Explore 10,000+ laboratory markers, in plain English.

A stress hormone produced by the adrenal glands

A stress hormone produced by the adrenal glands

A stress hormone produced by the adrenal glands

This is the first sample upon waking up and the value represents cortisol for the entirety of the night.

A stress hormone produced by the adrenal glands

Normally, cortisol levels rise within 10 to 30 minutes of waking

CAR

This is the 2nd cortisol sample of the day. Usually measured 30 to 60 minutes after waking.

Initial cortisol level measured

Cortisol is the main glucocorticoid released from the adrenal gland in response to stress. High levels of cortisol have been reported in cases of Cushing’s disease, malnutrition, early life stress, hypothyroidism, depression, alcoholism, obesity, and critical illness. Additionally, exogenous exposure to glucocorticoids prior to testing may be a source of cortisol elevations.

Stress hormone

This is the 3rd cortisol sample of the day (=afternoon levels)

Cortisol Clearance Rate (CCR) is a ratio on the DUTCH report that shows how quickly your body is metabolizing and clearing cortisol by comparing total cortisol metabolites (THF + THE) to free cortisol and cortisone measured over the day. A higher ratio means faster clearance, which can make free cortisol appear low even when production is high, while a lower ratio means slower clearance, which can leave free cortisol elevated and “feel” like high cortisol. CCR provides important context for symptoms such as fatigue, sleep issues, mood changes, weight shifts, and stress tolerance, and is best interpreted alongside related markers like 24-hour free cortisol, metabolized cortisol, and the Cortisol Awakening Response (CAR). Factors such as thyroid function, liver/kidney metabolism, BMI, stimulants, and medications can all influence CCR, which is why it should not be interpreted in isolation but rather with your full report and clinical guidance.

This is the 4th cortisol sample of the day (=evening/night)

main glucocorticoid released from the adrenal gland in response to stress

Stress hormone

This is the 3rd cortisol sample of the day (=evening levels)

This is the 4th cortisol sample of the day (=night)

A stress hormone produced by the adrenal glands

Cortisol, a glucocorticoid hormone synthesized from cholesterol in the adrenal cortex, plays a pivotal role in the human body's response to stress, metabolism regulation, immune response modulation, and maintenance of homeostasis. The "Cortisol Profile, Afternoon" specifically refers to the measurement of cortisol levels during the afternoon hours, a critical time point given cortisol's diurnal variation. Typically, cortisol levels peak in the early morning, shortly after waking, and decline throughout the day to reach their lowest levels at midnight. However, the afternoon cortisol levels are not merely an intermediate point in this daily cycle; they provide valuable insights into an individual's adrenal function and stress response. Measuring cortisol in the afternoon can be instrumental in diagnosing conditions such as Addison's disease, characterized by insufficient cortisol production, or Cushing's syndrome, marked by excessive cortisol levels. In healthy individuals, afternoon cortisol levels should reflect the downward trajectory of the diurnal cycle. Deviations from expected patterns can indicate disruptions in the hypothalamic-pituitary-adrenal (HPA) axis, which controls cortisol secretion. Furthermore, afternoon cortisol measurements can be affected by factors such as stress, sleep patterns, physical activity, and certain medications, making them a sensitive marker for assessing the impact of lifestyle factors on an individual's hormonal balance and stress physiology. Scientifically, the utility of the "Cortisol Profile, Afternoon" extends beyond diagnostic purposes; it also offers insights into the complex interplay between neuroendocrine rhythms and psychosocial stressors, contributing to a broader understanding of how chronic stress impacts physical health over time. Research employing afternoon cortisol measurements has been pivotal in elucidating the physiological mechanisms underlying stress-related disorders, emphasizing the importance of maintaining a balanced cortisol rhythm for overall health and well-being.