Cortisol assessment is a clinical diagnostic procedure used to measure the concentration of the glucocorticoid hormone cortisol in various biological fluids, including blood, saliva, or urine, over a specific time frame. This evaluation is essential for determining the function of the Hypothalamic-Pituitary-Adrenal (HPA) axis, which is central to the body’s stress response and metabolic regulation. The resulting profile helps diagnose conditions related to cortisol excess or deficiency and provides insight into chronic stress adaptation.
Origin
The practice of cortisol assessment arose from the discovery of cortisol in the 1930s and the subsequent understanding of its role in stress physiology, leading to clinical tests for Cushing’s syndrome and Addison’s disease. The term combines the hormone’s name, derived from its production in the adrenal cortex, with the clinical concept of “assessment,” which signifies a systematic evaluation. Advancements in immunoassay and chromatography have allowed for precise, non-invasive collection methods like salivary testing.
Mechanism
The assessment quantifies cortisol, a steroid hormone, which typically exhibits a diurnal rhythm, peaking in the morning and declining at night. By measuring cortisol at multiple points throughout the day, clinicians can map the patient’s circadian rhythm and total daily output. This process involves collecting samples that reflect the biologically active, free cortisol fraction, which then provides a functional picture of adrenal gland activity and HPA axis integrity beyond a single, static measurement.
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