saliva adrenal stress test genova diagnostics

The cortisol assay can cross-react with various glucocorticoid drugs. 6,8 A literature search may provide further insight into the clearance rate and impact the particular glucocorticoid may have on salivary testing. For example, if a clinician wishes to test a patient's baseline HPA axis function following a steroid injection, it may take up to 4 weeks or longer for recovery to baseline. When to test a patient following glucocorticoid discontinuation is dependent on multiple factors (mentioned above) and is at the discretion of the clinician.

12,13 Glucocorticoid-induced adrenal insufficiency may last up to 2-4 years after glucocorticoid withdrawal. 3,12,13 Long-term use of glucocorticoids can lead to adrenal atrophy, which is slowly reversible. In general, exogenous glucocorticoids - even with one-time administration - are known to suppress the HPA axis via negative feedback, which can result in lower endogenous production of cortisol. Not all glucocorticoids impact results the same. 1-11 The degree of impact depends on numerous factors including, but not limited to, preparation, specific drug, dosage, chronicity of use, and individual response to medications. GlucocorticoidsĪny steroid-based preparation including oral, topical (patch, cream), eye drops (minimal impact), nasal sprays, injections, and inhalers may influence the Adrenal Stress Profile findings. Drug databases such as, , or Epocrates may provide additional information. The timeframe to discontinue varies for each substance and is at the discretion of the clinician.Īny questions regarding a medication or supplement impact on biomarker results can be researched by contacting the medication/supplement manufacturer and/or searching the literature (PubMed, Google Scholar) for relevant information. A clinician may choose to discontinue a substance in order to evaluate the patient's baseline. There may be times when a patient may stay on a medication or dietary supplement during testing in order to evaluate its effectiveness or impact. Genova never recommends that patients discontinue medically necessary medications or supplements in order to complete testing. There are many substances that influence cortisol and DHEA levels, however no known substances will interfere with the ability to run the assay itself. Preparing for this Test Important Considerations Before TestingĬertain medications and supplements may impact test results, though in some instances that impact is unknown. CAR reflects a person's ability to cope with anticipated challenges and their perception of control around chronic stress, providing insight into HPA axis resiliency.Īdrenal Stress Profile testing can reveal these HPA axis imbalances and provide direction for clinical intervention with targeted therapeutic treatments such as nutrient support and/or adaptogens, stress management, behavioral modification and lifestyle interventions.

CAR is a transient, immediate rise in cortisol upon awakening and is distinct from the diurnal rhythm.

Ratio of DHEA to cortisol is calculated to provide insight into anabolic/catabolic balance.

DHEA is measured once in the 7:00 AM - 9:00 AM sample.

Four cortisol samples measured throughout the day give insight into the natural circadian diurnal cortisol rhythm, and help clinicians address specific daily stressors.

Neurodegenerative disease and cognitive decline.

Gastrointestinal and immune dysregulation.HPA axis dysfunction is associated with many conditions including but not limited to: 1, 2, 3, 4, 5, 6, 7, 8, 9 Imbalances in adrenal hormones can have a wide range of negative consequences that can adversely impact a patient's overall quality of life. Which patients might benefit from HPA axis testing?ĭaily hassles, chronic pain, blood sugar dysregulation, work stressors, and poor relationship quality can alter the HPA axis. The report offers an easy-to-interpret graphic which plots the results of the natural diurnal rhythm. Salivary testing is an easy, non-invasive option to measure unbound, biologically active parent hormone levels. The Adrenal Stress Profile (ASP) provides an assessment of the Hypothalamic-Pituitary-Adrenal (HPA) axis using carefully timed salivary samples of the hormones cortisol and DHEA. A Comprehensive Tool to Assess the HPA Axis - Stress Response and Resiliency

Saliva adrenal stress test genova diagnostics