Adrenocortex Stress Profile
Genova Diagnostics
Sample type: Saliva
Requires fasting: No
At home test
Details
HPA axis dysfunction is seen as a root cause of a variety of conditions, including cardiovascular disease, hypertension, diabetes, depression, fatigue, and more. Through carefully timed salivary samples throughout the day, this Adrenocortex Stress Profile provides a comprehensive assessment of cortisol diurnal rhythm, DHEA, and optional cortisol awakening response. It is a complete yet non-invasive test patients can easily do in their own homes.
- Cortisol Evening
- Cortisol Night
- Cortisol Noon
- Cortisol Morning
Estimated days for results: Results should arrive 7 business days after the lab receives samples.
HPA axis dysfunction is seen as a root cause for disease, making evaluation vital to a patient’s overall health.
Genova’s Adrenocortex Stress Profile is comprehensive – assessing cortisol diurnal rhythm, DHEA, and optional cortisol awakening response (CAR). Salivary testing is an easy, non-invasive, at-home collection.
Why choose Genova Diagnostics' Hormonal Health Products?
HPA axis dysfunction is seen as a root cause for disease, making evaluation vital to a patient’s overall health. Genova’s ASP is comprehensive – assessing cortisol diurnal rhythm, DHEA, and optional cortisol awakening response (CAR). Salivary testing is an easy, non-invasive, at-home collection.
A Comprehensive Tool to Assess the HPA Axis — Stress Response and Resiliency
The Adrenocortex Stress Profile (ASP) provides an assessment of the Hypothalamic-Pituitary-Adrenal (HPA) axis using carefully timed salivary samples of the hormones cortisol and DHEA. Salivary testing is an easy, non-invasive option to measure unbound, biologically active parent hormone levels.
The report offers an easy-to-interpret graphic which plots the results of the natural diurnal rhythm. Which patients might benefit from HPA axis testing? Daily hassles, chronic pain, blood sugar dysregulation, work stressors, and poor relationship quality can alter the HPA axis. Imbalances in adrenal hormones can have a wide range of negative consequences that can adversely impact a patient's overall quality of life.
HPA axis dysfunction is associated with many conditions including but not limited to:
Genova’s Adrenocortex Stress Profile is comprehensive – assessing cortisol diurnal rhythm, DHEA, and optional cortisol awakening response (CAR). Salivary testing is an easy, non-invasive, at-home collection.
Why choose Genova Diagnostics' Hormonal Health Products?
HPA axis dysfunction is seen as a root cause for disease, making evaluation vital to a patient’s overall health. Genova’s ASP is comprehensive – assessing cortisol diurnal rhythm, DHEA, and optional cortisol awakening response (CAR). Salivary testing is an easy, non-invasive, at-home collection.
A Comprehensive Tool to Assess the HPA Axis — Stress Response and Resiliency
The Adrenocortex Stress Profile (ASP) provides an assessment of the Hypothalamic-Pituitary-Adrenal (HPA) axis using carefully timed salivary samples of the hormones cortisol and DHEA. Salivary testing is an easy, non-invasive option to measure unbound, biologically active parent hormone levels.
The report offers an easy-to-interpret graphic which plots the results of the natural diurnal rhythm. Which patients might benefit from HPA axis testing? Daily hassles, chronic pain, blood sugar dysregulation, work stressors, and poor relationship quality can alter the HPA axis. Imbalances in adrenal hormones can have a wide range of negative consequences that can adversely impact a patient's overall quality of life.
HPA axis dysfunction is associated with many conditions including but not limited to:
- Hypertension
- Cardiovascular disease
- Gastrointestinal and immune dysregulation
- Diabetes and metabolic syndrome
- Depression
- Chronic fatigue
- Insomnia
- Weight gain
- Persistent pain
- Neurodegenerative disease and cognitive decline
7 business days
- Add-On: Cortisol Awakening Response (CAR)
Preparing for this Test
Certain medications and supplements may impact test results, though in some instances that impact is unknown.
There are many substances that influence cortisol and DHEA levels, however no known substances will interfere with the ability to run the assay itself.
Genova never recommends that patients discontinue medically necessary medications or supplements in order to complete testing.
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. A clinician may choose to discontinue a substance in order to evaluate the patient's baseline.
The timeframe to discontinue varies for each substance and is at the discretion of the clinician.
Glucocorticoids Any steroid-based preparation including oral, topical (patch, cream), eye drops (minimal impact), nasal sprays, injections, and inhalers may influence the Adrenocortex Stress Profile findings. 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. Not all glucocorticoids impact results the same.
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.
Shift Workers and Alternate Sleep-Wake Schedules
The reference ranges for the Adrenocortex Stress Profile (ASP) were designed for patients with normal sleep cycles and referenced for the specific time frames as graphed on the test report. However, some clinicians choose to test individuals with altered sleep cycles, knowing that the graph, and reference ranges may not directly apply.
Even though the reference ranges may not apply, there is still some clinical information to be gleaned based on the overall slope of the diurnal curve. It is unknown whether extrapolating from the diurnal curve and reference ranges would apply to someone on an alternate schedule - "healthy" or "normal" has not been defined for this population.
If the clinician chooses to test, the clinician can change the morning peak time to the patient's waking time (within one hour of waking) and then each additional sample will be approximately four hours after the prior.
In order to determine cortisol awakening response (CAR), samples must include both the waking and 30-minute samples. The timing of these collections should reflect when the patient wakes to begin their day. It has been shown in literature that patients who have alternate work schedules may 'reset' their internal circadian rhythm and, therefore, CAR sampling can be done during their normal waking cycle.
When the patient wakes, have them immediately give a saliva sample, then another exactly 30 minutes later for CAR. These two samples are used for the CAR calculation. The third sample should be within that hour, then every four hours after that to complete the ASP portion.
Bleeding Gums
Samples visibly contaminated with blood should be recollected. This can result in a false elevation of hormones. Blood concentrations of steroid hormones are several-fold higher than saliva levels.
For this reason, brushing and flossing is discouraged for 1 hour prior to salivary collection. Additionally, if the patient has a condition that causes gums to bleed easily, such as gingivitis or periodontitis, or has dentures and other oral appliances, a plan should be in place to ensure gums do not bleed during testing.
Certain medications and supplements may impact test results, though in some instances that impact is unknown.
There are many substances that influence cortisol and DHEA levels, however no known substances will interfere with the ability to run the assay itself.
Genova never recommends that patients discontinue medically necessary medications or supplements in order to complete testing.
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. A clinician may choose to discontinue a substance in order to evaluate the patient's baseline.
The timeframe to discontinue varies for each substance and is at the discretion of the clinician.
Glucocorticoids Any steroid-based preparation including oral, topical (patch, cream), eye drops (minimal impact), nasal sprays, injections, and inhalers may influence the Adrenocortex Stress Profile findings. 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. Not all glucocorticoids impact results the same.
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.
Shift Workers and Alternate Sleep-Wake Schedules
The reference ranges for the Adrenocortex Stress Profile (ASP) were designed for patients with normal sleep cycles and referenced for the specific time frames as graphed on the test report. However, some clinicians choose to test individuals with altered sleep cycles, knowing that the graph, and reference ranges may not directly apply.
Even though the reference ranges may not apply, there is still some clinical information to be gleaned based on the overall slope of the diurnal curve. It is unknown whether extrapolating from the diurnal curve and reference ranges would apply to someone on an alternate schedule - "healthy" or "normal" has not been defined for this population.
If the clinician chooses to test, the clinician can change the morning peak time to the patient's waking time (within one hour of waking) and then each additional sample will be approximately four hours after the prior.
In order to determine cortisol awakening response (CAR), samples must include both the waking and 30-minute samples. The timing of these collections should reflect when the patient wakes to begin their day. It has been shown in literature that patients who have alternate work schedules may 'reset' their internal circadian rhythm and, therefore, CAR sampling can be done during their normal waking cycle.
When the patient wakes, have them immediately give a saliva sample, then another exactly 30 minutes later for CAR. These two samples are used for the CAR calculation. The third sample should be within that hour, then every four hours after that to complete the ASP portion.
Bleeding Gums
Samples visibly contaminated with blood should be recollected. This can result in a false elevation of hormones. Blood concentrations of steroid hormones are several-fold higher than saliva levels.
For this reason, brushing and flossing is discouraged for 1 hour prior to salivary collection. Additionally, if the patient has a condition that causes gums to bleed easily, such as gingivitis or periodontitis, or has dentures and other oral appliances, a plan should be in place to ensure gums do not bleed during testing.
State restrictions:
Patient can't order this test if they are located in Hawaii, Puerto Rico, New Jersey, New York, or Rhode Island
