BioHealth Laboratory HPA Stress Profile
The HPA Stress Profile assesses Cortisol and DHEA-S via saliva samples collected by patient according to specific instructions.
For nearly 20 years, BioHealth has been a leader in salivary hormone testing, providing specific profiles for assessing cortisol, DHEA(S), melatonin, progesterone, estrogens and secretory IgA. Without doubt the most popular of these profiles have been those centering around the “adrenal stress index” or “adrenal fatigue test.”
Diurnal Cortisol Rhythm
The most common analyte for measuring HPA (hypothalamic-pituitary-adrenal) axis function is cortisol. Used in thousands of studies and clinical trials, it has established itself as the go-to marker for assessing status, reactivity and function of the HPA axis. The production of cortisol has a predictable diurnal pattern and can be intentionally suppressed or stimulated with various interventions making it easy to study. One of the most important feature of the HPA axis is its circadian rhythm, which results in a predictable diurnal cortisol secretion pattern. There should be a dramatic difference between awakening levels of cortisol and evening levels (greater than 5-fold).
DHEA-S is a neurosteroid that supplies 50% of the androgens in men, 75% of the active estrogens in premenopausal women and 100% in postmenopausal women. The more stable, sulfated form of DHEA, DHEA-S, provides a more reliable measure of DHEA levels than DHEA itself and salivary levels are ~1% of free serum levels and .05% of total serum DHEA-S levels. DHEA-S decreases with age and supplementation may be beneficial (if test results and symptoms show a need) for a wide range of symptoms, such as, but not limited to, sexual performance, bone mineral density, cardiovascular function and mental performance.
Cortisol to DHEA-S Ratio
This ratio of biomarkers has been studied extensively and can be thought of in a simplified sense as the ratio of catabolic to anabolic hormone. Because DHEA-S has a modulating/down regulation effect on cortisol, the ratio of the two is an important one. As one ages DHEA-S levels drop and the ratio of cortisol to DHEA-S increases. Therefore, it is helpful if DHEA-S results are delineated by age, as well as gender (reference ranges). Finally, it is helpful when looking at this ratio to look at them as a molar ratio taken off the 30-minute waking sample, when DHEA-S and cortisol are at their highest.