A systematic clinical evaluation of the physiological and psychological consequences resulting from an individual’s current pattern of cortisol secretion, metabolism, and receptor sensitivity. This assessment moves beyond simply measuring total cortisol levels to interpret the functional effect of the hormone on key systems, including metabolic balance, immune response, bone density, and cognitive function. It provides a holistic view of chronic stress load and HPA axis resilience.
Origin
This practice originates from the clinical recognition that total serum cortisol is often insufficient for understanding the full scope of stress-related pathology. The term “impact assessment” borrows a framework from environmental or risk analysis, applying it to human physiology to quantify the damaging effects of dysregulated glucocorticoid signaling. It is a cornerstone of functional and preventative endocrinology, guiding targeted stress-management and HPA axis support protocols.
Mechanism
The assessment relies on measuring cortisol and its metabolites in various matrices, such as saliva or urine, to capture the diurnal curve and total production. It also involves evaluating downstream effects, including glucose homeostasis markers, inflammatory cytokines, and bone turnover markers, which are all directly modulated by cortisol. By analyzing the correlation between cortisol patterns and these functional outcomes, the clinician can pinpoint areas of specific physiological damage and develop a precise, individualized therapeutic strategy to mitigate the negative impact.
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