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May 26, 2014 Puzzle Piece The Relationship of Cortisol Levels to Allergies

May 26, 2014 Puzzle Piece  


The Relationship of Cortisol Levels to Allergies

 This week's Puzzle Piece comes from Labrix Laboratories, who is my favorite on salivary testing for hormone levels.  They also have webinars and seminars to further our education.



For many of us, the increased sunshine, longer daylight hours, birds chirping, bees buzzing and flowers blooming that come with onset of spring are most welcome after cold, gray winter days. However, for the allergy sufferer, these can be the signal of just another season of frustrating runny noses and itchy, watery eyes. While most of us remember to test cortisol in our fatigued or chronically stressed patients, it can also be quite useful to test cortisol levels in those suffering from chronic allergies.


Conventional approaches to treating allergic symptoms have often involved the use of a topical or inhaled corticosteroid. The corticosteroid, while effective at reducing the inflammation, does not address the underlying question of "Why can't this patient tolerate seemingly benign environmental factors such as grass or pollen?"

What we know about the role of the hypothalamic-pituitary-adrenal axis (HPA) and allergies is complex. Research shows that even in early life, infants who have an atopic disposition have an aberrant cortisol response. Initially, in infancy, when a stressor is incurred, the infant with an atopic disposition produces a higher level of cortisol than his or her non-atopic counterparts. However, in atopic adults, we see an attenuated response of the HPA to a stressor. What is unclear is whether this reduced responsiveness represents a genetically determined predisposition or whether a hyporeactive HPA is a consequence of chronic inflammatory markers increasing negative feedback effects on the HPA over time.

Another interesting study shows that the hyporeactivity of the HPA in adult atopy may be related to disease severity. This suggests that adults with increased allergic or atopic symptoms may have increased hyporeactivity of their HPA than other atopic adults. Also, increased stress, in the form of anxiety, has been shown to heighten the magnitude of allergic symptoms. For clinicians, this makes sense as we often see an increase in atopic and allergic symptoms in our patients who are undergoing stressful life events.

Ultimately what this information gives us is an understanding that cortisol production in the atopic patient is irregular. In the very young infant or child, it can be quite elevated before the onset of disease or clinical manifestations. In the toddler, child or adult who has atopic symptoms, we can see depressed cortisol levels indicating hyporesponsiveness of the HPA and, often, the severity of the depression of cortisol levels can be correlated with the severity of symptoms. This information gives us great incentive for monitoring our atopic patients more closely with salivary cortisol levels in order to support their compromised HPA and help to holistically manage their symptoms.


  *  Buske-Kirschbaum A, Fischbach S, Rauh W, Hanker J, Hellhammer D. (2004). Increased responsiveness of the hypothalamic-pituitary-adrenal (HPA) axis to stress in newborns with atopic disposition. Psychoneuroendocrinology, 29(6), 705-11.
  *  Buske-Kirschbaum A, Ebrecht M, Hellhammer DH. (2010). Blunted HPA axis responsiveness to stress in atopic patients is associated with the acuity and severeness of allergic inflammation. Brain, Behavior and Immunity, 24(8), 1347-53.
  *  Kiecolt-Glaser JK, Heffner KL, Glaser R, Malarkey WB, Porter K, Atkinson C, Laskowski B, Lemeshow S, Marshall GD. (2009). How stress and anxiety can alter immediate and late phase skin test responses in allergic rhinitis. Psychoneuroendocrinology, 34(5), 670-80.
  *  Mizawa M, Yamaguchi M, Ueda C, Makino T, Shimizu T. (2013). Stress evaluation in adult patients with atopic dermatitis using salivary cortisol. Biomedical Research International, 2013:138027.
  *  Stenius F, Borres M, Bottai M, Lilja G, Lindblad F, Pershagen G, Scheynius A, Swartz J, Theorell T, Alm J. (2011). Salivary cortisol levels and allergy in children: The ALADDIN birth cohort. Journal of Allergy and Clinical Immunology, 128(6), 1335-9.


Labrix Founder and Medical Director Dr. Jay Mead, CEO and Associate Medical Director Dr. Erin Lommen, and Staff Physicians Dr. Robyn Kutka, Dr. Lylen Ferris, and Dr. Sara Wood present the fundamentals of hormone balancing, broken down into simple core concepts and related in a single day of engaging presentations and discussions. This event is designed for the provider who is new to the field of hormone balancing or is looking to brush up on the basics.

Join Labrix for this 8-hour training and leave with the tools and knowledge necessary to:
* Identify patients who would benefit from hormone balancing
* Understand the roles of major sex and adrenal hormones in men and women
* Appreciate the relationships between the various hormones and the entire endocrine system
* Recognize the role that sex and adrenal hormones play in several prominent disease processes
* Treat hormone imbalances with nutritional supplements, botanical medicines and BHRT

This event will be held on Saturday, August 2nd, 2014 at the Hilton Portland & Executive Tower.

This event is a non-CME event.


Thanks to Dr. Jay Mead and his staff or this excellent information, webinars and seminars to keep us up to speed with the most up to date information.  MaX Hypothalamus/Pituitary is a great modulator for the HPA.  MaX Adrenal, MaX Iodine and MaX Thyroid should be considered in helping bring patients to optimal function of the HPA.  HistDAO can be an incredible nutraceutical for allergies with histamine as part of the puzzle.

Yours in Health and Wellness,
John W. Brimhall, BA, BS, DC, FIAMA, DIBAK

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