to the salivary testing alone.
Hair: I do not currently offer this testing method in my practice, however there are studies exhibiting its efficacy.
If you haven't yet taken the short quiz to see if you should get your levels checked, head on over to last week's blog post.