Measure Your Allostatic Load: The 10-Marker Index You Can Track at Home

Why measurement is the leverage point

Allostatic load is the cumulative biological cost of sustained stress and incomplete recovery. It is what predicts breakdown into chronic disease more reliably than current stress levels do.

You cannot intervene on what you cannot see. And by the time the load has caused diagnosable disease, you have already paid the cost. The leverage point is measuring the load before the breakdown - then intervening on the inputs that are pulling it up.

The McEwen index uses 10 biomarkers across five systems. Most are practical to track at home or in routine bloodwork.

The 10 markers and how to track each one

HPA axis:

1. Cortisol, saliva cortisol curves (4-point or DUTCH test). Look for a steep morning peak and a low evening trough. Flat curves = high allostatic load. Available through functional medicine labs.

2. DHEA-sulfate, single blood test. Often falls with chronic load. Normal range varies by age and sex.

Sympathetic nervous system:

3. Resting heart rate (RHR), any wearable. Trends matter more than individual values. RHR creeping up over months = load.

4. HRV, wearables (Oura, Whoop, Garmin, Apple Watch with third-party app). Falling HRV trend = load.

Cardiovascular:

5. Systolic blood pressure, home cuff. Elevated trend = load.

6. Diastolic blood pressure, same.

Metabolic:

7. HbA1c (3-month average glucose), routine bloodwork. Rising = insulin resistance from chronic cortisol exposure.

8. Waist-hip ratio (visceral adiposity proxy), tape measure at home. Rising waist:hip ratio without weight change = visceral fat accumulation, a load marker.

Inflammatory:

9. hs-CRP (high-sensitivity C-reactive protein), routine bloodwork. Chronically elevated = systemic inflammation.

10. IL-6, less commonly tested but a clear load marker. Available through specialised labs.

Index score: count how many of the 10 markers are in the worst quartile for your age/sex. 0-2 = low load. 3-4 = moderate. 5+ = high load. The composite is what predicts disease.

Daily, lighter-touch measurement

Lab work is quarterly at best. Daily measurement is where the regulation work actually happens. The variables to log daily:

• Sleep hours and subjective quality
• Resting heart rate (morning)
• HRV (overnight)
• Mood
• Cognitive function
• Pain level
• Energy
• Activity load
• Major stressors

The Recalibrate Stability Score combines six of these (autonomic, pain, mood, cognition, sleep, activity) into a single daily number. Watching the Stability Score across weeks gives you a visible read of allostatic load trends - and surfaces which inputs (poor sleep, conflict, post-viral days, hormonal phase) are pulling it up for you.

What to do when the load is high

Lowering allostatic load is a 3-6 month project, not a one-month sprint.

The non-negotiables:
- Sleep architecture protection - the system requires deep sleep to downregulate cortisol overnight. This is the single largest lever.
- Daily vagal toning - HRV breathing, cold exposure, humming, or whatever sticks. 15 minutes a day, every day.
- Movement within tolerance - regular, gentle. Cortisol clears with movement, but too much produces a rebound.
- Glucose stability - protein and fat with carbs. No liquid sugar.
- Co-regulation - safe humans, safe animals, safe environments. Underrated and biological.

The lab markers move slowly. The daily Stability Score moves within weeks. Use the daily score for feedback; use the quarterly bloodwork for proof.

Track your allostatic load in Recalibrate →

Related reading:
→ Allostatic load explained
→ Stuck in fight or flight
→ Nervous system dysregulation pillar guide