Glossary

glossary

Adrenal Stress Profile

Assesses cortisol and DHEA levels to evaluate stress response.

What Does an Adrenal Stress Profile Test For?

The Adrenal Stress Profile evaluates the function of the Hypothalamic-Pituitary-Adrenal (HPA) axis by measuring key hormones involved in the body’s stress response. It specifically tests for:

  1. Cortisol Levels:
    • Measured at four intervals throughout the day to assess the natural circadian rhythm. Cortisol levels reflect how the body responds to daily stressors and regulates energy, blood sugar, and immune function.
    • Optional testing may include the Cortisol Awakening Response (CAR), a distinct spike in cortisol levels upon waking that provides additional insight into stress resilience.
  2. DHEA Levels:
    • Measured in the early morning to assess anabolic (building up) processes and balance against catabolic (breaking down) activity.
  3. DHEA-to-Cortisol Ratio:
    • This ratio reveals the balance between stress-induced breakdown processes and the body's ability to rebuild and repair.
  4. Salivary Secretory IgA (sIgA) (Optional):
    • Assesses immune function and its response to stress across mucosal membranes.

This comprehensive analysis helps identify HPA axis imbalances, guiding clinical interventions to address chronic stress, adrenal dysfunction, or related conditions.

How Does the Adrenal Stress Profile Differentiate Between Normal HPA Axis Function and Dysfunction?

The Adrenal Stress Profile identifies HPA axis dysfunction by analyzing deviations in hormone patterns:

  1. Normal Function:
    • Cortisol follows a diurnal rhythm, with high levels in the morning (to promote wakefulness and energy) and low levels at night (to allow for rest and recovery).
    • DHEA levels are appropriate for age and show a healthy balance with cortisol.
  2. Dysfunction:
    • Flattened Cortisol Curve: Suggests adrenal fatigue or chronic stress, where cortisol levels fail to rise or fall appropriately.
    • Elevated Evening Cortisol: Indicates heightened stress response, potentially linked to insomnia or anxiety.
    • Low DHEA-to-Cortisol Ratio: Reflects an imbalance where stress-induced catabolism dominates over repair and recovery.
    • Impaired CAR: A blunted or exaggerated cortisol spike upon waking signals poor adaptability to stress.

These patterns are evaluated alongside symptoms and clinical history to confirm HPA axis dysfunction and guide treatment.

What Are the Symptoms of Adrenal Stress?

Adrenal stress, often linked to HPA axis dysfunction, can manifest through a range of physical, mental, and emotional symptoms, including:

  • Fatigue: Persistent tiredness despite adequate sleep.
  • Sleep Disturbances: Difficulty falling or staying asleep, or feeling unrested upon waking.
  • Mood Changes: Irritability, anxiety, or depression.
  • Weight Changes: Unexplained weight gain, particularly around the abdomen, or difficulty losing weight.
  • Immune Issues: Increased susceptibility to infections or prolonged recovery from illnesses.
  • Cognitive Impairment: Brain fog, memory problems, or difficulty concentrating.
  • Digestive Issues: Bloating, changes in appetite, or gastrointestinal discomfort.
  • Chronic Pain: Persistent aches, headaches, or musculoskeletal pain.
  • Blood Sugar Imbalances: Hypoglycemia or insulin resistance.

These symptoms often overlap with other conditions, which makes the Adrenal Stress Profile a valuable diagnostic tool.

What Cortisol Level Indicates Adrenal Insufficiency?

Adrenal insufficiency is characterized by abnormally low cortisol levels and can be diagnosed through salivary or blood tests. Specific thresholds include:

  • Salivary Cortisol:
    • A flattened or very low diurnal cortisol pattern (across the day’s four samples) may suggest adrenal insufficiency.
    • Morning cortisol levels below the normal range (< 5 nmol/L or < 0.18 µg/dL in saliva) are particularly indicative.
  • Blood Serum Cortisol:
    • A morning cortisol level below 3 µg/dL (83 nmol/L) is strongly suggestive of adrenal insufficiency.
    • Levels between 3–10 µg/dL (83–276 nmol/L) may warrant an ACTH stimulation test for confirmation.

Adrenal insufficiency requires prompt medical evaluation and treatment, as it can be life-threatening in severe cases.

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