Stress is one of the top concerns for which patients seek medical support. Stress is a hormonal response of the body when we perceive we are under threat. The “fight or flight” response is a sympathetic nervous system response which is engaged when we encounter a stressful event, such as running into a predator. This response allows our bodies to fight or flee, protecting ourselves from danger. Once the danger has passed, our bodies shift to a relaxation state, or an activation of the parasympathetic nervous system.
Today, it is common to see chronic stress - stressful events or situations that do not pass, which results in our sympathetic nervous system being active for much longer than it is meant to be. Having chronic stress responses can lead to a variety of changes in our body, including changes in blood pressure, blood sugar, digestive issues, and hormonal imbalances.
Cortisol
Cortisol is one of the main hormones released by our adrenal glands (which sit atop the kidneys) during periods of stress. Normally, cortisol is released in a diurnal pattern - this means they rise and fall in a similar pattern throughout a 24 hour period. This is called our circadian rhythm. Typically, cortisol should be at its highest in the morning right after we wake up, and will drop throughout the day until it reaches its lowest levels in the evening around bedtime. Throughout the night, they will slowly begin to increase again until waking time the next day, and so on. In this normal pattern, cortisol functions in regulating the immune system, managing inflammation, and regulating our blood sugar and metabolism. However, during periods of increased stress, more cortisol is released into our bloodstream, which can impact our circadian rhythm and lead to health consequences - such as changes in appetite and weight, blood sugar imbalances, high blood pressure, memory impairment, and interference with other hormones such as melatonin, estrogen and testosterone.
How can I measure my cortisol levels?
Cortisol levels can be measured in the blood through regular blood work - keep in mind that because of cortisol’s diurnal rhythms, cortisol levels will change throughout the day and will be different depending on the time the blood draw is done. Also, cortisol may increase if you are nervous about getting a needle. Alternative ways to measure cortisol include through saliva and urine, which can be easily done at home multiple times throughout the day to provide a “4-point” measurement of cortisol (measured at four points throughout the day to make a graph of your diurnal rhythm).
Your naturopathic doctor has access to all of these types of testing, and can requisition a test for you to assess your cortisol levels. There are urine testing options, specifically Rocky Mountain Analytical’s Comprehensive Hormone Insights (CHI) test and Precision Analytical’s DUTCH test, both of which offer cortisol testing at multiple points throughout the day as well as an extensive assessment of hormonal health, including levels of estrogens, androgens and progesterone and their metabolites. These tests allow for an assessment of your hormone levels and an analysis of the interplay between them!
Based on the results of your test, your naturopathic doctor will recommend a holistic plan for you to support your hormones and decrease the impact stress has on your body and health. There are lots of modalities that have been found to help manage stress and reduce cortisol levels, including nutritional supplements, dietary changes, lifestyle recommendations, and even traditional medicine such as acupuncture and homeopathy.
Keep in mind that cortisol levels can be altered for medical reasons other than stress, and these conditions would be approached and treated differently!
Have questions about stress and cortisol testing? Call us today to get more information and to set up an appointment with one of our naturopathic doctors!
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