Sunday, February 25, 2024

4 Point Saliva Cortisol Test

What Does The Test Measure

My Saliva Cortisol Test Results – Do I Have Adrenal Fatigue?

Testing measures the cortisol hormone in the blood, urine, or saliva. Cortisol is one of several glucocorticoid hormones that help the body control blood sugar levels, respond to stress, and regulate the immune system.

It is normal for cortisol levels to change over the day and react to various stressors. The bodys process of producing cortisol requires several steps:

  • An area of the brain called the hypothalamus produces the corticotropin-releasing hormone .
  • CRH travels to another part of the brain called the pituitary gland and triggers the secretion of corticotropin, also called ACTH.
  • Finally, ACTH is transported to the adrenal glands, where it stimulates the production of cortisol.

In this way, cortisol levels reflect whether these different steps are being carried out normally in the body. Additional information may be gathered by conducting a cortisol test and other tests like the ACTH test.

Why Is It Problematic To Have A Cortisol Problem

  • If cortisol is too low , thyroid hormones cant get to the cells well, whether thyroid hormones made from our thyroid, or from thyroid meds. Cortisol is like the taxi to take your T3 out of the blood to your cells.
  • If thyroid hormones cant get to the cells well due to low cortisol, the T3 pools, going high in the blood and often causing hyper-like symptoms in some as they raise their thyroid meds.
  • If cortisol is too high, we also tend to see our reverse T3 go up, making us more hypo.
  • How Is The Test Performed

    The reason this test is called a 4 tube cortisol-salivary test is that it involves spitting into 4 test tubes at different times of the day. Your saliva contains a lot of information regarding your levels of cortisol. You should do this at different moments of the day to ensure an accurate reading.

    For example, the first collection time is in the morning right after you woke up. This is best done around 8 AM. The second collection time is at noon. In the evening or around 4 PM you should collect another sample. Finally, the last sample should be collected at midnight, preferably between 11 PM and 11:30 PM.

    Your cortisol levels vary depending on various factors. Collecting samples at different moments of the day offers a more accurate reading. The timing is crucial, so you will be responsible to set alarms throughout the day, so you can collect the samples at the right moment.

    Keep in mind that you might need to interrupt taking sublingual hormones or topical hormones at least 2-3 days before collecting the saliva samples. These hormones might interfere with the end result. Your doctor can tell you more information about this, so don’t be afraid to ask what you’re allowed and not allowed to do before taking a 4-tube cortisol-salivary test.

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    What Do The Results Mean

    A cortisol test alone can’t diagnose the cause of abnormal cortisol levels. If your cortisol level isn’t normal, you will usually have more tests to find out what is causing the problem.

    High levels of cortisol may be a sign that you have Cushing’s syndrome. It may be caused by:

    • Taking high doses of certain steroid medicines for a long time to treat conditions, such as asthma, rheumatoid arthritis, and lupus
    • Tumors in your pituitary gland or other parts of your body that make too much of the hormone that tells your adrenal glands to make cortisol
    • Tumors in your adrenal glands that make extra cortisol

    Low levels of cortisol may mean you have Addison disease or secondary adrenal insufficiency:

    • Common causes of Addison’s disease include damage to the adrenal glands from conditions, such as:
    • Certain infections, such as tuberculosis and HIV/AIDS
  • Common causes of secondary adrenal insufficiency include:
  • Autoimmune diseases
  • Traumatic brain injury
  • The most common cause of low cortisol levels is suddenly stopping steroid medicines after using them for a long time.

    If your cortisol results aren’t normal, it doesn’t always mean you have a medical condition that needs treatment. Cortisol levels can be affected by:

    • Certain medicines, such as birth control pills

    To learn what your test results mean, talk with your health care provider.

    Learn more about laboratory tests, reference ranges, and understanding results.

    How Much Does The Test Cost

    Stress Hormone at Home Saliva Test Kit

    The cost of a cortisol test depends on several factors, including:

    • Whether the test uses blood, urine, or saliva
    • Whether the test is done alone or in combination with other tests
    • Whether the test is repeated
    • Where the test is performed
    • Whether you have health insurance and, if so, the details of your health insurance coverage

    Total charges for cortisol testing can include fees for office visits, blood draws, and/or laboratory analysis. Insurance may cover all or some of these charges, but you may be responsible for deductibles or copayments. Talk with your doctors office and health insurance provider for detailed information about the costs of cortisol testing.

    If you do not have health insurance, talk with your doctor or a hospital administrator about cost estimates and whether any programs are available to reduce testing costs if you are uninsured.

    A cortisol test costs $69 from

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    Preventing Acth Stimulation Tests By Salivary Cortisol And Cortisone Measurements

    By using the newly defined cut-off values for salivary cortisol , we investigated their potential role in reducing the numbers of ACTH stimulation tests in the entire patient group . We also investigated the effect of performing a second measurement of morning plasma cortisol, by considering the t=0min plasma cortisol as a second measurement in the patients .

    How Do I Treat A Cortisol Problem Revealed By My Saliva Test

    This is where you can read the patient-to-patient information in the updated revision Stop the Thyroid Madness book, chapters 5 and 6.We all have to be informed in treating this. You can read more about this Bible of Thyroid Treatment here.And all of it can be shared to an open-minded and wise doctor!

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    Where Can I Find A 4 Specimen Cortisol Saliva Test Near Me

    Check our lab finder to locate a collection site in your area.

    Note: Result turn around times are an estimate and are not guaranteed. Our reference lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.


    People ordering this test must acquire a specimen collection kit at the lab prior to making a collection. Once the specimens have been collected, they should be frozen and returned to the lab within 24 hours. Please follow any additional instructions included with the collection kit or given by lab personnel regarding your collection.


    Biochemical Workup Of The Different Patient Groups Before Measurement Of Salivary Cortisol

    How to perform a saliva cortisol test

    All patients tested for adrenal insufficiency developed symptomatic hypoglycemia but did not experience any severe side effects in response to insulin administration during the ITT. Thirty-two patients responded normally to hypoglycemia , whereas 30 patients had a subnormal response . In detail, adrenal insufficient patients had a mean peak serum cortisol of 266.5±30.4nmol/l to insulin-induced hypoglycemia, whereas adrenal sufficient patients demonstrated a mean peak serum cortisol of 586.7±17.9nmol/l. Hypercortisolemic patients had a mean dexamethasone-suppressed serum cortisol of 480.6±35.2nmol/l. Furthermore, mean plasma ACTH was 5.3±0.6pg/ml in patients with cortisol-producing adrenal masses and 66.8±14.1pg/ml in patients with ACTH-dependent Cushing’s syndrome. On the contrary, patients with noncortisol-producing adrenal tumors had a mean serum cortisol of 43.6±4.9nmol/l after dexamethasone.

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    What Are Normal Values For Cortisol Levels

    There are a few reference values for salivary cortisol that help doctors diagnose adrenal insufficiency or other forms of problems with your adrenal glands. Your cortisol levels are usually the highest early in the morning and they drop throughout the day.

    For example:

    • Between 0.025 – 0.600 ug/dl in the morning
    • Between 0.010 – 0.330 ug/dl in the afternoon
    • Between 0.010 – 0.200 ug/dl in the evening
    • Between 0.010 – 0.090 ug/dl at night

    These are the standard values for salivary cortisol for children and adults. Anything higher or lower would qualify you for adrenal insufficiency. Once you get the results, you can compare them against these values as well as ask for assistance from your primary healthcare provider.

    Functions Influenced By Cortisol Levels

    Energy Production

    Abnormal adrenal function can alter the ability of cells to produce energy for the activities of daily life. People who have a hard time rising in the morning, or who suffer from low energy throughout the day, often have abnormal adrenal rhythms and poor blood sugar regulation.

    The maintenance of a stable blood sugar level depends on food choice, lifestyle, adrenal function, and insulin activity. The Adrenal Stress Index panel measures stress hormones and insulin, to help clarify the causes of fatigue, cravings, and obesity.

    Immune System Function

    Various immune cells cycle in and out of the spleen and bone marrow. The immune system trafficking follows the cortisol cycle. If the cycle is disrupted, especially at night, then the immune system is adversely affected. Short and long-term stress is known to suppress the immune response in the lungs, throat, urinary tract, and intestines. With lowered levels of mucosal antibodies , our resistance to infection is reduced and allergic reactions may increase.

    Skin Integrity

    Human skin regenerates mostly during the night. With higher night cortisol values, less skin regeneration takes place. Therefore a normal cortisol rhythm is essential for optimal skin health.

    Muscle and Joint Function

    Abnormal adrenal rhythms are known to compromise tissue healing. Reduced tissue repair and increased tissue breakdown can lead to muscle and joint wasting with chronic pain.

    Bone Health

    Allergies/Autoimmune Disorders

    Sleep Quality

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    When Should I Get This Test

    Your doctor may recommend cortisol testing if they think you have a condition affecting your cortisol levels.

    Doctors may initiate cortisol testing if you have a health problem unusual for people your age, such as young adults with hypertension or osteoporosis. They may also recommend cortisol testing if you have a severe health condition affecting cortisol levels or if your doctor finds an adrenal tumor during imaging tests conducted for an unrelated concern.

    Your doctor may recommend cortisol testing based on your symptoms, especially if you have more than one symptom of high cortisol that worsens with time. Symptoms of high cortisol include:

    • Unexplained weight gain, particularly in children
    • Fat accumulation around the base of the neck
    • A hump-like pad of fat between the shoulders
    • Slow growth in children
    • Unexplained weight loss

    Conditions that cause high and low cortisol levels are rare, and other diseases most often cause these symptoms. Thus, a doctor may test for more common conditions before initiating cortisol testing.

    In addition to diagnostic testing, cortisol may be tested as a type of monitoring if you have been previously diagnosed with high cortisol and are taking medications to lower your cortisol levels.

    Taking A Cortisol Test

    Stress Hormone at Home Saliva Test Kit

    Cortisol can be measured in the blood, saliva, or urine. Because cortisol levels change throughout the day, your doctor will likely recommend that your test be conducted at a specific time, depending on the tests purpose.

    Blood samples for cortisol tests are often collected early in the morning when the cortisol level in your blood should be at its highest. The blood sample is usually taken from your arm at a medical office, hospital, or lab.

    Saliva for a cortisol test may be collected at a medical office or home. When testing for high cortisol, your doctor may instruct you to collect a saliva sample late at night while at home.

    For a cortisol urine test, you will be provided with containers and detailed instructions on collecting all the urine you produce in 24 hours, after which you will return it to a lab. For convenience, you may choose a 24-hour period when you expect to be at home.

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    Best Urine Sample Cortisol Test: Everlywell Sleep & Stress Test

    • Sample type: This test requires a urine sample.
    • Results time: People receive their results in 25 days.
    • Pro: It tests for three hormones over different periods of the day. Everlywell also accepts flexible savings account and health savings account payments.
    • Con: It is expensive.

    This Everlywell product uses a urine sample to test the levels of three hormones, cortisol, cortisone, and melatonin, over four points during the day. It also tests for another marker, creatinine, which is a waste product of the muscles.

    There are three steps to this test. First, a person registers the testing kit on Everlywells website, follows the instructions to take the urine sample, places it in the prepaid package, and sends it off to Everlywells certified labs.

    People will receive their results digitally via the Everlywell website. Everlywell claims this can be within 25 days. Healthcare professionals can also offer insights into a persons results via Everlywells secure platform.

    In addition to providing a personalized report of each marker, Everlywell sends detailed information explaining the results.

    The company claims that the labs where Everlywell tests samples are CLIA certified. Everlywell also says it ensures that independent, board certified doctors within the persons state review and approve all results.

    This test is best for people who want into their hormone fluctuations and prefer urine sample tests.

    The Everlywell Sleep & Stress Test costs $199.

    When To Speak With A Doctor

    A person should undergo a cortisol test if they believe they may have high or low cortisol levels.

    They can do this at home or speak with a medical professional who can carry out the test for them.

    People may also wish to seek medical help if they show signs of too much or too little cortisol. This could indicate a potentially serious underlying health issue.

    Below are answers to common questions about at-home cortisol tests.

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    Are The Tests Accurate

    The results of your at-home cortisol test are processed in the same labs that a doctors office uses, so theyre generally accurate.

    However, the accuracy can depend on the type of test and collection method. If you receive your results and are unsure if theyre accurate, most test providers offer to review your results with you.

    Its also a good idea to talk with a doctor after taking the test if you need more insight or guidance for next steps.

    How Do You Prepare For A Cortisol Test

    (TBS #16) Is Salivary Cortisol Testing Worth the Money? 5 Important Things to Know

    It depends on the type of test youre taking and what your doctor tells you to do.

    If youre getting a salivary test, dont eat, drink, or brush your teeth beforehand. If youre getting a blood test, its important to be well hydrated.

    Try to relax and get some rest, as stress may affect your cortisol levels. Your doctor may ask you to avoid any strenuous physical activity the day before a cortisol test too.

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    How To Collect The Specimen

  • Use a permanent marker to write your childs full legal name, date of birth and date and time of the collection on the label in the kit. Attach it to the outside tube of the Salivette collection device .
  • Wash your hands with soap and water, rinse and dry well before starting the test.
  • Take the cap or stopper off the container to get to the swab . Never touch the swab with your hands. Always leave the insert inside of the tube . The insert is needed to process the specimen at the lab .
  • Tip the tube directly inside the childs mouth. The swab should fall on top of or under the tongue so that it can move freely in the mouth. Do not let the swab go in between the cheek and gum.
  • Please watch your child closely to be sure that they do not choke on or swallow the swab.
  • Ask your child to roll the swab inside their mouth for 2 to 3 minutes. It is OK to gently chew it. The swab must be completely wet to do the test right.
  • Ask your child to carefully spit the wet swab back into the insert without touching it.
  • Put the stopper back on tightly. The cap will click when closed correctly.
  • Look at the swab to make sure that there is no blood, mucus or bits of food or debris. The specimen should be clear.
  • Put the specimen in the refrigerator.
  • Advanced Adrenal Stress Test

    Stress Could Be A Cause of Your Patients Illness

    Precision Point Diagnostics Adrenal Stress Test measures 4-point cortisol, DHEA , and secretory IgA in a convenient saliva specimen. Cortisol has been found unbound in saliva samples, indicating a strong correlation to cortisol concentrations in serum.1 Checking patients for low or high cortisol over the course of the day is essential to address fatigue, insomnia, thyroid disorders, or weight gain. However, adrenal function, officially known as the hypothalamic-pituitary-adrenal axis, impacts many other systems and symptoms in the body. Low cortisol levels may cause blood pressure dysregulation, irritability, hypoglycemia, anxiety, depression, and difficulty coping with lifes challenges.

    Knowing exactly what your patients cortisol levels are throughout the day helps you customize an effective treatment to bring the cortisol curve- or circadian rhythm- back into balance. Findings from the Adrenal Stress Test can help to balance DHEA, a precursor hormone for estrogen and testosterone. The test also gives information about salivary sIgA, a critical player that prevents infection at the mucosal lining.

    A First-Line Test for Overall Health Assessment

    Abnormal Cortisol Symptoms

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    Order Your 4 Tube Cortisol Salivary Test Today

    Remember that many complicated and even life-threatening diseases are usually caused by too much stress. Not only that excessive stress reduces the quality of your life, but it can also make you ill in just a few years.

    Fortunately, you can now scientifically measure your stress levels using a 4 tube cortisol-salivary test. Order this type of test from today and check your cortisol levels. The results are completely confidential and they will be emailed back to you in just a couple of business days!

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