Add-On Extra Cortisol Marker

This test may be ordered as an add-on assessment to the DUTCH Plus, DUTCH CAR, or DUTCH Cycle Mapping Plus tests. 

The inclusion of an additional nighttime salivary cortisol marker provides valuable insights into the body's cortisol rhythm, offering a more comprehensive assessment of adrenal function.  Cortisol levels naturally fluctuate throughout the day, with a peak in the morning and a nadir at night, reflecting the body's circadian rhythm and stress response. 

By measuring cortisol levels at an additional time point during the night, healthcare providers can gain a deeper understanding of adrenal health and diurnal cortisol patterns.  This information is particularly relevant for individuals with conditions such as adrenal fatigue, insomnia, or night sweats, where nighttime cortisol levels may be dysregulated. 

Monitoring nighttime cortisol levels allows for more targeted interventions and personalized treatment approaches aimed at restoring healthy cortisol rhythms and optimizing overall health and well-being.

NOTE: You must tell your patients when you would like them to collect this sample.

When Would You Order the Add-On Extra Cortisol Marker to the DUTCH Plus, DUTCH CAR, or DUTCH Cycle Mapping Plus tests?

The add-on extra cortisol marker to the DUTCH Plus, DUTCH CAR, or DUTCH Cycle Mapping Plus tests would be ordered in specific situations where monitoring nighttime cortisol levels provides relevant clinical value. [ABEL, LIN, NEWELL, SHIN

For example, in patients with suspected adrenal dysfunction, such as adrenal fatigue or adrenal insufficiency, assessing nighttime cortisol levels can offer insights into the integrity of the body's stress response throughout the day and night. This can be especially enlightening if the patient also has a dysregulated CAR, or cortisol awakening response.  

Additionally, for individuals experiencing symptoms such as insomnia, night sweats, or disrupted sleep patterns, measuring nighttime cortisol levels can help identify potential hormonal imbalances contributing to these issues. 

In suspected circadian rhythm disturbances or conditions affecting sleep-wake cycles, evaluating nighttime cortisol levels can aid in understanding the underlying mechanisms and guiding targeted interventions to restore healthy cortisol rhythms. 

Overall, the add-on extra cortisol marker is beneficial in situations where nighttime cortisol assessment enhances the comprehensive evaluation of adrenal function and contributes to personalized treatment strategies aimed at optimizing hormonal balance and overall well-being.

References

[1.] Abell JG, Shipley MJ, Ferrie JE, Kivimäki M, Kumari M. Recurrent short sleep, chronic insomnia symptoms and salivary cortisol: A 10-year follow-up in the Whitehall II study. Psychoneuroendocrinology. 2016 Jun;68:91-9. doi: 10.1016/j.psyneuen.2016.02.021. Epub 2016 Feb 26. PMID: 26963375; PMCID: PMC4862960.

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[2.] Lin DC, Tsai PS, Lin YC. Midnight salivary cortisol for the diagnosis of Cushing's syndrome in a Chinese population. Singapore Med J. 2019 Jul;60(7):359-363. doi: 10.11622/smedj.2018154. Epub 2018 Nov 29. PMID: 30488082; PMCID: PMC6658651.

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[3.] Newell-Price J, Pivonello R, Tabarin A, Fleseriu M, Witek P, Gadelha MR, Petersenn S, Tauchmanova L, Ravichandran S, Gupta P, Lacroix A, Biller BMK. Use of late-night salivary cortisol to monitor response to medical treatment in Cushing's disease. Eur J Endocrinol. 2020 Feb;182(2):207-217. doi: 10.1530/EJE-19-0695. PMID: 31804965; PMCID: PMC7003692.

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[4.] Shin IY, Ahn RS, Chun SI, Lee YJ, Kim MS, Lee CK, Sung S. Cortisol awakening response and nighttime salivary cortisol levels in healthy working Korean subjects. Yonsei Med J. 2011 May;52(3):435-44. doi: 10.3349/ymj.2011.52.3.435. PMID: 21488186; PMCID: PMC3101060.

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