STEP 1. Test for Low or High Cortisol.
Both low and high cortisol can be debilitating and, interestingly enough, they can produce symptoms similar to those often experienced by men with low testosterone. Low cortisol is often in capacitating and can lead to severe fatigue, shakiness and heart palpitation. High estradiol is little better and is associated with prediabetes, visceral fat, cardiovascular disease and memory deficits. (It also will lower testosterone levels.) In my opinion, cortisol testing should be part of any yearly physical - it's simply that important. However, that is not likely to happen anytime soon due to our nearly bankrupt healthcare systems worldwide.
The bottom line is that, if you want cortisol testing done, you are probably going to have to do it yourself. If you can afford to pay cash for an anti-aging doctor or naturopath, then that, of course, is preferable. Most of us, though, will have to self-test to take a peek at our basic stress hormones.
And I have good news: it does NOT have to cost a lot of money. Testing prices have come down significantly in the last 5 years and placed many basic tests within the reach of most pocketbooks. (These are U.S. prices, but many countries have even better pricing available. Here is a sampling from various labs (and I currently have no affiliation with any of them):
1. Discounted Labs $199 (4-Tube Saliva Cortisol). Check out this link to order.
2. Health Tests Direct (Blood Test AM/PM Cortisol). $67.70. Check out this link to order.
3. Life Extension Foundation (Blood Test AM/PM Cortisol). $72 (members only). Check out this link to order.
4. Saveon Labs (2-Point Cortisol). $74 Check out this link to order.
Now why did I put the most expensive lab work on the top? Because, as far as I know, all the other tests use blood testing, which means that it will be total cortisol. Total cortisol is valuable, but some men with high cortisol binding globulin (CBG) will end up with low free cortisol that will not be revealed by a blood test. If you really want to cover your bases, it has to be done with a saliva test, because that measure free cortisol.
Now what I feel is important is at least a 2-point test, i.e. one in the morning and one in the evening, because this is so predicitive of certain symptoms based on what I have seen on Peak Testosterone Forum. For example, men with low morning cortisol often suffer from fatigue and other classic low cortisol symptoms. Men with high morning cortisol often struggle with anxiety and some of the medical issues associated with elevated cortisol levels. Men with high evening cortisol often have sleep difficulties. So this may seem like overkill, but it actually quite be quite useful.
NOTE: Once you pull your numbers, what should you do? In my opinion you should continue reading the Peak Testosterone Cortisol Program for more information and more things to discuss with your doctor.