Clin Invest Med 2007; 30 (5): E183-E191.
AbstractPurpose: Current methods for measuring long-term endogenous production of cortisol can be challenging due to the need to take multiple urine, saliva or serum samples. Hair grows approximately 1 centimeter per month, and hair analysis accurately reflects exposure to drug abuse and environmental toxins. Here we describe a new assay for measurement of cortisol in hair, and determined a reference range for non-obese subjects. Methods: For measurement of cortisol in hair we modified an immunoassay originally developed for measuring cortisol in saliva. We compared hair samples obtained from various parts of the head, and assessed the effect of hair dying. We analyzed hair samples from non-obese subjects, in whom we also obtained urine, saliva and blood samples for cortisol measurements. Results: The mean extraction recovery for hair cortisol standards of 100 ng/ml, 50 ng/ml and 2 ng/ml (n=6) was 87.9%, 88.9% and 87.4%, respectively. Hair cortisol levels were not affected by hair color or by dying hair samples after they were obtained. Cortisol levels were decreased in hair that was artificially colored before taking the sample. The coefficient of variation was high for cortisol levels in hair from different sections of the head (30.5%), but was smaller when comparing between hair samples obtained from the vertex posterior (15.6%). The reference range for cortisol in hair was 17.7-153.2 pg/mg of hair (median 46.1 pg/mg). Hair cortisol levels correlated significantly with cortisol in 24-hour urine (r=0.33; P=0.041).
Conclusion:The correlation of hair cortisol with 24-hour urine cortisol supports its relevance as biomarker for longterm exposure.Cortisol is a glucocorticoid hormone produced by the adrenal glands. In humans, cortisol levels are increased in severe stress, depression, and selected systemic diseases such as Cushing's syndrome. Proper assessment of endogenous cortisol secretion is required to adequately determine its relation to these clinical conditions. For that end, cortisol is currently measured in saliva, serum and urine. While each of these measurements has advantages and limitations, all these methods require multiple samples to provide an assessment of cortisol levels over prolonged periods of time. Furthermore, due to diurnal variations