, Volume 63, Issue 1, pp 131–139 | Cite as

Assessment of hair cortisol in euthyroid, hypothyroid, and subclinical hypothyroid subjects

  • Darya Saeed AbdulateefEmail author
  • Taha Othman Mahwi
Original Article



Hypothyroidism is associated with an increase in serum cortisol level while the long-term activity of hypothalamic-pituitary-adrenal (HPA) axis in hypothyroid, and subclinical hypothyroid (SCH) subjects has not been studied. This study aimed to assess the hair cortisol levels as a long-term activity of HPA axis in hypothyroid, SCH and a group of healthy adult subjects. Also, it aimed to examine the correlation of hair cortisol levels with hypothalamic-pituitary-thyroid (HPT) axis and anthropometric measures.


We prospectively evaluated a group of normal, SCH and hypothyroid subjects. Serum TSH, FT4, and FT3 were measured as a component of the HPT axis. Hair samples were collected, prepared, followed by extraction of hair cortisol and measurement in pg/mg of hair. Hair cortisol levels were compared in normal, SCH and hypothyroid groups and correlated with HPT axis and anthropometric data.


A total of 65 healthy volunteers were analyzed, and the mean hair cortisol level was reported to be 17.38 pg/mg of hair. Hair cortisol level was slightly higher in the SCH subjects, 18.19 pg/mg of hair; however the difference was not significant. Compared to the euthyroid subject, a significantly higher hair cortisol level was recorded in the hypothyroid subjects, 24.17 pg/mg hair, p < .05. Hair cortisol was significantly and positively associated with each of the serum TSH, age, weight and BMI (p < .05).


Overt hypothyroidism but not SCH is significantly associated with higher hair cortisol levels compared to normal subjects, and a significant relation between hair cortisol with HPT axis was found. Also, weight and BMI were positively correlated with hair cortisol level.


Hair cortisol Hypothyroid Subclinical hypothyroidism Euthyroid TSH BMI 



The authors would like to express their gratitude to all the staff members of Saman's Lab in the Sulaymaniyah city. Here, a part of the hair cortisol preparation and analysis was conducted with the help of Dr. Saman, and the biologists Kamaran Jamal and Karzan. We would like to acknowledge all the staff members of MediaMed Lab in the Sulaimaniyah city, especially their Lab Manager; Mohammed Musa, for his unforgettable help in hormone measurement and providing some materials for hair cortisol analysis as pure methanol and the microbiologist, Mahmood Qaradakhy. We also appreciate the help of Shar Hospital Medical ward and Laboratory staff for allowing the research. We are indebted to the family, friends, and the hospital staff and their relatives for volunteering in this study. Without them, the study could not have been completed.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the ethics committee of the College of Medicine-University of Sulaimani under meeting number 62, and all procedures in the study have been performed in accordance with the ethical standards of the 1964 Declaration of Helsinki.

Informed consent

Written informed consent was obtained from all individual participants included in the study.


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Authors and Affiliations

  1. 1.Physiology Department, College of MedicineUniversity of SulaimaniSulaymaniyahIraq
  2. 2.Department of Medicine, College of MedicineUniversity of SulaimaniSulaymaniyahIraq

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