Is Cortisol Testing Accurate?
Aug 12, 2024Testing cortisol on a single day doesn’t accurately reflect your true cortisol levels, even with the DUTCH test. Cortisol fluctuates significantly and is influenced more by situational factors than by long-term traits. Some common factors that affect cortisol include:
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Time of awakening, time of day
- Thyroid status
- Illness & inflammation
- Sleep duration and quality
- Ambient light levels
- Seasons
- Weekdays vs. weekends
- Prior day experiences and anticipation of the day ahead (prospective memory load)
- Eating habits and macronutrient distribution
- Smoking, alcohol, exercise, and caffeine
- Gender, socioeconomic status, race, and age
To get a precise picture, ideally, you’d need to test five times, spaced three months apart, with each visit involving three days of sampling and six collections per day (PMID: 24119668). Since this approach is impractical, a more feasible method is to take 4-6 samples over 1-2 weeks, including both workdays and days off, at the same time each day. While this won't assess your diurnal rhythm or cortisol awakening response (CAR), it will give you a better sense of whether your cortisol levels are generally high or low.
In addition to testing, consider these symptoms of cortisol imbalance:
Low Cortisol Symptoms:-
Lack of appetite
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Stomach pain
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Body aches
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Muscle cramps
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Dizziness
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Salt cravings
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Orthostatic hypotension
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Low blood pressure
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Hypoglycemic symptoms (low blood sugar)
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Low-normal sodium and high-normal potassium on blood work
High Cortisol Symptoms:-
Easy bruising
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High blood pressure
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Poor wound healing
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Acne
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Muscle weakness
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Weight gain
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Elevated glucose despite healthy habits
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Elevated HbA1c despite healthy habits
Many of my women clients have imbalanced cortisol levels. Using both testing and symptom assessment is a reliable way to determine your cortisol status
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