Adrenal Stress Profile Overview

The Adrenal Stress Profile measures cortisol levels at strategic times during the day (to assess deviations from normal 24-hour rhythms) and measures the most abundant form of DHEA known as DHEA sulfate (DHEA-S). Only free (unbound) circulating and biologically active hormones are measured in this profile.

For many individuals chronic stress can disrupt metabolism and ultimately contribute to neurological conditions, gastrointestinal symptoms, skin issues, disruption of thyroid hormone production and balance; and other complications.4-9 Cortisol increases gut permeability thereby contributing to food sensitivities, resulting in more symptoms and increased stress. 10

Chronic stress ultimately disrupts the circadian rhythm of the body. This disruption can be assessed by measuring levels of the stress hormone cortisol (increased during stress) and the “de-stress” hormone DHEA (reduced during stress).11-15 In this DHEA and cortisol are inversely related, precursors (made from cholesterol) that would ordinarily be used to make DHEA are taken and shifted into cortisol production.16 The resulting increase in the cortisol:DHEA ratio reflects a state of “emergency” versus a state of “repair and relax.” Assessing the balance and ratio of these two hormones provides insight into how the body is handling and responding to stress. This profile may also identify insufficient cortisol production related to a complex response to chronic stress.17 Evaluating several samples over time can help identify changes in hormone patterns that reflect a maladaptive response to stress and may provide guidance for therapeutic intervention.


Cortisol and DHEA-S are tested through the enzyme-linked immunosorbent assay (ELISA) from saliva samples collected throughout the day and evening.

Who Should Test

Individuals presenting with signs or symptoms of prolonged stress or chronic metabolic dysfunction are candidates for adrenal testing. Test results may suggest that a patient is actively under stress or that a prolonged stress response has progressed into a dysfunctional hormonal pattern. For example persistent stress may lead to a decrease in cortisol in the morning when it is needed most and/or an increase at night when levels should be declining.

Adrenal hormone imbalance and potential disorders

  • Neurological conditions such as Chronic fatigue syndrome, mood disorders, depression, anxiety, memory loss 5, 18-22
  • Metabolic disorders such as menstrual irregularities, obesity, thyroid diseases 4, 6, 23
  • Cardiovascular diseases such as myocardial infarction, heart diseases 11, 24, 25
  • Gastrointestinal disorders such as constipation, diarrhea, reflux 9
  • Skin disorders such as eczematous dermatitis, psoriasis, decreased skin elasticity 8, 26
  • Inflammatory and Immune dysfunction such as more prone to infections, autoimmune disease 7,12, 24, 26-28

Collection Schedule

The adrenal stress profile provides six vials and a plastic straw for collection. While only five collections are required, an optional sixth collection is recommended for deeper insights into adrenal function.

1st collection – within 30 minutes of waking up, before 8 am
2nd collection – 1.5 hours after initial collection, before 10 am
3rd collection – noon to 1 pm
4th collection – approximately 5 pm
5th collection – bedtime, before midnight
6th collection (optional) – for best results, collect 6th sample approx. 2 hours prior to patient's normal waking time

Clear test results with smart commentaries

Easy to understand color-coded test report compares patient results to reference ranges for cortisol and DHEA along with research based result specific Smart Commentaries.

About our lab

Cell Science Systems, Corp. is a specialty clinical laboratory that develops and performs laboratory testing in immunology and cell bioligy supporting the personalized treatment and prevention of chronic disease. Cell Science Systems, Corp. operates a CLIA certified laboratory and is an FDA inspected and registered, cGMP medical device manufacturer meeting ISO EN13485 2012 standards.

Committed to quality

Cell Science Systems fulfills high quality standards in accordance with state, federal and international regulations.

  • CLIA-ID#10D0283906
  • CE Marked. TUV Certified and safety monitored
  • Supported by the EU and the State of Brandenburg
  • ISO 13485:2003 + AC:2012

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9 Mönnikes H, Tebbe JJ, Hildebrandt M, Arck P, Osmanoglou E, Rose M, Klapp B, Wiedenmann B, Heymann-Mönnikes I. Role of stress in functional gastrointestinal disorders. Evidence for stress-induced alterations in gastrointestinal motility and sensitivity. Dig Dis. 2001;19(3):201-11.

10 Yang PC, Jury J, Söderholm JD, Sherman PM, McKay DM, Perdue MH. Chronic psychological stress in rats induces intestinal sensitization to luminal antigens. Am J Pathol. 2006 Jan;168(1):104-14.

11 McCraty R, Barrios-Choplin B, Rozman D, Atkinson M, Watkins AD. The impact of a new emotional self-management program on stress, emotions, heart rate variability, DHEA and cortisol. Integr Physiol Behav Sci. 1998 Apr-Jun;33(2):151-70.

12 Butcher SK, Killampalli V, Lascelles D, Wang K, Alpar EK, Lord JM. Raised ortisol:DHEAS ratios in the elderly after injury: potential impact upon neutrophil function and immunity. Aging Cell. 2005 Dec;4(6):319-24

13 Traish AM, Kang HP, Saad F, Guay AT. Dehydroepiandrosterone (DHEA)—a precursor steroid or an active hormone in human physiology. J Sex Med. 2011 Nov;8(11):2960-82.

14 Lennartsson AK, Kushnir MM, Bergquist J, Jonsdottir IH. DHEA and DHEA-S response to acute psychosocial stress in healthy men and women. Biol Psychol. 2012 May;90(2):143-9.

15 Lennartsson AK, Theorell T, Kushnir MM, Bergquist J, Jonsdottir IH. Perceived stress at work is associated with attenuated DHEA-S response during acute psychosocial stress. Psychoneuroendocrinology. 2013 Sep;38(9):1650-7.

16 Anderson, D. Assessment and nutraceutical management of stress-induced adrenal dysfunction. Integrative Medicine 2008;7(5).

17 Miller GE, Chen E, Zhou ES. If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. Psychol Bull. 2007 Jan;133(1):25-45

18 Delmirack, M.A. et al. Evidence for impaired activation of the hypothalamic-pituitary-adrenal axis in patients with chronic fatigue syndrome. J. Clin. Endocrin. Metab. 1991.73:1224-1234.

19 Blood, GW et al. Subjective anxiety measurements and cortisol responses in adults who stutter. J. Speech and Hear. Res. 1994. 37:760-768.

20 Boscarino JA. Posttraumatic stress disorder and physical illness: results from clinical and epidemiologic studies. Ann N Y Acad Sci. 2004 Dec;1032:141-53.

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22 Bertorini TE, Perez A. Neurologic complications of disorders of the adrenal glands. Handb Clin Neurol. 2014;120:749-71.

23 Hang Din, JU., et al. 1988. High serum cortisol levels in exercise associated amenorrhea. Ann. Int. Med. 108:530-534.

24 Stahl, H., et al. Dehydroepiandrosterone (DHEA) levels in patients with prostatic cancer, heart diseases and under surgery stress. Exp. Clin. Endocrin. 1992. 99:68-70.

25 Donald, R. A. et al. Plasma corticotrophin releasing hormone, vasopressin, ACTH and cortisol responses to acute myocardial infarction. Clin. Endocrin. 1994. 40:499-504.

26 Lind M. Cure of Psoriasis and Arthritis when Addison's Disease Was Detected. Case Rep Dermatol. 2010 Jun 1;2(2):95-98.

27 Loria, RM et al. Protection against acute lethal viral infections with the native steroid dehydroepiandrosterone (DHEA). J. Med. Virol. 1988.26:301-314.

28 Jacobson, MA et al. Decreased serum dehydroepiandrosterone is associated with an increased progression of human immunodeficiency virus infection in men with CD4 cell counts of 200-499. J. Infect. Dis. 1991.164:864-868.