Why a Salivary Cortisol Test can help you feel better

It seems as though everyone is stressed these days and chronic health conditions are on the rise. Most conventional therapies do not aim to address the fundamental root cause of illness, which in most cases, is stress. In my practice, I help people understand the impact of stress on their body and get them to see it with the use of different testing. I feel that once people see the effects of stress manifesting in their bodies, they are more motivated to change.

Let us have a look at the body‘s stress response. It starts in the adrenal gland. We have two glands that sit on top of the kidneys. These amazing glands are made up of an adrenal medulla and adrenal cortex. The adrenal medulla releases catecholamines such as adrenaline and noradrenaline which help us with our fight or flight response.

The adrenal cortex secretes a lot more hormones. It releases glucocorticoids and cortisol which acts as an anti-inflammatory and also creates sugar for quick energy in the danger of “running from a bear”. It is also responsible for releasing androgens such as testosterone and DHEA. In addition, it releases mineralcorticoids and aldosterone which increases blood pressure and maintains a healthy sodium/potassium ratio in the blood.

Let me now explain the general adaptation syndrome (GAS) as developed by Hans Selye. The GAS has proven useful for many years by providing a model of how stress induced illness arises and by giving clinicians like myself insight into how to manage stress related conditions in the patient. According to Hans Selye, there are three stages of the stress response.

Stage one, alarm phase, which is acute stress.
Stage two, resistance phase, which deals with chronic stress.
Stage three, exhaustion phase, which is synonymous with burn out.

Please remember that stress does not only include psychological stress, but any insult to the body that may put extra pressure on the adrenal glands to function. This may include chronic infections, allergies, chemical toxins, stimulants like nicotine and caffeine, poor nutrition, physical trauma, poor sleep habits, steroid use and pharmaceutical drugs.

Alarm phase
The alarm phase occurs when a stress is first encountered and an alarm sounds in the body. This alarm is sometimes called the “fight or flight” response. It is associated with an increase in sympathetic nervous system response. Hormonally, we see an increase in the release of cortisol and also epinephrine. This phase is meant to last 24-48 hours and is accompanied by a rest period after the initial stressor. Continued stress, as in PTSD and anxiety disorders, can lead to weight loss, ulcers and autoimmune disorders. This highlights the importance of the rest period.

Resistance phase

Due to the challenge of modern life for many people, perceived stressors are not short term but chronic. In the second phase of the GAS, the organism is still reacting to a perceived stressor or stress. Although the person may appear to be functioning normally, this is not the case because immunity and inflammatory responses are lowered thus increasing ones susceptibility to infection‘s, neoplasia, arthritis, allergies and autoimmune conditions. In addition, chronically elevated adrenal hormone levels may lead to depression, hyperlipidemia, atherosclerosis, hypertension, insulin resistance, diabetes, osteoporosis, and other general diseases.

Exhaustion phase

Chronic stress can eventually lead to an exhaustion phase characterized by deficient glucocorticoid and mineralcorticoid production. Adrenal exhaustion is associated with decreased resistance to stress, premature aging, and even death. Conditions that are common in people in this phase include allergies, chronic fatigue syndrome, fibromyalgia, hypoglycemia, multiple chemical sensitivity‘s, irritable bowel syndrome, infertility, hypotension, insomnia, hypothyroid, lack of motivation and anxiety disorders.

Lab testing can be very helpful in diagnosing adrenal insufficiency and in what stage. In my practice, I use salivary cortisol measurement. Salivary cortisol is likely the best single test. Saliva hormones indicate the amount of hormone inside cells and the testing is simple, noninvasive and easy to do. The best way to use a saliva test is to measure cortisol levels at least four times per day- waking, noon, afternoon and evening, which increases the chances of detecting a failure of adrenal reserve. DHEA and Testosterone levels can also be measured with saliva testing and if lowered are considered to be indicators of adrenal exhaustion or if high maybe indicate adrenal resistance phase.

Once the levels are examined and a report is created, I am then able to sit down with my patient and explore in which phase of the GAS they are living in. This insight would give us a great platform to begin treatment.

Treatment may include any of the following:

Exploring emotional and physical stressors. Beginning a mindfulness based practice such as meditation, prayer, yoga, acupuncture and/or Reiki. Supplementing with adaptogenic herbs such as Ashwaghanda, licorice, American ginseng, Siberian ginseng, Astragalus and Rhodiola.

Nutrition deficiencies can also lead to adrenal insufficiency. Some of the most important minerals for the adrenal gland are vitamin C, vitamin E, vitamin B5, vitamin B6, magnesium, calcium and omega 3 fatty acid‘s.

A healthy diet should focus on consumption of a whole foods, natural, preferably organic diet. Meals should combine fats, protein and complex carbs. Non-starchy vegetables should be eaten in 6-8 servings per day. Eating smaller meals more frequently while being aware of the glycemic index in food is necessary. Beverages conducive to adrenal recovery include good quality water, herbal teas, green tea, fresh organic veggies and alternatives to dairy such as nut milks, rice milk’s etc. All stimulants should be avoided including caffeine, ephedra and nicotine. Soft drinks should be avoided due to the high amounts of sugar or artificial sweeteners or caffeine.

If you are interested in having this test done, reach out. I am happy to help you heal your body and decrease stress so you can live a more youthful life!

Dr. Jennifer Cisternino  Naturopath, Reiki Master
416-301-3477

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