Technical and clinical aspects of cortisol as a biochemical marker of chronic stress

Abstract

Stress is now recognized as a universal premorbid factor associated with many risk factors of various chronic diseases. Acute stress may induce an individual’s adaptive response to environmental demands. However, chronic, excessive stress causes cumulative negative impacts on health outcomes through “allostatic load”. Thus, monitoring the quantified levels of long-term stress mediators would provide a timely opportunity for prevention or earlier intervention of stressrelated chronic illnesses. Although either acute or chronic stress could be quantified through measurement of changes in physiological parameters such as heart rate, blood pressure, and levels of various metabolic hormones, it is still elusive to interpret whether the changes in circulating levels of stress mediators such as cortisol can reflect the acute, chronic, or diurnal variations. Both serum and salivary cortisol levels reveal acute changes at a single point in time, but the overall long-term systemic cortisol exposure is difficult to evaluate due to circadian variations and its protein-binding capacity. Scalp hair has a fairy predictable growth rate of approximately 1 cm/month, and the most 1 cm segment approximates the last month’s cortisol production as the mean value. The analysis of cortisol in hair is a highly promising technique for the retrospective assessment of chronic stress. [BMB Reports 2015; 48(4): 209-216]

Mindfulness‐based program for stress reduction in infertile women: Randomized controlled trial

“…Cortisol is the paradigmatic chronic stress hormone and responds to the activation of the hypothalamic‐pituitary‐adrenal axis (Lee, Kim, & Choi, ). Cortisol can be measured in blood, saliva, or hair samples.…”

Hypothalamic Dysfunction and Multiple Sclerosis: Implications for Fatigue and Weight Dysregulation

“…Cortisol is important in several homeostatic functions, including metabolism [62], immune function [63], and wakefulness [64]. It is released in response to a variety of stressors [65] and perturbed cortisol secretion is predictive of poorer outcomes in both neurologic and non-neurologic diseases [66–68]. Cortisol contributes to wakefulness mainly through the cortisol awakening response (CAR), a spike in serum cortisol approximately 30 to 45 min after awakening.…”

The Effects of Adaptogens on the Physical and Psychological Symptoms of Chronic Stress

“…In normal amounts cortisol, which is synthesized from cholesterol, helps to stimulate gluconeogenesis, which is the formation of glucose in an early fasting state (Lee, 2015). Cortisol also helps to suppress the immune system's inflammatory response to mediators of inflammation (Lee, 2015). However, chronic psychological and physical stress can result in elevated cortisol levels.…”

“…The human HPA axis meets the demands of stress primarily through the synthesis and secretion of three hormones, corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and cortisol (Miller & O'Callaghan, 2002). In normal amounts cortisol, which is synthesized from cholesterol, helps to stimulate gluconeogenesis, which is the formation of glucose in an early fasting state (Lee, 2015). Cortisol also helps to suppress the immune system's inflammatory response to mediators of inflammation (Lee, 2015).…”