Stress Q&A by Dr. Stöppler
Your doctor can order laboratory tests to check your cortisol levels. While the most common test is measurement of the cortisol level in the blood, a saliva sample may also be used, as salivary cortisol levels have been shown to be an index of blood cortisol levels. The body's level of cortisol in the bloodstream displays what is known as a diurnal variation, that is, normal concentrations of cortisol vary throughout a 24-hour period, with levels in normal individuals being highest in the early morning at around 6-8 a.m. The lowest levels occur around midnight.
An elevated cortisol level requires additional testing to determine if the cause is related to a physical problem, hormone imbalance, or to stress or other lifestyle factors. If your level is only mildly elevated, it may help to repeat testing at a time when you are feeling well and rested to see if your body is producing too much cortisol under normal conditions. A mild elevation in cortisol levels may not produce recognizable symptoms. Your doctor can decide which diagnostic tests are most appropriate for your situation.
Cushing's syndrome is a condition that results from dramatically elevated levels of cortisol in the bloodstream. The symptoms and signs of Cushing's syndrome include elevated blood pressure, diabetes, pink to purple stretch marks on the abdomen, fatigue, depression, moodiness, and accentuated fatty tissue on the face and upper back. Women with Cushing's syndrome may develop irregular menstrual periods and develop new facial hair growth. Men may show a decrease in sex drive.
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Last Editorial Review: 2/22/2007