{"product_id":"dutch-cortisol-awakening-response-car","title":"DUTCH Cortisol Awakening Response (CAR)","description":"\u003cp\u003e\u003cstrong\u003eA low or blunted Cortisol Awakening Response\u003cspan\u003e \u003c\/span\u003e\u003c\/strong\u003ecan be a result of an underactive HPA axis, excessive psychological burnout, seasonal affective disorder (SAD), sleep apnea or poor sleep in general, PTSD, chronic fatigue and\/or chronic pain. A decreased CAR has also been associated with systemic hypertension, functional GI diseases, postpartum depression, and autoimmune diseases.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eAn elevated Cortisol Awakening Response\u003cspan\u003e \u003c\/span\u003e\u003c\/strong\u003ecan be a result of an over-reactive HPA axis, ongoing job-related stress (anticipatory stress for the day), glycemic dysregulation, pain (i.e. waking with painful joints or a migraine), and general depression (not SAD). A recent study1 showed that neither the waking nor post-waking cortisol results correlated to Major Depressive Disorder, but the CAR calculation (the change between the first two samples) did. This measurement of the response to waking has independent clinical value showing dysfunction that may be hidden by current testing options.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eWhat is the Cortisol Awakening Response and how do we test for it?\u003cspan\u003e \u003c\/span\u003e\u003c\/strong\u003eWhen we open our eyes upon waking, cortisol levels naturally begin to rise by an average of 50%. 30 minutes after waking, cortisol levels will still show this sharp increase. By 60 minutes after waking, cortisol levels have peaked and begin to decline. Measuring this rise and fall of cortisol levels at waking can be used as a “mini stress test”. Research shows that the size of this increase correlates with HPA-axis function, even if the sample measurements are all within range. A quick saturation of saliva swabs upon waking, and at 30 and 60 minutes after waking, provide what is required to assess a patient’s Cortisol Awakening Response.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eHow to Collect Saliva\u003c\/strong\u003e\u003c\/p\u003e\n\u003col\u003e\n\u003cli\u003eBegin collecting right when you wake up, before getting out of bed. Remove the blue cap, and place the cotton swab from the collection device in mouth.\u003c\/li\u003e\n\u003cli\u003eLeave in mouth until fully saturated but not longer than 5 minutes. Lightly chewing on the swab may help stimulate saliva flow.\u003c\/li\u003e\n\u003cli\u003eOnce done, place swab back in the same tube, just as you found it. Do not remove the inner tube.\u003cspan\u003e \u003c\/span\u003e\u003cstrong\u003eYou do not need to spit into the tube.\u003c\/strong\u003e\u003cspan\u003e \u003c\/span\u003eTouch the swab as little as possible with your hands.\u003cspan\u003e \u003c\/span\u003e\u003cstrong\u003eLabel each device completely.\u003c\/strong\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eFreeze\u003c\/strong\u003e\u003cspan\u003e \u003c\/span\u003eall saliva samples until they are ready to ship.\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e\u003cstrong\u003eImportant Note:\u003cspan\u003e \u003c\/span\u003e\u003c\/strong\u003eFor the waking sample, set the saliva collection device, the requisition form, and a pen next to your bed. It is helpful to have a timer nearby to set for 30 and 60 minutes after you have begun your first collection. After collecting the first sample, it is best for you to be in a well-lit place.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eHow to Return\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eUpon Completion\u003c\/strong\u003e\u003c\/p\u003e\n\u003col start=\"1\" type=\"1\"\u003e\n\u003cli\u003eAfter freezing the saliva samples, place them back inside the test kit box.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eBe sure to check that each sample is clearly labeled.\u003c\/strong\u003e\u003cspan\u003e \u003c\/span\u003eInclude the completed requisition form.\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e\u003cstrong\u003eShipping Information\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003ePlace the entire test kit box inside the return envelope. Affix the prepaid label or postage if applicable. Return using the appropriate carrier. International patients: please check with your practitioner on where to return the kit if there is not a return envelope\/label included (avoid leaving out in warm weather).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e*Not available in NY, NJ , and RI*\u003c\/strong\u003e\u003c\/p\u003e","brand":"Precision Analytical","offers":[{"title":"Default Title","offer_id":53307840463145,"sku":null,"price":315.0,"currency_code":"USD","in_stock":true}],"url":"https:\/\/brighterlifelabs.com\/products\/dutch-cortisol-awakening-response-car","provider":"Brighter Life Labs","version":"1.0","type":"link"}