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Hair cortisol analysis: An update on methodological considerations and clinical applications
Abstract
Background Hair cortisol analysis is increasingly being appreciated and applied in both research and medicine, aiding endocrinologists with diagnosis. Content We provide an overview of hair cortisol research in general and an update on methodological considerations including the incorporation of cortisol into hair, hair growth rates, and sampling procedures, mincing vs. grinding of samples during preparation for extraction, various extraction protocols, and quantification techniques. We compare the clinical utility and application of hair cortisol with traditional methods of measurement while acknowledging the limitations of analysis including variations in hair growth parameters. We explore the value of hair cortisol in cases of Cushing syndrome (particularly Cyclical Cushing), Adrenal insufficiency (including Addison's disease), therapy monitoring, cardiovascular disease, stress, and mental illness. Summary Hair cortisol provides a unique objective biomarker for the analysis of endogenous cortisol levels for not only clinical diagnostic purposes but also in research. The use of hair cortisol has great potential for advancing patient care.
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“Depending on the length of the collected hair sample, it is possible to make timelines of past glucocorticoid exposure (64).”
From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [64]
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Metadata
- Authors
- Greff, M. J. E., Levine, J. M., Abuzgaia, A. M., Elzagallaai, A. A., Rieder, M. J., & van Uum, S. H. M.
- Affiliations
- Western University (CA)
- Venue
- Clinical Biochemistry
- Publisher
- Elsevier BV
- Published
- 2019-01
- Volume
- 63
- Pages
- 1-9
- ISSN
- 0009-9120 (ISSN-L)
- OpenAlex
- W2893689668
- Cited by
- 260
- References
- 97
- Citations by year
- 2026: 28 · 2025: 41 · 2024: 49 · 2023: 39 · 2022: 30 · 2021: 32 · 2020: 24 · 2019: 16
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Biochemistry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
- Keywords
- hair cortisol, hair growth rate, hair sampling, hair sample preparation, Cushing's syndrome, adrenal insufficiency, Addison's disease, treatment monitoring, cardiovascular disease, stress, mental illness, endogenous cortisol, biomarkers
- MeSH terms
- Adrenal Insufficiency, Mental Disorders, Cardiovascular Diseases, Cushing Syndrome, Hair, Humans, Hydrocortisone, Stress, Psychological
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