Stress, regardless of its source, affects the production of many hormones and neurotransmitters. Cortisol, as an example, is rapidly elevated following acute stress and remains elevated when the body is subjected to prolonged, stressful circumstances. Epinephrine, the "fight or flight" hormone, is also produced when the body is confronted with stress. Even when these hormones are not the intended measurand, many have a secondary effect on the more commonly measured analytes. One such example is glucose, which becomes elevated as a result of cortisol being elevated as the body is attempting to assure itself with an energy source to confront the stress. Hospitalized patients often have higher glucose levels due to the increased degree of stress. High cortisol due to prolonged periods of stress can also increase cholesterol, which is the building block used to produce cortisol and the steroid hormones.
Maintaining a comfortable and stress-free phlebotomy draw station, minimizing wait times, and facilitating pleasant interactions may alleviate the anxiety and stress of blood collection.