Question 1

What is the Meaning of Free Cortisol Curve?

Accepted Answer

The Free Cortisol Curve is a diagnostic representation, typically generated from multiple saliva or dried urine samples collected throughout a single day, that graphically maps the circadian rhythm of the biologically active, unbound cortisol hormone. This curve is a precise clinical tool used to assess the functional integrity of the Hypothalamic-Pituitary-Adrenal (HPA) axis and to identify deviations from the expected pattern, such as a flattened, inverted, or excessively high diurnal cycle. Analyzing this dynamic curve provides far more actionable information about an individual's stress adaptation capacity than a single static blood measurement.

Question 2

What is the Origin of Free Cortisol Curve?

Accepted Answer

The concept stems from the fundamental physiological understanding of the adrenal gland's pulsatile and diurnal secretion pattern, where cortisol levels naturally peak in the morning and decline throughout the day to a nocturnal nadir. Clinical application of this concept evolved with the advent of non-invasive collection methods, particularly salivary and dried urine testing, which accurately measure the free, active fraction of cortisol that can readily bind to receptors. The "curve" itself is the visual interpretation of these time-point measurements.

Question 3

What is the Mechanism of Free Cortisol Curve?

Accepted Answer

The mechanism relies on the fact that only unbound, or free, cortisol is biologically active and capable of diffusing into the salivary gland or being excreted in the urine, making these fluids a reliable proxy for tissue exposure. The HPA axis regulates this curve: the morning peak, known as the Cortisol Awakening Response, is driven by the pituitary's release of ACTH, stimulating adrenal cortisol production. Subsequent levels reflect the feedback inhibition and metabolic demand throughout the day. Deviations in the curve, such as a lack of morning rise or an elevated evening level, indicate specific patterns of HPA axis dysregulation related to chronic stress or underlying pathology.

Free Cortisol Curve

Meaning

Origin

Mechanism

Can Salivary Hormone Testing Replace Blood Tests for Comprehensive Endocrine Evaluation?

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