Cortisol is a key stress hormone, and its measurement depends on the clinical question. In medical diagnostics (e.g., Cushing's syndrome, adrenal insufficiency), saliva, serum, or 24-hour urine cortisol is used, often combined with a dexamethasone suppression test. For consumer use, there are home test kits (saliva, hair) that claim to map daily cortisol patterns. However, interpretation is challenging: cortisol has a strong circadian rhythm (high in the morning, low at night) and is influenced by acute stress, sleep deprivation, diet, and medications. A single reading is rarely meaningful. DNA tests that claim to analyze cortisol-related gene variants lack clinical validity – regulation is too complex. Anyone with symptoms like chronic fatigue, weight gain, or sleep issues should seek medical evaluation rather than relying on self-testing. Without professional guidance, home cortisol tests can lead to misinterpretation and unnecessary worry. Evidence: practice-based for clinical use; weak for consumer self-tests.
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