• Stress regulation: Over-reactive HPA axis patterns.
• Work-related stress: Ongoing job-related or anticipatory stress.
• Mood concerns: Depression not linked to seasonal patterns.
• Pain patterns: Waking with pain, including migraines or joint discomfort.
• Metabolic regulation: Glycaemic dysregulation.
• Stress reactivity: Difficulty coping with daily stressors despite normal baseline cortisol levels.
• Sleep-related symptoms: Non-restorative sleep or difficulty waking refreshed.
• Energy patterns: Marked morning energy fluctuations.

DUTCH CAR™ (Cortisol Awakening Response) measures free cortisol levels in saliva collected at waking, 30 minutes after waking, 60 minutes after waking, and later in the day. This targeted sampling captures the characteristic rise and fall in cortisol that occurs in the first hour after waking, alongside the broader daily cortisol pattern.

These markers are included to assess how the stress response system reacts at the moment of waking, which provides information beyond overall daily cortisol levels. The magnitude and timing of the cortisol increase after waking may highlight patterns of heightened or reduced stress reactivity that are not always visible in standard diurnal cortisol testing.

Practitioners typically review CAR results alongside symptom patterns, sleep quality, perceived stress, daily routines and other relevant laboratory findings. Results are interpreted in context to understand how the waking stress response aligns with the lived experience of clients.

Test Type:

Five saliva samples collected over the course of one day, from waking to bed time

Turnaround Time:

Maximum of 21 days