Adrenal Stress Profile

A Comprehensive Tool to Assess the HPA Axis — Stress Response and Resiliency

The Adrenal Stress Profile (ASP) provides an assessment of the Hypothalamic-Pituitary-Adrenal (HPA) axis using carefully timed salivary samples of the hormones cortisol and DHEA. Salivary testing is an easy, non-invasive option to measure unbound, biologically active parent hormone levels. The report offers an easy-to-interpret graphic which plots the results of cortisol's natural diurnal rhythm.

DHEA is measured once in the 7:00 – 9:00 AM sample and a ratio of DHEA to cortisol is calculated to provide insight into anabolic/catabolic balance.

Daily hassles, chronic pain, blood sugar dysregulation, work stressors, and poor relationship quality can alter the HPA axis. Imbalances in adrenal hormones can have a wide range of negative consequences that can adversely impact a patient's overall quality of life. The symptoms of HPA axis dysfunction can be vague, and are highly variable, but may include: fatigue, insomnia, weight gain, depression, GI complaints, and chronic pain. HPA axis dysfunction is associated with many conditions including:

  • hypertension
  • cardiovascular disease
  • gastrointestinal and immune dysregulation
  • diabetes and metabolic syndrome
  • depression
  • chronic fatigue
  • persistent pain
  • neurodegenerative disease and cognitive decline

Adrenal Stress Profile testing can reveal these HPA axis imbalances and provide direction for clinical intervention with targeted therapeutic treatments, such as nutrient support and/or adaptogens, stress management, behavioral modification, and lifestyle interventions.

Optional Add-on:

  • Cortisol Awakening Response (CAR)
    • Two awakening samples to evaluate CAR
    • CAR is a transient, immediate rise in cortisol upon awakening and is distinct from the diurnal rhythm. CAR reflects a person's ability to cope with anticipated challenges and their perception of control around chronic stress, providing insight into HPA axis resiliency.
    References

    • Tsigos C, Chrousos GP. Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. J Psychosom Res. 2002;53(4):865-871.
    • Fries E, Dettenborn L, Kirschbaum C. The cortisol awakening response (CAR): facts and future directions. IntJPsychophysiol. 2009;72(1):67-73.
    • Clow A, Hucklebridge F, Stalder T, Evans P, Thorn L. The cortisol awakening response: more than a measure of HPA axis function. NeurosciBiobehavRev. 2010;35(1):97-103.
    • Hackett RA, Kivimäki M, Kumari M, Steptoe A. Diurnal Cortisol Patterns, Future Diabetes, and Impaired Glucose Metabolism in the Whitehall II Cohort Study. J Clin Endocr Metab. 2016;101(2):619-625.
    • Hammer F, Deutschbein T, Marx A, et al. High evening salivary cortisol is an independent predictor of increased mortality risk in patients with systolic heart failure. Inter J Cardiol. 2016;203:69-73.
    Analyte List
    Cortisol
    DHEA
    Specimen Requirements
    4 saliva samples (5ml) collected at specific times over a 24-hour period (frozen)