SAVE THE DATE
Laboratory, Endocrine, & Neurotransmitter Symposium
February 15 - 17, 2018
Las Vegas, NV
CMES will be available
Gain additional clinical insight and treatment considerations to evaluate some of the most prevalent and challenging conditions that patients present with, including depression, anxiety, altered mental focus and stamina, sexual dysfunction, sleep disturbances, addictions and dependencies, weight management, and chronic disease. Click the button below to be the first to know when registration for LENS 2019 opens.
Topic: Modern Approach to Weight Loss
October 3, 2018
Join Labrix clinical staff and special guests on the first Wednesday of every month at 9:30 AM and 12:00 PM PST. This free, live webinar series will cover a variety of neuroendocrine topics that will enhance your knowledge, with clinically applicable testing and treatment considerations.
Burlington, VT: September 27 - 30, 2018
Labrix will be in Vermont for the AARM Conference later this weekend. Come chat with our booth representative and learn more about testing with Labrix.
Unlocking the Wisdom of Waking: the Cortisol Awakening Response may be the missing link
Most practitioners are familiar with the concept of HPA axis dysregulation and have grasped the concept of the typical diurnal pattern of cortisol secretion, with a rise of cortisol 30 minutes after waking followed by a downward sloping curve throughout the day. While this first collection (“AM 30”), and other points throughout the day (before lunch, before dinner, before bedtime) offer insight into the overall health of the HPA axis, fully assessing the cortisol awakening response (CAR) might offer a missing piece to an individual’s stress puzzle.
Two events contribute to the dynamic rise of cortisol in the morning. The first is the adrenal gland’s response to ACTH output from the pituitary as a part of the normal circadian activities of the HPA axis. The second occurs in response to exposure to daylight which activates the suprachiasmatic nucleus in the brain (the “master clock”). Simultaneously, these two phenomena result in a 35-60% elevation in cortisol about 30- 40 minutes after waking with a noticeable drop in cortisol 60 minutes post waking. This response is transient and limited only to the physiologic response to morning waking, not waking from a nap or waking during the night. Because of its predictable pattern, the cortisol awakening response can be used as an effective assessment of HPA axis reactivity.
When examining the CAR, it is important to note the percentage of change between the waking sample and the rise at 30 minutes post waking (AM 30) as well as the percentage change between the waking sample and 60 minutes post waking (AM 60). Ideally, the initial waking sample should be taken as quickly as possible, within the first 5 minutes of waking, to establish a baseline to compare 30 and 60-minute collections. Understanding these sensitive time points may offer insight into the root cause of HPA axis dysfunction.
Researchers have established evidence suggesting a lower cortisol awakening response in individuals with:
- Chronic Fatigue
- High levels of psychosocial burnout
- Seasonal affective disorder (during winter)
- Shift workers
- Sleep apnea
- Short sleep cycles
- Chronic inflammation
- Adrenal insufficiency
- Lack of morning sunlight exposure
- Hippocampal damage or atrophy
- Amnesia (from temporal lobe damage)
Elevations in CAR have been linked to:
- Ongoing job-related and perceived stress (CAR is significantly higher on work days)
- Immediate access to light upon waking
- Sleep issues
- Older age
Testing for the cortisol awakening response is available now. Unlock the potential of the HPA axis by offering your patients CAR testing as a stand-alone test or in an addition to the Adrenal Cortisol Profile or any other saliva profile. This information can provide much needed insight and treatment guidance for your most challenging patients.
Schlotz W, Hellhammer J, Schulz P, Stone AA. 2004. Perceived Work Overload and Chronic Worrying Predict Weekend–Weekday Differences in the Cortisol Awakening Response.Psychosomatic Medicine [accessed 2018 Aug 28]; 66:207–214.
Wolfram M, Bellingrath S, Kudielka B. 2011. The cortisol awakening response (CAR) across the female menstrual cycle.Psychoneuroendocrinology [accessed 2018 Aug 28]; 36:905–912.
Thorn L, Evans P, Cannon A, Hucklebridge F, Clow A. 2011. Seasonal differences in the diurnal pattern of cortisol secretion in healthy participants and those with self-assessed seasonal affective disorder.Psychoneuroendocrinology [accessed 2018 Aug 28]; 36:816–23. https://www.ncbi.nlm.nih.gov/pubmed/21145663
Guilliams T. 2015. The role of stress and the HPA Axis in Chronic Disease Management: Principles and Protocols for Healthcare Professionals. Point Institute.
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The Anti-Anxiety Diet
by Ali Miller, RD, LD, CDE
Ali Miller, RD, LD, CDE has a contagious passion for food as medicine. In her new book The Anti-Anxiety Diet, she explains that the foundation of healthy neurotransmitter levels begins with adequate protein intake as well as B vitamins, which serve as cofactors to neurotransmitter action. Neurotransmitters are derived from amino acid precursors and in turn, these amino acids are derived from dietary protein. Thus, a diet either deficient in adequate protein OR an impaired digestive system can lead to imbalance.
If your patients are struggling from the effects of neurotransmitter imbalances, utilize The Anti-Anxiety Diet for inspirational protein and nutrient-rich neurotransmitter balancing recipes. Using matcha as medicine, Ali’s Matcha Green Smoothie (pg 207, and below) provides high amounts of l-theanine, which serves to tonify neurotransmitter levels. For even more mouth-watering recipes and scientifically based strategies for neurotransmitters support, grab a copy of her book at www.alimillerrd.com/the-anti-anxiety-diet/.
Disclaimer: All information given about health conditions, treatment, products, and dosages are for educational purposes only and do not constitute medical advice.