Cortisol, Salivary, 24-Hour Composite (Total)
This test measures the total amount of cortisol, a natural steroid hormone, in your saliva over a 24-hour period. Cortisol helps regulate metabolism, immune response, and stress reactions.
["Assesses long-term cortisol levels to help diagnose conditions like Cushing’s syndrome or adrenal insufficiency."]
Key facts at a glance
- LOINC
- 109644-5
- Short code
- Cortis Msmt Sal
- Synonyms
- Cortis Msmt Sal
- Category
- hormone
- Sample
- serum
- Container
- Red-top tube (SST)
- Units
- N/A
- Fasting
- false
- Population
- adult
- Sex
- all
- Age range
- 18–65 years
- Specimen volume
- 5 mL
- Stability
- Room temperature: 4h, Refrigerated: 24h, Frozen: 7d
- Hemolysis max
- 500
- Lipemia max
- 1000
- Icterus max
- 500
- TAT
- 4–24 hours
- Order
- routine
Why This Test Matters
Salivary cortisol is often used because it reflects free (unbound) cortisol levels in your body, which can be more accurate than blood tests. Measuring it over 24 hours gives a full picture of your cortisol rhythm, which may not be captured by single blood samples.
How It’s Collected
You’ll collect saliva samples at regular intervals (usually every 30–60 minutes) over 24 hours. A healthcare provider will provide instructions on how to properly collect each sample to ensure accuracy.
What It Measures
Cortisol is a hormone produced by your adrenal glands, which sit on top of your kidneys. It peaks in the morning and drops at night, helping you manage stress and maintain energy levels. Abnormal levels can indicate conditions like overproduction (Cushing’s) or underproduction (adrenal insufficiency).
When It’s Ordered
Your doctor may recommend this test if you have symptoms like unexplained weight changes, fatigue, high blood pressure, or signs of hormonal imbalances. It’s also used in research or specialized evaluations for stress-related or endocrine disorders.
Clinical interpretation
How abnormal results are interpreted and what conditions they suggest.
Elevated salivary cortisol over 24 hours may suggest Cushing’s syndrome, where the body produces too much cortisol due to tumors or long-term steroid use. Low levels could indicate adrenal insufficiency, where the adrenal glands don’t produce enough cortisol. This test helps rule out or confirm these conditions by showing consistent patterns of hormone release.
Short name
24-Hour Salivary Cortisol
Frequently asked questions
What does a high or low result mean?
How long does it take to get results?
Can I take medications before this test?
Sources
- 1
- 2Lab Tests OnlineSource
- 3
Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 16, 2026. · Read our editorial policy