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Stress Assessment

Stress and the problems associated with it (e.g. anxiety, fatigue, brain fog) is complex - it's both physical and psychological in nature. Different people experience it in different ways. An effective stress management approach needs to:

  • be personalized: we need to take account of your individual problems and goals
  • address underlying causes rather than merely suppressing symptoms.

My approach involves:

  • An online intake process: questionnaires etc. designed to give a complete picture of how stress is affecting you, and saving face-to-face time.
  • Objective, physiological assessments - looking at how stress is manifesting in your body.
  • Formulating realistic, personalized goals based on the above.

Physiological Assessments of Stress

I have a range of tools for assessing stress: some office based, some you can try at home, and also functional lab tests (involving easy sample collection from home).

Officed based stress assessments include:

  • Breathing (using capnometry, also known as capnography) - a capnometer is a device that can detect (degree of) over-breathing, which is the most significant form of stress-related breathing dysregulation. Over-breathing (or hyperventilation) is both common, and (in its mild form) largely unrecognized. Read more about capnometry here.
  • Heart Rate Variability Analysis - HRV is a significant health biomarker and gives us a window on Autonomic Nervous system (ANS) functioning, i.e. on the balance between the "fight-or-flight" response and the "rest-and-digest" response.
  • EEG Assessment - this tool looks for patterns within the EEG (brainwaves) that correlate with stress-related symptoms. For example a common marker for depression is a difference between the left and right sides of the brain, seen in the alpha and/or beta bands. Read more about EEG assessment here.

Functional Laboratory Testing for Stress

A functional lab test looks at how well a body system is functioning, rather than for signs of disease. The test that's most directly relevant to stress, emotional wellbeing and fatigue is the adrenal profile, which looks at hormones produced by the adrenal glands, most notably:

  • Cortisol - this stress hormone helps mobilize energy to help you cope with stress. Imbalanced cortisol can cause you to feel anxious and wired (poor stress tolerance), or fatigued.
  • DHEA - this hormone is associated with wellbeing generally, and has been dubbed the "youth hormone" because levels are highest in your twenties, then fall from the mid-thirties onwards.

Adrenal dysregulation is sometimes known as adrenal fatigue.

Important disclaimer: the adrenal profile should be regarded as a stress test, not a medical test. Adrenal fatigue is best understood as a stress condition, not a medical condition I am not medically qualified, and cannot diagnose or treat medical conditions.

Adrenal Dysregulation Patterns

The most common and significant patterns of adrenal dysregulation are:

  • cortisol consistently too high (classic acute stress)
  • cortisol consistently too low (classic burnp-out or adrenal fatigue)
  • loss of daily cortisol rhythm (cortisol should be high in the morning, dropping steadily over the day).

The DUTCH Test -The Best Available Adrenal Profile

I use a form of adrenal profile based on dried urine samples (taken four times over the course of a day, and sent to the lab by post). The DUTCH test is superior to the commonly used saliva test because it looks at both cortisol production (total) and free (active) cortisol levels (saliva only tells you about free cortisol).

More Functional Lab Tests

Besides the adrenal profile, I sometimes order other functional tests for a more in-depth look at the physiological basis of stress, including:

  • Gut function status (the gut-brain axis is key to optimal brain function)
  • Vitamin D status

I can advise on dietary and nutritional strategies for managing stress and optimizing energy and brain performance.

To find out more about how I can help you personally, please contact me to arrange a no-obligations free initial consultation.



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