Feeling overwhelmed or suspect that stress may be affecting your energy levels and mood? Our Cortisol Saliva Stress Test measures your cortisol levels at four key points throughout the day, helping you understand your daily hormone rhythm and pinpoint imbalances that might be impacting your well-being.
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What's in the test?
Adrenal hormones
Cortisol - waking
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Cortisol levels should be highest in the morning, peaking 20-30 minutes after waking, and then declining gradually through the day until midnight.
Cortisol 1200
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By midday your cortisol should have declined significantly from its level on waking.
Cortisol - 16:00
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Cortisol - before bed
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Cortisol levels decline gradually throughout the day and should be at their lowest at bed time to ensure a good night's sleep.
How to prepare for your test
Do not eat or drink for 60 minutes before your test. Do not brush your teeth for 30 minutes before your test. Your result could be affected by corticosteroid medication (e.g. prednisolone). Ask your doctor whether you should stop before testing. HRT and the contraceptive pill can affect the results of this test, taking the test during a break from these will give more accurate results. Do not take biotin supplements for 2 days prior to this test. If you are taking prescribed biotin you should discuss this with your doctor.
Test limitations
Although a Cortisol Blood Test can tell you if your cortisol level is outside the normal range, it cannot pinpoint the cause. It’s important to see your GP if your level is abnormally high or low, as this may indicate a condition that needs treatment.
Even if your result is normal, you may still have an adrenal condition. If you have symptoms of Addison’s disease or Cushing’s syndrome, you should visit your GP who will likely request further tests.
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FAQs
When should I take my cortisol saliva sample?
Cortisol levels naturally fluctuate throughout the day but sometimes your levels might higher or lower than normal causing symptoms such as difficulty waking in the morning or going to sleep at night and craving sugary snacks especially late in the day. Cortisol levels should be highest just after waking in the morning and lowest at bedtime. This test establishes the levels of cortisol in the saliva at 4 different points in the day. Samples are taken after waking, 12 noon, 4pm and before going to sleep.
What can I learn from the cortisol saliva test?
This test can tell you if you are experiencing excessive stress during the day and whether you need to be adjusting your lifestyle to introduce more relaxation and modify other lifestyle factors such as your sleep and your diet. This test may help identify Cushing's syndrome, which is caused by too much cortisol. The Endocrinology Society Guidelines advise 2 raised salivary before-bed cortisol levels for the diagnosis of Cushing’s; therefore, if you have a raised before-bed cortisol, you may be advised to have a repeat test.
This test is not appropriate for diagnosing Addison's disease, which is caused by damage to the adrenal glands and is associated with too little cortisol. The reference ranges for most times of the day do not have a lower limit, meaning these results would not be classified as low even if Addison's disease is possible.
We recommend you consult your GP or usual doctor if you think you have symptoms of this condition (e.g., weakness, tiredness, loss of appetite, nausea, weight loss, darkened skin, muscle weakness and low blood pressure (particularly on standing up causing dizziness and fainting.)
What is cortisol?
Cortisol is a steroid hormone, produced by the adrenal glands. It is vital for survival given its role in various functions such as immunity, regulating blood pressure and releasing insulin for blood sugar maintenance. Cortisol has been termed the 'stress' hormone because it is secreted in higher quantities during the body's 'fight or flight' response to stress, and is responsible for several stress-related changes in the body.