Stress Test 101

When our adrenal glands are functioning optimally, they produce adequate amounts of the stress hormones cortisol and DHEA that help us cope with stress and power us through the day.

Whether stress comes from outside in the form of a natural disaster, or from within like the anxiety we experience before public speaking, it's the adrenal glands' and their secretion of cortisol and DHEA that helps us adapt to the situation.

The Stress Environment

The human stress response is based on two factors ‐ one, the actual stressors (the events and circumstances that impact our lives), and two, how we cope with those stressors (how we interpret and respond to those stressors).

In general, we can exert:

• Control over the stressors: identifying what in our circumstances/environment can be changed and what cannot be changed. This is the stressor context around which we often have the least control.
• Control over the coping response: this includes behavioral responses and biological responses (interpretation, language, empathy, understanding, medical treatment, diet, nutrition, movement/physical activity, sleep habits, etc.). This is the stressor context around which we often have the most control.

Testing for cortisol and DHEA levels reveals the pattern of these two key measures of our stress response (stressors and coping). The degree to which cortisol and DHEA levels fall outside the normal pattern can be used to guide the recommended diet, nutrition, physical activity, lifestyle, and behavioral interventions, as well as the level of aggressiveness one should apply to those interventions.

Cortisol and DHEA

When our adrenal glands are in balance, they produce adequate amounts of two stress hormones ‐ cortisol and DHEA ‐ to power us through the day and to help us cope with stress. Cortisol has wide-ranging effects in the body: it interacts with the reproductive, immune, and endocrine systems. Cortisol, as part of the stress response, prepares the body for its "fight-or-flight" response by suppressing the production and release of other hormones, such as DHEA and thyroid hormones. Cortisol levels fluctuate naturally through the day—it is highest in the morning and lowest at night. Thorne's Stress Test takes four saliva samples at four time-points during the day to capture your true cortisol rhythm. Stressors, such as those present in your work or home life, often trigger a release of cortisol, either acutely or persistently, and can harm your health in a variety of ways. Dehydroepiandrosterone (DHEA) is a hormone also produced in the adrenal glands (along with smaller amounts from the brain and the sex organs) and is used to assess adrenal function. DHEA is a precursor molecule for testosterone and estrogen synthesis, and has many other effects in the human body. The body's DHEA production generally declines with age.

Cortisol and DHEA's Interaction in a Stressful Environment

Metabolically in the body, cortisol and DHEA are antagonistic to each other, partially because they originate from a common precursor, the hormone pregnenolone. When stress elevates your cortisol level, pregnenolone is diverted from producing DHEA (the precursor for testosterone and estrogen) and is used to produce more cortisol. Thus, cortisol and DHEA exist in a dynamic "tug-of-war" with each other and when one is found to be elevated, the other is commonly found at lower levels. Each hormone can also directly antagonize the physiological effect of the other one in the body.

Thorne's Stress Test measures DHEA-sulfate (DHEA-S), the sulfate-bound form of DHEA. This form of DHEA is measured in saliva in preference to free DHEA, because it is present in higher concentrations and is more stable.