HPA-Stress-Cortisol: Connecting the Dots
By: SideCar, LLC

Course Description

Each currently available test for cortisol offers different pieces of the HPA-axis puzzle. Salivary testing offers the pattern of free cortisol and, most recently, the CAR (cortisol awakening response). Urine testing typically includes cortisol metabolites which is a better marker for overall production. Serum testing lacks both of these pieces. In complex cases, a more comprehensive approach (one that includes the information available in saliva and urine testing) helps providers make clinical decisions.


In this presentation, we will navigate the pros and cons of each available testing modality. Research and case studies will be used to highlight the types of cases requiring more comprehensive testing for an accurate diagnosis. There will also be some discussion of the evolving understanding of the source of HPA-axis dysfunction (adrenal versus CNS/brain). The evolving nature of our understanding of the HPA-axis and the cause of its various states of dysfunction also alters our collective understanding of how to effectively treat patients. We’ll also briefly discuss treatment options in light of the testing conclusions. The presentation will leave attendees more confident and competent as they treat patients with stress responses that are atypical and problematic.

 Key Clinical Takeaways

 • Outline the pros and cons of the options currently available for assessing cortisol and HPA-axis function.

 • Help providers draw appropriate clinical conclusions regarding adrenal hormones with case studies. 

• Discuss the evolving landscape of understanding HPA-axis dysfunction, its terminology (i.e. “adrenal fatigue”), testing, and treatment options.

Course Details

  • HPA-Stress-Cortisol: Connecting the Dots
  • By:    SideCar, LLC
  • Instructor:    Mark Newman, MS – CEO and Founder, Precision Analytical Inc./ Dutch Labs
  • Total CE Hours:    1
  • Course Format:     Online Distance Learning
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  • Course Categories:     DC Continuing Education
  • Course Subjects | CE HOURS:
    • Nutrition  -1 CE Hours