With the help of at-home stress test called Base, I sent my spit to a lab to measure my cortisol levels through a hectic workday — and the results weren’t what I expected.

By Megan Falk
November 13, 2020
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Credit: Base - Megan Falk - Design: Alex Sandoval

Like many millennials living in the age of WFH and burnout, I’m simultaneously fulfilled by my career and stressed out by it. 

As much as I love getting out of bed every day, walking into my kitchen, and writing about health trends, game-changing products, and people shaking up the status quo in the fitness world, sometimes it's the one email I forgot to send the day before or the upcoming interview I have that’s waking me up from my slumber. I thrive under the pressure of deadlines, yet sleeping, eating, working, and exercising in the same 500-square-foot box each and every day (thanks, COVID) means I’m always thinking — and mildly freaking out — about them. And even though I willingly chose a profession in which I constantly receive feedback, at times, I still struggle to keep my cool when I get an unexpectedly large batch of edits. 

So when I had the opportunity to try an at-home stress test with Base — a direct-to-consumer testing company that helps users track their stress, sleep, diet, energy, and sex drive — I jumped on it. If my mind felt a bit on-edge while cranking away at my day job, I wanted to know if my body actually reflected that. I wanted hard proof that my experience was valid and concrete steps I could take to improve it — and maybe this stress test could do just that.

The Link Between Cortisol, Stress, and Your Health

Before diving into the stress test itself, a quick refresher on your body’s response to stress — particularly the key hormone behind it, cortisol. Produced in the adrenal glands (right above the kidneys) and secreted into the bloodstream, cortisol helps control blood sugar levels, regulate metabolism, and reduce inflammation, according to the Endocrine Society. “It's a hormone that’s important in your body’s physiological response to normal day-to-day activities,” says Kenneth J. Perry, M.D., a fellow of the American College of Emergency Physicians. “It’s associated with why you might be waking up at a certain time and why you might be hungry at certain times.”

Since it plays such a key role in these everyday bodily functions, cortisol levels naturally ebb and flow throughout the day; typically, they’ll spike in the morning so you’re ready to tackle what lies ahead, then they’ll gradually decline throughout the day and hit their lowest point while you snooze at night, explains Dr. Perry.

Still, a stressful event like leading a big presentation or driving in a blizzard to get to work can trigger your adrenal glands to kick the production of cortisol up a notch, since it helps your body stay on high alert during times of stress. “When your body’s making that cortisol, it’s kind of like a shot of, ‘Hey we’re in stress mode. We need to tamp down some of our non-essential functions right now so we can really focus on this fight-or-flight threat that’s in front of us right now,” says Chloe Carmichael, Ph.D., a licensed clinical psychologist. “In the short term, it can elevate your heart rate and give you a little bit of extra energy.” You’ll also start breathing more rapidly, blood vessels in your arms and legs will dilate (increasing the amount of blood pumped to these body parts and elevating blood pressure), and your bloodstream glucose levels will increase, according to the American Psychological Association.

Though beneficial in the moment, having this physiological reaction day after day after day — due to constant stress — can do some damage. For starters, consistently having raised levels of stress hormones (like cortisol), an increased heart rate, and an elevated blood pressure can increase your risk for hypertension, heart attack, and stroke, per the APA. Not to mention, being stressed AF 24/7 can be mentally and physically draining, says Carmichael. “In the long term, if you have a lot of extra cortisol in your body, eventually you just start to run out of energy and you can start feeling very depleted,” she explains. “It’s almost like you’re putting the gas pedal down to the floor but there’s nothing left in the tank.” (This might be why — months into the Coronavirus pandemic — you're feeling quarantine fatigue.)

Taking the Stress Test

Since cortisol is intrinsically linked to stress, the Base stress test (Buy It, $60, get-base.com) measures your levels of this hormone at four points throughout the day — when you first wake up, before lunch, before dinner, and right before you hit the sheets — via saliva. Base ships you a kit with all the essentials, including simple instructions, four plastic saliva test tubes, a biohazard bag to stash them in, and a prepaid shipping label to send your spit off to its certified lab partners, which then analyze your samples. 

Credit: Base - Megan Falk - Design: Alex Sandoval

So after a relaxing three-day weekend, I decided to put my stress to the test (literally). That Tuesday morning, I climbed out of bed, grabbed my first test tube, and slowly started to drain my saliva into the tiny vial. While the tube was only about 3 inches tall, it seemed to take me at least 10 minutes to fill it up three-fourths of the way — not including bubbles — a best practice recommended by the company. And that, friends, marks the first (good? weird?) lesson I learned in this journey: I don’t produce as much spit as I had imagined. 

Like most mornings, I woke up feeling anxious about everything penned into my planner for the day — but my workload wasn’t anything totally out of the ordinary. On a scale of “calm AF” to “full-on panic mode,” my mental condition felt like “grimacing face emoji 😬” (or, a 6 out of 10) — a typical, mildly-stressed state for 8 a.m. (Related: How to Stop Stress-Induced Overthinking, According to Mental Health Experts)

That slight sense of uneasiness was still there when I ducked into the bathroom to fill up my second tube five hours later, mid-workday. After conquering my to-dos without any major hiccups, my feelings of stress finally dipped when the clock struck 6 p.m. I powered through a HIIT workout, topped off another spit tube, ate some tacos, and waited another four hours to groggily fill up my final tube right before I snuggled into bed.

With a whole day’s worth of saliva collected, I tossed each of the vials into the biohazard bag, popped it in the fridge right next to my milk, and hit the sheets. The next morning, I'd head to the Post Office to ship my stress test samples off to Base.

 

Credit: Megan Falk

My At-Home Stress Test Results

Unlike getting a blood test done at the doctor’s office, you don’t need to wait around for a letter in the mail or phone call telling you your at-home stress test results. Instead, Base sends you your stats through its app a few weeks later, which also gives you doctor and nutritionist-approved recommendations for supplements, diet modifications, and lifestyle changes that could potentially help you improve your cortisol levels.

When I got a notification that my results were ready, TBH, part of me was expecting to see flashing lights and bold, angry-looking type declaring I had a serious stress problem that I needed to get under control. In reality, the at-home stress test showed my cortisol levels were totally normal. Though they were slightly high first thing in the morning and a bit low before bed, my levels all fell into the healthy range, according to the app. Cue: Me seriously questioning the validity of my own experience with stress: "Was this all in my head? Was I actually imagining my stress? Is this anxious feeling normal for everyone?"

Credit: Megan Falk

To find out exactly what was going on with my cortisol levels — and why they didn’t reflect my perceived mental state throughout the day — I called up Dr. Perry. And as it turns out, even though I felt stressed, the fact that my numbers were in the “healthy” range is a good thing, he says. If a stress test shows that your cortisol levels are through the roof, your adrenal glands could be secreting too much of the hormone, which could mean your adrenal glands themselves aren’t working properly or the “switch” in the endocrine system that tells the glands to start producing more cortisol isn’t functioning right, explains Dr. Perry. “[Your results] aren't saying you're not stressed — it's just saying you have a normal system that’s supposed to tell your adrenal glands to secrete,” he says. “That’s why it’s within a normal level even if you still feel stressed and feel like that day was a little bit worse.”

On the flip side, a person's cortisol levels may be off if they don't have that spike in the morning that gets them ready to tackle the day or if the spike is too big, says Dr. Perry. And since cortisol levels are related to your circadian rhythm, night-shift workers may also have peculiar results. "Night-shift workers are sleeping when their cortisol levels are starting to come down and they aren’t going to have that spike when they’re trying to wake up," says Dr. Perry. "This is really going to affect metabolism and their energy levels, and it's why people who work night shift can have some long term health implications." (If you're experiencing changes in blood pressure, weight, or energy levels, it's best to talk to your doc about trying a cortisol test, as all of these symptoms are associated with adrenal gland disorders, according to the U.S. National Library of Medicine.)

While I’m glad to know that my endocrine system appears to be A-OK — and I have the same healthy spike and fall in cortisol levels that Dr. Perry previously mentioned — I’m still left with questions. If these initial results give me only an overarching look at how my cortisol levels stacked up against the norm, how am I supposed to know if they ever jump higher than my own, personal “normal”? Turns out, you’d have to take a cortisol level test every single day, at the exact same times, to get a clear understanding of your baseline levels and be able to recognize any kind of spikes and dips that would fall within the normal range, says Dr. Perry. (FWIW, Base offers at-home stress tests on a subscription basis, so I could have a test delivered to me every one or three months.)

OK, so I still don’t know exactly how my body physiologically reacts to stress just from this one stress test, but it did give me some insight into why I feel extra jittery and why my heart feels like it’s thumping a bit louder than usual in the morning (thanks to those ever-so-slightly elevated cortisol levels). The results detailing low levels before bed also shows why I have difficulty focusing later into the evening, a symptom of lower cortisol levels, says Dr. Perry. (Another side effect: Not wanting to eat much late at night, but my daily post-dinner dessert cravings prove I’m in the clear on that one.)

How I’m Coping Post-Stress Test

While I haven't yet tried Base’s bigger-picture recommendations to regulate my cortisol levels. For example, overhauling my vegetarian eating style in favor of an adrenal fatigue diet seems like too big of an undertaking for me at the moment (they recommended it since I wasn't 100-percent on par and my morning and night levels were on the lower end of the "healthy" range). However, I have put some of its simpler, more accessible stress-relieving tips into action. To get the anxiety-reducing benefits of aromatherapy, I now keep a soothing candle burning or a diffuser blowing lavender essential oil on my desk throughout the workday. When I need to shut off my brain, I try to fill some of the time I typically spend binge-watching TV shows with relaxing, artistic activities — like watercolor painting and baking fancy desserts that require a steady hand for decorating — which research has shown to help decrease feelings of stress and anxiety.

Plus, I’ve got Carmichael’s stress-relieving tips in my back pocket, too. Whenever I’m feeling overwhelmed, I practice one of her go-to deep breathing exercises, the three-part breath, which helps calm any jitters I may be feeling and stop my mild feelings of panic from spiraling. And if that doesn’t make much of a difference, I send a quick text to my best friend or walk into the other room to chat with my boyfriend for a few minutes to get my mind off my worries. “Connecting socially with other people can help to reduce your stress, which would presumably lower your cortisol levels,” she says. So far, these tricks have given my mind and body the TLC it needs. 

The Bottom Line

Though the Base at-home stress test didn’t give me as much detailed insight into my physiological stress response as I had hoped, it did, at least, show me that I don’t have a serious cortisol problem that needs to be addressed ASAP and reminded me that feeling a little stressed is totally normal (and not always a bad thing!). It also gave me some useful tips that have helped me chill out when I’m on the verge of becoming the “this is fine” dog. But most importantly, I’m learning not to question my stressed-out state. Even if this one test showed I had healthy cortisol levels at the same times I felt anxious, my mental and emotional wellbeing can't and shouldn't be defined entirely by it.

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