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Please note that if you buy through links in this article, Medical News Today may earn a small commission. Here’s their process. Cortisol is a hormone with various functions throughout the body. However, if a person’s body cannot regulate their cortisol levels, it could lead to a serious health condition. In these cases, home cortisol tests may be useful to indicate when someone might need medical attention. This article discusses: what cortisol is what a home cortisol test is why a person might buy a home cortisol test some home cortisol tests to purchase online when to see a doctor What is cortisol? Cortisol is the stress hormone that affects several systems in the body, including the: nervous system immune system cardiovascular system respiratory system reproductive system musculoskeletal system integumentary system The adrenal glands produce cortisol. Most human body cells have cortisol receptors, and the hormone can help in several ways, including: reducing inflammation regulating metabolism assisting with memory formation controlling blood pressure developing the fetus during pregnancy maintaining salt and water balance in the body controlling blood sugar levels All these functions make cortisol a vital part of maintaining overall health. If the body can no longer regulate cortisol levels, it can lead to several health disorders, such as Cushing’s syndrome and Addison’s disease. Without treatment, these conditions could cause life threatening complications. The body requires certain cortisol levels during times of stress, such as: in the event of an injury during illness during a surgical procedure What are home cortisol tests? A cortisol test usually involves a blood test. However, some may require saliva and urine samples instead. There are several home cortisol tests available to purchase over the counter or online. These allow a person to take a sample of blood, urine, or saliva before sending it off for analysis. After taking a home cortisol test, people can usually receive their results within 2–5 days online or via a telephone call with a healthcare professional. However, there are currently no studies investigating the reliability of these home cortisol tests. Therefore, people should follow up on their test results with a healthcare professional. Why and when do people need them? A person should take a home cortisol test if they feel they may have a cortisol imbalance. If cortisol levels are too high, a person may notice the following: rapid weight gain in the face, chest, and abdomen high blood pressure osteoporosis bruises and purple stretch marks mood swings muscle weakness an increase in thirst and need to urinate If cortisol levels are too low, a person may experience the following symptoms: fatigue loss of appetite unintentional weight loss muscle weakness abdominal pain Additionally, low cortisol levels may lead to: low blood pressure low blood sugar low blood sodium high blood potassium A test can help individuals check their cortisol levels. If the test results show these levels are too high or too low, people should seek medical advice. A cortisol imbalance may be a sign of an underlying condition, which can lead to serious complications without treatment. If a person cannot carry out a home cortisol test, they should speak to a medical professional who can arrange a cortisol test at a healthcare facility. What to look for in a home cortisol test At a clinic or hospital setting, a medical professional will usually take a blood sample and analyze it for an individual’s cortisol levels. Home cortisol tests involve a person taking a sample of blood, urine, or saliva. There are currently no studies investigating the accuracy of these results. However, home cortisol tests may be faster and more convenient than making an appointment with a doctor to take a sample. People may consider several factors when deciding to purchase a home cortisol test, including: Sample type: Some tests require a blood sample, while others need a sample of urine or saliva. With this in mind, a person may wish to buy a product that uses a testing method they are comfortable providing. Test analysis: A person may wish to purchase a product from a company that sends tests to Clinical Laboratory Improvement Amendments (CLIA)-certified labs for analysis. The Food and Drug Administration (FDA), Center for Medicaid Services, and the Centers for Disease Control and Prevention (CDC) regulate these labs to help ensure safety and accuracy. Accuracy: Individuals may wish to speak to a pharmacist or other healthcare professional before purchasing to ensure the test is reliable and accurate. Products Several online retailers offer home cortisol tests. It is important to follow all test instructions to ensure a valid result. Please note, the writer has not tested these products. All information is research-based. LetsGetChecked – Cortisol Test This cortisol test uses the finger prick method to draw blood for the sample. Here are the steps to take and send off a blood sample: Individuals fill in their details on the collection box and activate their testing kit online at the LetsGetChecked website. People need to wash their hands with warm soapy water before using an alcohol swab to clean the finger that they will prick. Once the finger is completely dry, individuals pierce the skin using the lancet in the test kit. A person must wipe away the first drop of blood before squeezing some into the blood collection tube. After closing the tube, individuals must invert it 5–10 times before placing it in the included biohazard bag, which they then place in the box. After following these steps, people can send the sample back to LetsGetChecked using the kit’s prepaid envelope. Test results usually come back within 2–5 days. LetsGetChecked tests samples in the same labs that primary care providers, hospitals, and government schemes use. These labs are CLIA-certified and CAP-accredited. The company also has a team of nurses and doctors available 24 hours a day, 7 days a week, to offer ongoing support. These healthcare professionals are on hand to discuss a person’s results with them over the phone. Everlywell At-Home Cortisol Levels Test Kit – Sleep & Stress Test This Everlywell product uses a urine sample to test a person’s cortisol levels. The test measures the levels of three hormones in a person’s body: cortisol, cortisone, and melatonin. It also measures a person’s creatinine levels. There are three steps with this test: Individuals register their testing kit on Everlywell’s website. A person follows the instructions carefully to take their urine sample. Once they have their urine sample, they place it in the prepaid package and send it off to Everlywell’s labs. Within a few days, individuals will receive their results digitally via the Everlywell website. Medical professionals can also offer helpful insights via their secure platform. As well as sending a personalized report of each marker, Everlywell also sends detailed information about what the results mean. The labs where Everlywell tests samples all carry certification with CLIA. The company also ensures that all results are reviewed and certified by independent board-certified physicians within the person’s specific state.SHOP NOW Healthlabs Cortisol, AM & PM Test Healthlabs offers a cortisol test that tests a person’s cortisol levels twice — once in the morning and once in the evening. The company says they do this because a person’s cortisol levels fluctuate throughout the day. Therefore, by testing twice, they can gather information on this fluctuation. This test uses a blood sample, which a person takes once in the morning and once in the afternoon. They must follow the instructions clearly to ensure they take suitable samples. The manufacturer says that people should collect a morning sample between 7–9 a.m. and an evening sample between 3–5 p.m. They then need to send off their sample for analysis. After testing is complete at a CLIA-certified lab, a person will receive their results, which usually takes between 1–2 days. SHOP NOW When to speak with a doctor A person should undergo a cortisol test if they believe they may have high or low cortisol levels. They can do this at home or speak with a medical professional who can carry out the test for them. People may also wish to seek medical help if they show signs of too much or too little cortisol. This could indicate a potentially serious underlying health issue. Summary Cortisol is an important hormone that affects almost all parts of the body. It has many functions, including reducing inflammation, regulating metabolism, and controlling blood pressure. If a person believes they have high or low cortisol levels, they may wish to take a cortisol test. Usually, these tests take place at a medical practice. However, several home cortisol tests are available to purchase. A person can take these tests at home by providing a urine, blood, or saliva sample. Once a lab analyzes the test, people usually receive their results within a few days. Individuals should follow up any test results with a healthcare professional. No clinics, no stress. Test your cortisol levels from home Test your cortisol level from home with LetsGetChecked. Get free shipping, medical support, and results from accredited labs within 2–5 days. Order today for 30% off. LEARN MORE Last medically reviewed on April 29, 2021 at https://www.medicalnewstoday.com/articles/3-of-the-best-home-cortisol-tests
John P H Wilding 1 Affiliations expand PMID: 32061161 DOI: 10.1530/EJE-20-0099 Abstract Endocrine disorders such as Cushing's syndrome and hypothyroidism may cause weight gain and exacerbate metabolic dysfunction in obesity. Other forms of endocrine dysfunction, particularly gonadal dysfunction (predominantly testosterone deficiency in men and polycystic ovarian syndrome in women), and abnormalities of the hypothalamic-pituitary-adrenal axis, the growth hormone-IGF-1 system and vitamin D deficiency are common in obesity. As a result, endocrinologists may be referred people with obesity for endocrine testing and asked to consider treatment with various hormones. A recent systematic review and associated guidance from the European Society of Endocrinology provide a useful evidence summary and clear guidelines on endocrine testing and treatment in people with obesity. With the exception of screening for hypothyroidism, most endocrine testing is not recommended in the absence of clinical features of endocrine syndromes in obesity, and likewise hormone treatment is rarely needed. These guidelines should help reduce unnecessary endocrine testing in those referred for assessment of obesity and encourage clinicians to support patients with their attempts at weight loss, which if successful has a good chance of correcting any endocrine dysfunction. Similar articles Classical endocrine diseases causing obesity. Weaver JU.Front Horm Res. 2008;36:212-228. doi: 10.1159/000115367.PMID: 18230905 Review. Is obesity an endocrine condition? Stocks AE.Aust Fam Physician. 1977 Feb;6(2):109-16.PMID: 558747 FPIN’s clinical inquiries. Secondary causes of obesity. Allen G, Safranek S.Am Fam Physician. 2011 Apr 15;83(8):972-3.PMID: 21524038 No abstract available. [Role of the endocrine system in the pathogenesis of non-alcoholic fatty liver disease]. Hagymási K, Reismann P, Rácz K, Tulassay Z.Orv Hetil. 2009 Nov 29;150(48):2173-81. doi: 10.1556/OH.2009.28749.PMID: 19923096 Review. Hungarian. Obesity and endocrine disease. Kokkoris P, Pi-Sunyer FX.Endocrinol Metab Clin North Am. 2003 Dec;32(4):895-914. doi: 10.1016/s0889-8529(03)00078-1.PMID: 14711067 Review. From https://pubmed.ncbi.nlm.nih.gov/32061161/
I'm going to make a very long story somewhat short here.... I have had all kinds of health issues over the last 10-12 years that has lead me to many Dr's, mis-diagnosis and giving up on figuring it out. Nov. 2018 my normal nausea and vomiting turned into turned into vomiting everything I ate or drank and by early Feb 2019 I ended up seeing my PCP. She sent me for an abdominal CT scan as well as to a Gastroenterologist. Blood work found nothing, gastric emptying study was only half completed because I got sick (but was normal). The CT scan however showed a 4.4CM adrenal adenoma on my left adrenal gland as well as a few small nodules in my left lung. I was sent for a follow up CT scan with contrast related to the adrenal nodule- adrenal mass 4.4cm HU13 washout 79%. I'm told this means that it's most likely not cancer or functioning. I really don't know anything and I move on. Still no relief to issues going on. I go to see an acupuncturist and during the consult they mentioned Cushings syndrome. I bring that up and my Dr blows me off. I requested a referral to an endocrinologist, and am told no. A few months pass with no change other than less control for diabetes. Dr. says I should see an endo, however the endocrinologist denied the referral. HMO's can be so horrible. So I appeal it, they decide to test my blood cortisol 8 am. It's normal. Appeal was denied, followed by two more appeals. The final appeal goes to an independent review board and they overturn HMO's ruling and I get to see an endo (this was just a couple weeks ago). Due to Covid they are only doing phone appointments so no exam, endo was nice but didn't really think too much of all my symptoms or anything. Kept referring back to radiology stating that it isn't cancer/functioning, but decides to run tests. His notes related to tests, as well as results are below. He was honestly irritated when I asked questions (mainly on ACTH, I asked what is considered low. He said there is no low ACTH), he mentioned he went to school an additional 6 years to be an endo..blah blah blah. I am taking dexamethasone tonight, hoping that will help. Am I crazy to keep pursuing? Dr's and honestly family make me feel like I am losing it, making symptoms up. etc. Screening overall negative - 24 hour urine free cortisol minimally elevated - - equivical results < 2 x ULN and not consistent with cushing's syndrome. No change in her symptoms Overall based on past work up and imaging - suggest this is a benign, non functional adenoma. Given size - would merit annual biochemical screening and 1-2 imaging.... TOTAL TESTOSTERONE 4 ng/dL DHEA SO4 24 mcg/dL CORTISOL 7.9 mcg/dL ACTH 7 pg/mL 24 hr URINE FREE CORTISOL 96.3 mcg/24hr (H) TSH 2.17 mcIU/mL NORMETANEPHRINE, 24 HR URINE 469 mcg/24hr METANEPHRINE, TOTAL, 24H, URINE 505 mcg/24hr METANEPHRINE 24 HR UR 36 mcg/24hr (L) ALDOSTERONE 5 ng/dL RENIN ACTIVITY 2.63 ng/mL/hr ALDOSTERONE/RENIN RATIO 1.9 ratio
Abstract Despite various approaches to immunoassay and chromatography for monitoring cortisol concentrations, conventional methods require bulky external equipment, which limits their use as mobile health care systems. Here, we describe a human pilot trial of a soft, smart contact lens for real-time detection of the cortisol concentration in tears using a smartphone. A cortisol sensor formed using a graphene field-effect transistor can measure cortisol concentration with a detection limit of 10 pg/ml, which is low enough to detect the cortisol concentration in human tears. In addition, this soft contact lens only requires the integration of this cortisol sensor with transparent antennas and wireless communication circuits to make a smartphone the only device needed to operate the lens remotely without obstructing the wearer’s view. Furthermore, in vivo tests using live rabbits and the human pilot experiment confirmed the good biocompatibility and reliability of this lens as a noninvasive, mobile health care solution. INTRODUCTION The steroid hormone, cortisol, which is known as a stress hormone, is secreted by the adrenal gland when people are stressed psychologically or physically (1). This secretion occurs when the adrenal gland is stimulated by adrenocorticotropic hormone, which is secreted by the pituitary gland when it is stimulated by the corticotropin-releasing hormone secreted by the hypothalamus. This serial cortisol secretion system is referred to as a hypothalamus–pituitary gland–adrenal gland axis, which is affected by chronic stress, resulting in abnormal secretion of cortisol (2, 3). The accumulation of cortisol caused by the abnormal secretion of cortisol increases the concentrations of fat and amino acid, which can result in diverse severe diseases (e.g., Cushing’s disease, autoimmune disease, cardiovascular complications, and type 2 diabetes) and neurological disorders (such as depression and anxiety disorders) (2–7). In contrast, abnormally low cortisol levels can lead to Addison’s disease, which results in hypercholesterolemia, weight loss, and chronic fatigue (8). In addition, it was recently reported that plasma cortisol can be correlated to the prognosis of traumatic brain injury (9). Furthermore, the extent of cortisol secretion varies from person to person, and it changes continuously (10, 11). Thus, developing health care systems for real-time monitoring of the cortisol level has been explored extensively over the past decade as the key to the quantitative analysis of stress levels. Although various efforts have led to the development of cortisol sensors that can measure the concentration of cortisol in blood, saliva, sweat, hair, urine, and interstitial fluid (12–17), the accurate measurement of cortisol concentrations has been limited because of the difficulties associated with the transportation and storage of cortisol as well as the instability of the biologically active cortisol in these body fluids at room temperature. In addition, these conventional sensing methods require bulky equipment for the extraction and analysis of these body fluids, which is not suitable for mobile health care systems (12, 18). Therefore, the development of noninvasive and wearable sensors that can monitor cortisol concentration accurately is highly desirable for a smart health care solution. For example, the immunoassay method, which uses an antigen-antibody binding reaction, has been used extensively for electrochemical cortisol immunosensors using saliva and interstitial fluid, except tears (12, 14, 19). However, these immunosensors still require the use of bulky impedance analyzers for the analysis of the Nyquist plot from electrochemical impedance spectroscopy. Although the cyclic voltammetry (CV) technique can be used as an alternative approach for sensing cortisol, additional bulky electrochemical instruments still are necessary for analyzing the CV curves (13, 14, 19). Recently, wearable forms of cortisol sensors that use sweat were developed (15), but they still required bulky measurement equipment (15, 16). Therefore, portable and smart sensors that can monitor the accurate concentration of cortisol in real time are highly desirable for use in mobile health care. Among the various body fluids, tears, in particular, contain important biomarkers, including cortisol (20, 21). Thus, the integration of biosensors with contact lenses is a potentially attractive candidate for the noninvasive and real-time monitoring of these biomarkers from tears (22–25). However, an approach for fabricating a smart contact lens for sensing the cortisol in tears has not been demonstrated previously. Thus, here, we present an extraordinary approach for the formation of a smart, soft contact lens that enables remote, real-time monitoring of the cortisol level in the wearer’s tears using mobile phones. This smart, soft contact lens is composed of a cortisol sensor, a wireless antenna, capacitors, resistors, and integrated circuit chips that use stretchable interconnects without obstructing the wearer’s view. The components of this device (except the antenna) were protected from mechanical deformations by locating each of the components on discrete, rigid islands and by embedding these islands inside an elastic layer. A graphene field-effect transistor (FET; with the binding of monoclonal antibody) was used as this cortisol immunosensor, which exhibited a sufficiently low detection limit, i.e., 10 pg/ml, for its sensing of cortisol in human tears in which the cortisol concentration ranges from 1 to 40 ng/ml (26). This sensor was integrated with a near-field communication (NFC) chip and antenna inside the soft contact lens for the real-time wireless transmission of the data to the user’s mobile device (e.g., a smart phone or a smart watch). The antenna occupies a relatively large area of this soft lens, so it requires its high stretchability, good transparency, and low resistance for operating a standard NFC chip at 13.56 MHz. In our approach, the hybrid random networks of ultralong silver nanofibers (AgNFs) and fine silver nanowires (AgNWs) enabled high transparency and good stretchability of this antenna and its low sheet resistance for reliable standard NFCs (at 13.56 MHz) inside this smart contact lens. Thus, the fully integrated system of this smart contact lens provided wireless and battery-free operation for the simultaneous detection and transmission of the cortisol concentration from tears to a mobile phone using standard NFC. In addition, a human pilot trial and in vivo tests conducted using live rabbits demonstrated the biocompatibility of this lens, and its safety against inflammation and thermal/electromagnetic field radiation suggests its substantial usability as a noninvasive, mobile health care solution. RESULTS Cortisol immunosensor A graphene FET sensor was fabricated by binding the cortisol monoclonal antibody (C-Mab) to the surface of graphene for the immunosensing of cortisol. Here, graphene acts as a transducer that converts the interaction between cortisol and C-Mab into electrical signals. Figure 1A shows the immobilization process of C-Mab to graphene. Immobilization proceeds through amide bonding of the C-Mab onto the carboxyl group of the graphene surface via the EDC [1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride]/NHS (N-hydroxysulfosuccinimide) coupling reaction. A chemical vapor deposition–synthesized graphene layer was transferred onto a desired substrate and exposed to ultraviolet ozone (UVO) to activate the surface of the graphene with the carboxylate group. Figure S1 shows the contact angle between this surface of the graphene and a droplet of deionized (DI) water. Longer exposure time to UVO can decrease the hydrophobicity of graphene with decreasing the contact angle. Table S1 shows the increase in the electrical resistance of graphene that resulted from this UVO treatment. In our experiment, 2 min of exposure time to UVO decreased the contact angle from 70° to 38° without increasing the resistance of the graphene notably. UVO exposure times longer than this threshold time degraded the resistance of the graphene excessively, so the time of exposure of our samples to UVO was limited to 2 min. Figure S2A illustrates the process of immobilizing C-Mab through the EDC/NHS coupling reaction. This two-step coupling reaction of EDC and NHS can mediate the amide bonding between the carboxylate group of the UVO-exposed graphene and the amine group of the protein (12, 17, 27, 28). Here, EDC forms reactive O-acylisourea ester, thereby making the surface unstable. This O-acylisourea ester reacts with the NHS to form amine-reactive NHS ester with the surface still remaining semistable. Then, C-Mab with the amine group reacts with the amine-reactive NHS ester, thereby forming stable amide bonding that can immobilize C-Mab to the NHS on the surface of the graphene. Figure S2B shows the Fourier transform infrared (FTIR) spectroscopy spectra of the DI water after the cortisol sensor had been immersed for 24 hours. The spectra of the DI water in which the sensor was immersed were not significantly different from those of the pristine DI water. However, the C-Mab solution that had a concentration of 1 μg/ml had a significant peak intensity in the range of 3000 to 2800 cm−1, representing the N-H bonding in the C-Mab. These results indicated that C-Mab formed stable bonding on the carboxylated graphene and was negligibly detached by exposure to water. From https://advances.sciencemag.org/content/6/28/eabb2891