Materials and device architectures for cortisol detection: Mechanisms, measurement technologies, and clinical...

Cortisol, the primary glucocorticoid produced in response to stress, can be a chronic health risk or a protective partner. Cortisol spikes can help people survive by triggering energy mobilization, immune regulation, and neuroendocrine balance, but sustained or low cortisol levels precipitate diseases including immune dysfunction, metabolic syndrome, mood disorders, and cognitive impairment. This contribution is a review of the opposing role of cortisol, elucidating its physiological role, pathological consequences, detection techniques, regulation mechanisms, and biosynthesis. It reviews different regulatory modalities for both pharmacological and lifestyle aspects, evaluates ways of measurement, such as new wearable biosensors, and focuses on early responses of cortisol in response to factors related to pharmacological and lifestyle-based regulatory strategies and the importance of early events on responsiveness. A detailed discussion of numerous methods for the detection of cortisol is carried out. A multi-sided view of the role of cortisol in both health and disease is provided in presenting evidence from past perspectives, clinical situations, and present-day evidence based on some of the newest research.