Correlates of cortisol in human hair: Implications for epidemiologic studies on health effects of chronic stress
Open accessAbstract
Assessment of cortisol concentrations in hair is one of the latest innovations for measuring long-term cortisol exposure. We performed a systematic review of correlates of cortisol in human hair to inform the design, analysis, and interpretation of future epidemiologic studies. Relevant publications were identified through electronic searches on PubMed, WorldCat, and Web of Science using keywords, "cortisol," "hair," "confounders," "chronic," "stress," and "correlates." Thirty-nine studies were included in this review. Notwithstanding scarce data and some inconsistencies, investigators have found hair cortisol concentrations to be associated with stress-related psychiatric symptoms and disorders (e.g., post-traumatic stress disorder), medical conditions indicating chronic activation of the hypothalamic-pituitary-adrenal axis (e.g., Cushing's syndrome), and other life situations associated with elevated risk of chronic stress (e.g., shiftwork). Results from some studies suggest that physical activity, adiposity, and substance abuse may be correlates of hair cortisol concentrations. In contrast to measures of short-term cortisol release (saliva, blood, and urine), cigarette smoking and use of oral contraceptives appear not to be associated with hair cortisol concentrations. Studies of pregnant women indicate increased hair cortisol concentrations across successive trimesters. The study of hair cortisol presents a unique opportunity to assess chronic alterations in cortisol concentrations in epidemiologic studies.
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HCC has potential as a robust biomarker for assessing stress-related psychiatric conditions.
“By quantifying cortisol levels in hair samples, this research not only highlights the profound impact of stress on the body but also emphasizes the potential of HCC as a robust biomarker for assessing stress-related psychiatric conditions [59].”
From The Role of Cortisol in Chronic Stress, Neurodegenerative Diseases, and Psychological Disorders (2023) · cites this paper as [59]
The Discussion describes HCC as a promising biomarker and suggests it may be associated with stress-related psychiatric conditions. But the Results (Psychiatric Symptoms and Disorders) report mixed findings and say more studies are needed to establish HCC as a clear biomarker. The source supports its potential, not its characterization as robust for assessing these conditions. (LLM, conf=0.86)
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Stress-related and basic determinants of hair cortisol in humans: a meta-analysis
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“By quantifying cortisol levels in hair samples, this research not only highlights the profound impact of stress on the body but also emphasizes the potential of HCC as a robust biomarker for assessing stress-related psychiatric conditions [59].”
BackgroundAssessing cortisol from hair samples in a large observational cohort: the Whitehall II study
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Hair cortisol concentrations in war-affected adolescents: A prospective intervention trial
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The Association between Hair Cortisol and Self-Reported Symptoms of Depression in Pregnant Women
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Hair cortisol concentrations in a Spanish sample of healthy adults
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Effects of psychosocial work characteristics on hair cortisol – findings from a post-trial study
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Gorter, J. W., Fehlings, D., Ferro, M. A., Gonzalez, A., Green, A. D., Hopmans, S. N., McCauley, D., Palisano, R. J., Rosenbaum, P., Speller, B., et al. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11113060 · Cited by 14 · see citing works
- Authors
- Wosu, A. C., Valdimarsdóttir, U., Shields, A. E., Williams, D. R., & Williams, M. A.
- Affiliations
- Harvard University (US)
- Corresponding author
- Wosu, Adaeze C.
- ORCID
- Venue
- Annals of Epidemiology
- Publisher
- Elsevier BV
- Published
- 2013-12
- Volume
- 23
- Issue
- 12
- Pages
- 797-811.e2
- ISSN
- 1047-2797 (ISSN-L)
- PMC
- PMC3963409
- OpenAlex
- W2093203548
- Semantic Scholar
- 8e472b15bcfb1c49347c9aaeea9a70ca7d644905
- Cited by
- 199
- References
- 113
- Citations by year
- 2026: 13 · 2025: 8 · 2024: 12 · 2023: 15 · 2022: 16 · 2021: 22 · 2020: 17 · 2019: 25 · 2018: 13 · 2017: 22 · 2016: 18 · 2015: 13 · 2014: 5
- FWCI
- 0.99
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000170)
- National Center for Advancing Translational Sciences
- National Institute on Minority Health and Health Disparities (T37MD001449)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Veterinary › Small Animals › Animal Behavior and Welfare Studies
- Keywords
- hair cortisol, chronic stress, confounding factors, post-traumatic stress disorder, Cushing's syndrome, shift work, physical activity, adiposity, substance abuse, cigarette smoking, oral contraceptives, pregnancy, hypothalamic-pituitary-adrenal axis, stress biomarkers
- MeSH terms
- Mental Disorders, Chronic Disease, Female, Hair, Health Status, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Saliva, Stress, Psychological, Biomarkers, Epidemiologic Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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