Clinical applications of cortisol measurements in hair

Abstract

Cortisol measurements in blood, saliva and urine are frequently used to examine the hypothalamus-pituitary-adrenal (HPA) axis in clinical practice and in research. However, cortisol levels are subject to variations due to acute stress, the diurnal rhythm and pulsatile secretion. Cortisol measurements in body fluids are not always a reflection of long-term cortisol exposure. The analysis of cortisol in scalp hair is a relatively novel method to measure cumulative cortisol exposure over months up to years. Over the past years, hair cortisol concentrations (HCC) have been examined in association with a large number of somatic and mental health conditions. HCC can be used to evaluate disturbances of the HPA axis, including Cushing's syndrome, and to evaluate hydrocortisone treatment. Using HCC, retrospective timelines of cortisol exposure can be created which can be of value in diagnosing cyclic hypercortisolism. HCC have also been shown to increase with psychological stressors, including major life events, as well as physical stressors, such as endurance exercise and shift work. Initial studies show that HCC may be increased in depression, but decreased in general anxiety disorder. In posttraumatic stress disorder, changes in HCC seem to be dependent on the type of traumatic experience and the time since traumatization. Increased hair cortisol is consistently linked to obesity, metabolic syndrome and cardiovascular disease. Potentially, HCC could form a future marker for cardiovascular risk stratification, as well as serve as a treatment target.

Hair cortisol and self-reported stress in healthy, working adults

“…Evidence is accumulating for the potential application of HCC in clinical and epidemiological studies (Wester and van Rossum, 2015;Wosu et al, 2013) and various relationships have been demonstrated between HCC and, for example, Cushing's Syndrome (Manenschijn et al, 2012), cardiovascular disease (Manenschijn et al, 2013), depression and mood disorders (Dettenborn et al, 2012b), and anxiety (Steudte et al, 2011). However, the association between HCC and subjectively measured stress remains unclear.…”

Hair cortisol and cortisone are decreased by natural sunlight

“…Over the past decade, the measurement of cortisol and cortisone in scalp hair has emerged as a method to estimate the long-term exposure to glucocorticoid hormones in humans (Gao et al, 2015;Wester and van Rossum, 2015). Increased hair cortisol (HairF) and/or cortisone (HairE) have been linked to psychopathology, physical and psychological stressors, and the cardiovascular risk profile (Wester and van Rossum, 2015).…”

“…Increased hair cortisol (HairF) and/or cortisone (HairE) have been linked to psychopathology, physical and psychological stressors, and the cardiovascular risk profile (Wester and van Rossum, 2015). Furthermore, they are promising markers in the evaluation of endocrine diseases of the HPA axis (e.g.…”

Biomarkers for Hearing Dysfunction: Facts and Outlook

“…As such, cortisol (human) or corticosterone (rodents) are promising candidates for biomarker status, as they can be noninvasively collected from urine, saliva, blood, or hair follicles [22,[134][135][136] . Glucocorticoids (GCs), secreted from the adrenals in hourly pulses and after stress with the goal of maintaining resilience and health, display an impressive diversity of actions, mediated by mineralocorticoid and GC receptors [137,138] .…”