Page 1 - Saliva Cortisol Testing

The Importance of Accurate Cortisol Testing to Understand Stress Levels

Submitted by the International Autoimmune Institute & Bingham Memorial Center for
Functional Medicine

Autoimmune disease is recognized as a major health crisis in the United States. Today, 50
million Americans—80 percent of whom are women—suffer one or more autoimmune
conditions. Thirty years ago, only one in 400 people developed an autoimmune disease. Today,
one in 12 Americans—one in nine women—have an autoimmune disease. More women are
diagnosed each year with an autoimmune disease than breast cancer and cardiovascular disease
combined.

An autoimmune disease is a condition in which the immune system mistakenly attacks the
body’s own tissue. Some of the more common conditions include rheumatoid arthritis, lupus,
multiple sclerosis, psoriasis, Hashimoto’s thyroiditis, type 1 diabetes, and ulcerative colitis or
Crohn’s disease, but the National Institutes of Health estimates there are more than 100 types of
autoimmune diseases.

David J. Bilstrom, MD—the Director of the International Autoimmune Institute & Bingham
Memorial Center for Functional Medicine—explores why accurate cortisol testing is important
to understand how stress levels may be contributing to autoimmune disease.

What is cortisol?
Cortisol, often called the “stress hormone,” is a vitally important hormone that is necessary to
eliminate inflammation in the body. Cortisol is made by the adrenal gland that sits on top of the
kidneys.

“A good example of how cortisol reduces inflammation in your body is that cortisol turns into
cortisone—a steroid hormone that your body makes naturally to get rid of inflammation,” Dr.
Bilstrom says.

If somebody gets any benefit from using a steroid medication, whether it’s a steroid cream for a
rash, a steroid nasal spray, a steroid for asthma, a steroid injection for a bad knee, or oral
steroids, this always begs the question: “Why do they need a man-made steroid from the outside?
Why are they not making enough steroids on the inside of their bodies to get rid of this
inflammation on its own??

How is cortisol tested?
Ideally, cortisol should be the highest in the morning and slowly decrease throughout the day;
hitting its low point late in the evening in order to fall asleep easy. However, that isn’t the case
for many people.

“Often time’s cortisol is tested through a blood test and only tested in the morning,” Dr. Bilstrom
says. “Knowing that it should be different at different times in the day means that just testing in
the morning doesn’t give you enough information to understand what is going on.”