Cortisol Awakening Response + DHEA (Saliva)

Cortisol Awakening Response (CAR):

- CAR represents the momentum of rising cortisol levels that begins several hours prior to awakening and an additional
transient increase.

- CAR reflects a person’s ability to cope with anticipated challenges and the perceptions of control around chronic stress.

Elevated levels of CAR:

- Elevated levels may be due to stress, exercise, alcohol, and specific lifestyle stressors.

- Elevated evening salivary cortisol is linked to insomnia.

- High evening cortisol levels are also associated with various diseases such as diabetes, cardiovascular disease, hormonally driven cancers, and osteoporosis.

DHEA:

DHEA levels peak at around age 25, then decline steadily through the following decades. DHEA can be converted downstream in the steroidogenic pathway to create androgens and estrogens. It has antioxidant and anti-inflammatory properties and can be protective against corticosterone’s neurotoxic effects.

- Lower levels of DHEA are seen with advancing age and have been associated with immune dysregulation, cardiovascular disease, arthritis, osteoporosis, insomnia, declining cognition, depression, fatigue, and decreased libido.

- Elevated levels of DHEA may reflect endogenous exposure and supplementation. Other considerations include Polycystic Ovarian Syndrome (PCOS,) adrenal hyperplasia and adrenal tumors.

General recommendations include overall control of the cortisol response, HPA axis support using nutrition, adaptogens, and behavioral modification.