• Dr. Sarah Dimunno, ND

Testing Trends: Do You Need a Test to Tell You’re Stressed?

Stress. Its presence is always something I make sure to ask my patients about. We work together to identify stressors and how to manage them in a way to create a happier and healthier life. In some cases, stress management might actually be the reason a patient comes in. In other cases, stress is addressed only as part of a bigger picture. I find those that can’t pin point emotional stress usually deny stress being a part of their lives. However, stressors are demands we put on our body emotionally, AND physically. They can happen as one big event, several small events over time, or vice versa. Also, stress doesn’t always have to be “bad”. It can be something that you associate with motivation and excitement. Regardless, once the body labels something as a stressor, it sends out what is known as the stress response.

The Stress Response

The stress response is a cascade of signals through your body to help you get out of danger. Heart rate and respiration turn up. Things that won’t help you make a quick getaway like digestion, ovulation and immune function are turned off. The body releases adrenaline and cortisol in support of the stress response. The main job of cortisol is to make sure there is enough sugar in the blood to fuel your body in times of crisis (therefore cortisol release can be preventing you from loosing weight). The body can’t sustain living at this high level and begins to run out of resources after chronic exposure to stress. Bottom line - you burn out.

Cortisol as a Steroid Hormone

Once the stress response is weakened, the body begins to pull on other resources to continue to produce cortisol over other hormones. This further creates hormonal imbalances specifically including thyroid and menstrual irregularities as well as reducing insulin sensitivity.

Measuring Cortisol

Traditionally, cortisol is measured using blood, saliva, or dried urine with the latter being the most accurate. It’s important to collect samples from multiple points in the day to assess your cortisol slope with the morning having the biggest spike, a small spike in the afternoon and lowest levels before bed so you can fall asleep.

Do You Need it to Test it?

I tell every patient that I will only recommend testing for them if the result of the test will change the course of treatment. In this case, I find listening to patient reports usually diagnostic enough to know whether their cortisol is spiking at the wrong times, is too high, or not spiking at all. If there is evidence of stress and cortisol dysregulation, I will put them on an individualized adrenal protocol with the goal of increased energy, better sleep, and boosted immune system. However, testing cortisol is necessary in disease states of the adrenal glands called Addison’s disease (too little cortisol) and Cushing’s Syndrome (too much cortisol) and would be associated with a specific set of symptoms. It might also be useful to test cortisol levels to establish a baseline.

Draw Your Cortisol

To get an idea of what your cortisol slope looks like, make a graph of your energy levels throughout the day starting with half hour after you wake up and ending with a point before bed. If you end up with a flat line, have to press snooze 1000 x before getting out of bed (no morning spike), or perk up at night (spike at night), you might need some help getting your cortisol and stress levels on track.

Dr. Sarah is a Naturopathic Doctor practicing in South Mississauga at Clarkson Family Naturopathic ( She is accepting new patients that want to bend the rules and put themselves first, so that they can get back to being the world’s best household CEO. Email her at to inquire about a complimentary 15 min meet and greet.

#Stress #weightloss #thyroid #womenhealth


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Disclaimer: Any information on this website is for informational purposes only and are not intended to be used in place of professional medical advice.

Always seek the advice of a qualified health care practitioner with any questions or health concerns you may have.


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