Normally, cortisol levels rise within 10 to 30 minutes of waking to help boost energy levels and then drop throughout the day. This is known as the cortisol awakening response (CAR). Cortisol levels are a good indication of baseline HPA axis function since they represent the lowest level during the circadian rhythm. Cortisol is often reflective of glycemic control due to the post-prandial timing of collection. Cortisol measurement reflects peak ACTH-mediated adrenal gland response.
What is the HPA axis?
The HPA axis is a set of interactions among the hypothalamus, the pituitary gland, and the adrenal gland.
HPA stands for hypothalamic-pituitary–adrenal axis.
Let’s look at these 3 words a little closer:
Hypothalamus: The hypothalamus is a small but really important area in the center of the brain. It plays an essential role in hormone production and helps to stimulate various important functions in the body, such as:
– body temperature
– thirst
– appetite and weight control
– emotions
– sleep cycles
– sex drive
– childbirth
– blood pressure and heart rate
– production of digestive juices
– balancing bodily fluids
The hypothalamus acts as the connector between the endocrine and nervous systems. It is located between the pituitary gland and the thalamus.
Pituitary gland: The pituitary gland is a tiny organ, the size of a pea, found at the base of the brain. As the “director gland” of the body, it produces many hormones that travel throughout the body, directing specific processes or communicating to other glands to produce certain hormones.
Adrenal glands: Your adrenal glands are endocrine glands that produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol. They are found above the kidneys.
————————————
Together these three above elements work together very much like an orchestra to regulate the following:
– stress response
– mood
– motivation
– metabolism
– energy levels
– and immune system.
There are 3 important hormones when it comes to the hypothalamic-pituitary-adrenal axis:
- Corticotropin-Releasing Hormone (CRH) Released by the Hypothalamus in response to stress
- Adrenocorticotropic Hormone (ACTH) Released by the Pituitary when it’s sensing CRH
- Cortisol Released by the Adrenal glands when ACTH was able to dock onto them. With the rise in cortisol glucose is also being elevated as the body is triggered to make more energy (=ATP) to cope with the stress.
When any one part of the HPA axis isn’t running as it should, it can affect the other parts and various reactions. We call this an HPA axis dysfunction or dysregulation. External stressors are translated into biochemical signals, many of which influence the feedback loops of the HPA axis. Prolonged stress may continually activate the HPA axis and affect the balance of hormone and cell mediators. Cortisol is perhaps the most important hormone involved in the process. HPA axis activation and cortisol issues can persist for years, with effects on most major body systems including: gastrointestinal, neurological, musculoskeletal, endocrine, respiratory, and immune.
– Stress activates the HPA axis and sets off a cascade of neuroendocrine signals that ultimately leads to the release of hormones and neurotransmitters like cortisol, norepinephrine (noradrenaline), and epinephrine (adrenaline).
– Over time, the chronic activation of our stress–response system erodes resilience and depletes metabolic reserve. Resilience is the immediate capacity of cells, tissues, and organ systems to respond to changes in physiological need. Metabolic reserve refers to the long-term capacity of our body to respond to these changes.
– The loss of resilience and the depletion of metabolic reserve lead to changes in cortisol output (most commonly too much, but sometimes too little), disruption of the diurnal cortisol rhythm (too little cortisol in the morning or too much at night), and changes in the production of other hormones and neurotransmitters related to the HPA axis, such as DHEA, melatonin, and epinephrine.
– Previously, clinicians focused on the necessity of supporting adrenal function and coined terms such as “adrenal fatigue;” however, we have since learned that the effects of stress affect more than the adrenals.
– In addition, focusing only on cortisol and/or adrenal function may overly simplify complex interactions among several systems, and miss the contributions of the central nervous system, environmental factors, and other metabolic factors.
Lifestyle and Nutritional Support
The ability to respond to stress has the potential to interfere with the enjoyment of life and even the ability to perform ordinary daily activities. Incorporating lifestyle, nutritional, and behavioral recommendations can help support healthy HPA axis function. Although specific recommendations differ based on the stage of stress resistance, here are a few considerations:
- Obtain regular exercise
- Establish regular bedtimes and obtain sufficient sleep
- Practice relaxation activities (e.g., meditation, yoga, hobbies)
- Consider smoking cessation programs
- Avoid or limit alcohol and sugar consumption
- Identify and remove food intolerances
Supplemental support
Early Stage:
In the Early-Stage of stress resistance, patients can benefit from supplementation with herbs and nutrients that calm HPA axis activation, support healthy cortisol balance, and help relieve occasional anxiety and stress.
- Ashwagandha (Withania somnifera) has been shown in clinical studies to reduce stress and occasional anxiety in adults.
- L-Theanine, an amino acid found in green tea, has been shown to inhibit cortical neuron excitation, thereby creating feelings of calm, supporting blood pressure already within normal limits, and improving mood.
- Magnolia (Magnolia officinalis) has been shown to provide calming effects, which can be in part attributed to its interaction with receptors for the neurotransmitter gamma-aminobutyric acid (GABA).
- Phosphatidylserine (PS) has been shown to support an adaptive cortisol response to stress.
Mid-Stage:
Patients in the Mid-Stage of the stress response can benefit from adaptogens, which are botanical ingredients that support the body’s ability to respond to stress and restore homeostasis. This may, in turn, influence mood, cognition, and energy levels.
- Rhodiola (Rhodiola rosea) is an adaptogen that that helps to reduce occasional fatigue, improve mood, and promote psychological adaptation.
- Holy basil (Ocimum tenuiflorum) prevents reductions in brain catecholamine and monoamine oxidase levels and may increase dopamine and serotonin levels during stress.
- Eleuthero (Eleutherococcus senticosus) supports adrenal function, regulates neurotransmitters, and may increase resistance to stress.
- Ashwagandha (Withania somnifera) may modulate hormonal changes that occur during stress.
- Maca (Lepidium meyenii) has been shown in preliminary human research to have a positive influence on mood, feelings of occasional anxiety, and libido.
Late-Stage:
In the Late-Stage, patients can benefit from adrenal-supportive nutrients and botanicals to support healthy cortisol production. Fortifying the diet with essential vitamins that can be depleted by stress is also important in maintaining adrenal cortex function, combatting occasional stress-related fatigue, and promoting energy recovery.
- Vitamin B1 (thiamine) is a water-soluble, sulfur-containing member of the B vitamins; the coenzyme form of thiamine plays a role in energy production.
- Vitamin B2 (riboflavin) is necessary for energy production as well as normal cell function and growth. Animal research shows that a riboflavin deficiency leads to an initial increase, followed by a decrease, in adrenal cortex activity.
- Vitamin B5 (pantothenic acid) is involved in numerous biological reactions, including the production of energy and the synthesis of steroid hormones, including cortisol.
- Vitamin B6 (pyridoxine) is a cofactor for approximately fifty different enzymes and plays a role in the production of neurotransmitters, such as serotonin, dopamine, epinephrine, norepinephrine, and gamma-aminobutyric acid (GABA).
- Licorice (Glycyrrhiza glabra) root extracts have been shown to influence cortisol production in both animals and humans by inhibiting 11beta-hydroxysteroid dehydrogenase, the enzyme responsible for converting cortisol to cortisone.
References:
– https://www.ncbi.nlm.nih.gov/pubmed/30890970
– https://www.ncbi.nlm.nih.gov/pubmed/30872618
– https://www.ncbi.nlm.nih.gov/pubmed/30862458
– https://www.ncbi.nlm.nih.gov/pubmed/27557747
– https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181830/
– https://www.ncbi.nlm.nih.gov/pubmed/27557747
– https://pdfs.semanticscholar.org/6048/41ef91b63ad62a7bb05110e971c65caaea9b.pdf
Your medical lab tests hold vital information about your health. Our tools help you understand what's going on and how to take action.
$15 $5.99/first month
Cancel or upgrade anytime
Possible reasons for a high cortisol awakening response (CAR):
– Overactive HPA axis
– Short-term stress about a future event [L]
– Shoulder and neck pain [L]
– Anticipating having to wake up at a certain time [L]
– Visceral adiposity in men (=Excess weight that develops over time around the center of the body). Likely caused by elevated cortisol, not vice versa. [L, L, L, L]
– Upper respiratory infection / a cold [L]
Anthony
Unlimited Plan Member since 2021
I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
Karin
Advanced Plan Member since 2020
What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
Paul
Healthmatters Pro Member since 2024
As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
Possible reasons associated with low cortisol awakening response (CAR):
Normally, cortisol levels rise within 10 to 30 minutes of waking to help boost energy levels and then drop throughout the day. This is known as the cortisol awakening response (CAR)
– Underactive HPA axis
– Chronic stress, including psychological stress (L)
– Seasonal affective disorder (L)
– Type 2 diabetes and insulin resistance (L, L)
– Insomnia or other sleep issues, including sleeping in late (L, L) PTSD (L, L, L, L)
– Chronic fatigue syndrome (L)
– Chronic pain (L)
– High blood pressure (L)
– IBS and dyspepsia (L)
– Fibromyalgia (L)
Guiding our users for 10 years to promptly understand, track, and act on their laboratory results.
$15 $5.99/first month
Cancel your subscription at any time.
$250/once
full premium version
$45/month
track your clients’ labs
Cancel your subscription at any time.
Guiding our users for 10 years to promptly understand, track, and act on their laboratory results.
Personal plans
track personal results
Professional Plan
track multiple client's results
$15 $5.99/first month
$250/once
own it for life
$45/month
for health professionals
Complete Plan
Unlimited Plan
$15 $5.99
$250 full version
Are you a health professional?
Level up your lab report analysis with our Pro plan, built for health practitioners like you.
Health Business Account
$45/month
Cancel your subscription at any time.
Unlock additional Pro plans when you sign up.
Anthony
Unlimited Plan Member since 2021
I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
Karin
Advanced Plan Member since 2020
What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
Paul
Healthmatters Pro Member since 2024
As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
Healthmatters is a highly-personalized health dashboard.
Instead of searching for your lab results in different places or tracking them down from different providers, Healthmatters houses, organizes, and interprets them all in one central location.
With a Healthmatters account, you can dive into the details of each biomarker and gain insights into the meaning behind your medical test data, anytime, anywhere.
For our professional users, Healthmatters provides intuitive tools that not only streamline analysis but also save valuable time when delving into your client's lab report history.
Healthmatters.io personal account provides in-depth research on 4000+ biomarkers, including information and suggestions for test panels such as, but not limited to:
You can combine all test reports inside your Healthmatters account and keep them in one place. It gives you an excellent overview of all your health data. Once you retest, you can add new results and compare them.
If you are still determining whether Healthmatters support your lab results, the rule is that if you can test it, you can upload it to Healthmatters.
While we work with many popular labs, we welcome reports from lots of other places too.
It's as simple as this: if you can get a test done, you can upload it to Healthmatters and we can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.
If you’re on the hunt for a specific biomarker, contact us and we'll add it to our database. Anything from blood, urine, saliva, or stool can be uploaded, understood, and tracked with your Healthmatters account.
There are two ways to add your test reports to your Healthmatters account. One option is to input the data using the data entry forms. The other method is to utilize our "Data entry service."
Our data entry forms offer an easy, fast, and free way for you to input the reports yourself. Self-entry allows you to add an unlimited number of reports at no cost. We make the self-entry process user-friendly, providing dozens of templates that pre-populate the most popular laboratory panels and offering instant feedback on entered values.
For those who prefer assistance, we offer a "Data entry service" to help you input your data. Simply attach an image or file of your lab test results, and a qualified team member from our data entry team will add the results for you.
We support various file types, including PDFs, JPGs, or Excel. This service is particularly useful if you have many reports to upload or if you're too busy to handle the data entry yourself.
Our special data entry service makes it easy to add your results to your private dashboard. Just attach an image or a file of your lab test results, and our skilled data entry team will do the work for you. It's all done by humans, ensuring that your data is entered accurately and with personal care for each client.
Depending on your account, the data entry service can be included for free or come at an additional cost of $15 per report.
For users on the Complete monthly plan, the first report is entered free of charge, and each additional report incurs a fee of $15.
Unlimited account holders enjoy the entry of ten reports without charge. Subsequent reports are subject to a $15 fee per report.
Additionally, users on the Complete plan can upgrade to a yearly subscription from the account settings. The annual subscription includes a data entry service for five reports.
The Unlimited plan is a one-time purchase for $250, and it covers your account for a lifetime with no additional payments.
For the Complete plan, the cost is $15 per month. You have the flexibility to cancel it anytime through your account settings, ensuring no further payments. To avoid charges, remember to cancel at least a day before the renewal date. Once canceled, the subscription remains active until the end of the current billing cycle.
Additionally, you can upgrade to the yearly Advanced plan from within your account. The annual cost is $79, and it comes with a data entry service for five reports.
You can always upgrade to a lifetime version with a prorated price from a monthly or yearly subscription.
Simply log in and navigate to your account settings to cancel your subscription. Scroll down to locate the 'Cancel' button at the bottom of the page. Ensure you cancel at least one day before the renewal date to prevent any charges. Once cancellation is requested, the subscription remains active until the conclusion of the current billing cycle.
Our goal has been to make your Healthmatters account as intuitive as possible.
We’ve crafted multiple ways for you to navigate your data, whether you're glancing at a single report or delving into your historical test reports.
1. Graph View:Dive into a visual journey with our biomarker graphs, showcasing over 40 data points. Combining years of results unveils trends, empowering you to make informed decisions. Our visualization tools make it a breeze to compare and understand changes over time, even if your results are from different labs. A search function and filters simplify the exploration of extensive data, allowing you to focus on what needs attention.
2. All Tests ViewExplore neatly organized reports on a timeline, highlighting crucial details like dates, critical results, and lab/panel names. Each report opens up to reveal in-depth descriptions and additional recommendations for each biomarker. The history of previous results is just a click away, and you can download a comprehensive report for deeper insights. Color-coded and user-friendly, it's designed for easy reading, understanding, and navigation.
3. Table View:For a holistic view of all biomarkers side by side, our table view is your go-to. Results are neatly displayed in a categorized and dated table, ideal for those with an extensive test history. Utilize sorting, filters, and color-coding to enhance your analysis and gain extra insights.
Yes, you can download information from your account. We can compile your labs into a CSV file. To download all your labs, you can go to Account Settings, and at the bottom of the page, you will find a link to download your information.
Yes, you can print your report. To do so, navigate to "All tests" and open the report you wish to print. You'll find a print button in the right corner of the report. Click on it, and your browser's print window will open. If you prefer to print in a bigger typeface, adjust the scale using the print window settings.
Yes, you can! We highly recommend activating Two-Factor Authentication (2FA) for your account. To do so, please navigate to the "Profile and Security" section of your account, where you will find instructions for activating 2FA.
Yes, you can. When entering values for the biomarker, you will see an "Edit Range" button. Click this button, and you'll have the option to enter a custom range.
A personal account is all about keeping your own lab test results in check. It's just for you and your personal use.
The professional account is designed for health professionals who wish to track and organize their clients' laboratory results.
To learn more about Healthmatters Pro, please refer to the professional page.
At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. We've put industry-leading security standards in place to help protect against the loss, misuse, or alteration of the information under our control. We use procedural, physical, and electronic security methods designed to prevent unauthorized people from getting access to this information. Our internal code of conduct adds additional privacy protection. All data is backed up multiple times a day and encrypted using SSL certificates. See our Privacy Policy for more details.
