Cortisol Diurnal Profiling is a diagnostic procedure involving the collection of multiple cortisol samples, typically saliva or urine, taken at specific, timed intervals throughout a 24-hour period. This testing methodology is essential for mapping the natural circadian rhythm of cortisol secretion, which normally peaks shortly after waking and declines throughout the day, reaching its nadir at night. Clinical interpretation of this profile reveals critical information about HPA axis function and the body’s capacity to manage chronic stress. It provides a dynamic view of adrenal health, unlike a single snapshot blood test.
Origin
The practice is derived from chronobiology and endocrinology, recognizing that cortisol is a pulsatile and rhythmically secreted hormone whose concentration varies significantly over the day. Profiling evolved as a clinical tool to move beyond diagnosing severe pathologies like Cushing’s or Addison’s disease to assessing subtle, functional HPA axis dysregulation. This non-invasive approach offers superior insight into the physiological reality of the stress response.
Mechanism
The profile measures the cortisol awakening response (CAR), the slope of the morning decline, and the evening trough, all of which are governed by the suprachiasmatic nucleus (SCN) driving the HPA axis. Deviations, such as a flattened curve or an inverted rhythm, indicate dysregulation, suggesting issues with central drive or chronic adrenal over- or under-stimulation. This dynamic data guides targeted clinical interventions aimed at restoring the natural, protective cortisol rhythm.
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