The health of the entire hypothalamic-pituitary-adrenal (HPA) axis is critically important for maintaining proper health primarily because of cortisol’s role in the body.

Cortisol is known as a glucocorticosteroid because of its effects on blood sugar regulation (gluco), it is made in the cortex of the adrenal glands (cortico) and of course, its action as a potent steroid hormone with effects that are far reaching systemically. Released primarily in response to perceived low blood sugar in order to directly stimulate glucuoneogenesis and indirectly, glycogenolysis, cortisol helps to counter inflammation through certain cytokines in the immune system and increases to prepare the body for “fight or flight” as part of the normal, healthy stress response. Like all things, balance is key as high levels can result in inflammatory tissue damage, bone loss, blood sugar dysregulation, memory loss via the hippocampus and insomnia.

Further content is restricted to registered practitioners. 

Existing Users Log In


1. Contreras, L. N., S. Hane and J. B. Tyrrell (1986). “Urinary cortisol in the assessment of pituitary-adrenal function: utility of 24-hour and spot determinations.” J Clin Endocrinol Metab 62(5): 965-969.

2. Cook, M. R., C. Graham, R. Kavet, R. G. Stevens, S. Davis and L. Kheifets (2000). “Morning urinary assessment of nocturnal melatonin secretion in older women.” J Pineal Res 28(1): 41-47.

3. Denari, J. H., Z. Farinati, P. R. Casas and A. Oliva (1981). “Determination of ovarian function using first morning urine steroid assays.” Obstet Gynecol 58(1): 5-9.

4. Hoshiro, Y. Ohno, H. Masaki, H. Iwase and N. Aoki (2006) “Comprehensive study of urinary cortisol metabolites in hyperthyroid and hypothyroid patients” Clinical Endocrinology 64: 37-45

5. Iranmanesh, A, Lizarralde, G, Johnson, M, and Veldhuis, J, (1990) “Dynamics of 24-Hour Endogenous Cortisol Secretion and Clearance in Primary Hypothyroidism Assessed before and after Partial Thyroid Hormone Replacement*” Journal of Clinical Endocrinology and Metabolism 70(1): 155-161

6. Jerjes, W. K., A. J. Cleare, S. Wessely, P. J. Wood and N. F. Taylor (2005). “Diurnal patterns of salivary cortisol and cortisone output in chronic fatigue syndrome.” J Affect Disord 87(2-3): 299-304.

7. Jerjes, W. K., T. J. Peters, N. F. Taylor, P. J. Wood, S. Wessely and A. J. Cleare (2006). “Diurnal excretion of urinary cortisol, cortisone, and cortisol metabolites in chronic fatigue syndrome.” J Psychosom Res60(2): 145-153.

8. C. Vantyghem, A. Ghulam, C. Hober, C. Schoonberg, M. D’Herbomez, A. Racodot, A. Boersma and J. Lefebvre (1998) “Urinary cortisol metabolites in the assessment of peripheral thyroid hormone action: Overt and subclinical hypothyroidism.” J.Endocrinol. Invest. 21:21-225

9. Miro, F., J. Coley, M. M. Gani, P. W. Perry, D. Talbot and L. J. Aspinall (2004). “Comparison between creatinine and pregnanediol adjustments in the retrospective analysis of urinary hormone profiles during the human menstrual cycle.” Clin Chem Lab Med 42(9): 1043-1050.

10. Mistry, H. D., N. Eisele, G. Escher, B. Dick, D. Surbek, C. Delles, G. Currie, D. Schlembach, M. G. Mohaupt and C. Gennari-Moser (2015). “Gestation-specific reference intervals for comprehensive spot urinary steroid hormone metabolite analysis in normal singleton pregnancy and 6 weeks postpartum.” Reprod Biol Endocrinol 13: 101.

11. Munro, C. J., G. H. Stabenfeldt, J. R. Cragun, L. A. Addiego, J. W. Overstreet and B. L. Lasley (1991). “Relationship of serum estradiol and progesterone concentrations to the excretion profiles of their major urinary metabolites as measured by enzyme immunoassay and radioimmunoassay.” Clin Chem 37(6): 838-844.

12. Probst-Hensch, N. M., S. A. Ingles, A. T. Diep, R. W. Haile, F. Z. Stanczyk, L. N. Kolonel and B. E. Henderson (1999). “Aromatase and breast cancer susceptibility.” Endocr Relat Cancer 6(2): 165-173.

13. Roos, J., S. Johnson, S. Weddell, E. Godehardt, J. Schiffner, G. Freundl and C. Gnoth (2015). “Monitoring the menstrual cycle: Comparison of urinary and serum reproductive hormones referenced to true ovulation.” Eur J Contracept Reprod Health Care 20(6): 438-450.

14. Taioli, E., A. Im, X. Xu, T. D. Veenstra, G. Ahrendt and S. Garte (2010). “Comparison of estrogens and estrogen metabolites in human breast tissue and urine.” Reprod Biol Endocrinol 8: 93.

15. Taniyama, M, Keiko Honma, K and Ban, Y (1993) “Urinary Cortisol Metabolites in the Assessment of Peripheral Thyroid Hormone Action: Application for Diagnosis of Resistance to Thyroid Hormone” Thyroid 3(3): 229-233

16. Waller, K., S. H. Swan, G. C. Windham, L. Fenster, E. P. Elkin and B. L. Lasley (1998). “Use of urine biomarkers to evaluate menstrual function in healthy premenopausal women.” Am J Epidemiol 147(11): 1071-1080.

17. Oskis, A., C. Loveday, F. Hucklebridge, L. Thorn, and A. Clow (2012) “Diurnal patterns of salivary cortisol and DHEA in adolescent anorexia nervosa” Stress 15(6): 601-607

18. Wassif, S. W., D. M. McLoughlin, R. P. Vincent, S. Conroy, G. F. M. Russell, and N. F. Taylor (2011) “Steroid metabolism and excretion in severe anorexia nervosa: effects of refeeding” The American Journal of Clinical Nutrition 93: 911-917

19. Boyar, R. M., L. D. Hellman, H. Roffwarg, J. Katz, B. Zumoff, J. O’Connor, H. L. Bradlow, D. K. Fukushima (1977) “Cortisol secretion and metabolism in anorexia nervosa” New England Journal of Medicine296(4): 190-193

20. Abraham, S. B., Rubino, N. Sinaii, S. Ramsey, L. K. Nieman (2013) “Cortisol, obesity and the metabolic syndrome: A cross-sectional study of obese subjects and review of the literature” Obesity (Silver Spring)21(1): E105-E117

21. Tomlinson, J. W., J. Finney, B. A. Hughes, S. V. Hughes, P. M. Stewart (2008) “Reduced Glucocorticoid Production Rate, Decreased 5?-Reductase Activity, and Adipose Tissue Insulin Sensitization After Weight Loss” Diabetes 57: 1536-1543


Dr Carrie Jones, ND, MPH, Medical Director for Precision Analytical

Dr. Carrie Jones’ passion and expertise lies in the areas of hormonal, adrenal, and thyroid health. She recognises that imbalance can occur at any age and believes it is important to look at the big picture such as the appropriate use of lab testing. Dr. Jones graduated from the National University of Natural Medicine (NUNM) in Portland, Oregon then went on to complete her residency in women’s health, endocrinology and hormones. Later she graduated from Grand Canyon University’s Master of Public Health program with a goal of doing more international work and health empowerment. Dr. Jones is an adjunct professor at NUNM and regularly consults, lectures, and writes on the topic of hormones, thyroid, adrenals, autoimmune and more.

As the Medical Director for Precision Analytical, Inc., her goals are to provide ongoing cutting edge integrative clinical education to the large network of providers paving the way of healthcare with functional medicine.

Mark Newman, Owner and President of Precision Analytical

Mark is a recognised expert and international speaker in the field of hormone testing. He has assisted many laboratories in developing novel tests to create world-class laboratory testing. He has also educated thousands of providers about hormone monitoring best practices.

Precision Analytical (dutch testing) was established by Mark to address the need for better clinical accuracy, subsequently developing one of the most advanced and comprehensive models for testing a patients steroid and adrenal hormones.

Dr Joseph Mercola, Dr Sara Gottfried, and Chris Kresser are just a few of the international experts that have found the dutch model to be the most advanced test for hormone testing.