Cortisol, Salivary, Free, 24-Hour Integrated
This test measures the amount of free cortisol naturally present in your saliva over a 24-hour period. It helps assess cortisol levels, which are linked to stress and adrenal gland function.
["A 24-hour salivary cortisol test helps diagnose conditions related to cortisol imbalance, including Cushing’s syndrome or adrenal insufficiency."]
Key facts at a glance
- LOINC
- 58678-4
- Short code
- Cortis pre 1 ug/kg CRH IV Sal-mCnc
- Synonyms
- Cortis pre 1 ug/kg CRH IV Sal-mCnc
- Category
- hormone
- Sample
- serum
- Container
- Red-top tube (SST)
- Units
- N/A
- Fasting
- false
- Population
- adult
- Sex
- all
- Age range
- 18–65 years
- CPT
- 86701
- 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 Is Done
Your doctor may recommend this test if they suspect an issue with your body’s cortisol production. Cortisol is a hormone produced by your adrenal glands that helps regulate stress responses, metabolism, and immune function. Salivary cortisol testing is often used because it reflects free (unbound) cortisol levels, which are more accurate than blood tests for certain conditions.
How the Test Works
You’ll collect saliva samples throughout the day, typically every few hours, into pre-labeled containers. These samples are then sent to a lab for analysis. The lab measures the cortisol concentration in each sample and integrates the results over the full 24 hours to provide an average level.
What to Expect Before the Test
No special preparation is usually needed, but avoid caffeine, nicotine, or certain medications that could affect cortisol levels for a few hours before testing. Follow your doctor’s instructions carefully.
What to Expect During the Test
You’ll collect saliva samples at home or in a clinic, depending on your doctor’s instructions. It’s a simple process—just spit into the container at the scheduled times. The samples are then mailed or delivered to the lab for processing.
Clinical interpretation
How abnormal results are interpreted and what conditions they suggest.
High or low cortisol levels can indicate serious conditions, such as Cushing’s syndrome (too much cortisol) or adrenal insufficiency (too little cortisol). Salivary cortisol testing is particularly useful for diagnosing Cushing’s syndrome because it measures free cortisol, which is less affected by binding proteins in the blood. It can also help rule out other conditions like pituitary tumors or stress-related cortisol fluctuations.
Short name
Salivary Cortisol (24-hour)
Frequently asked questions
What does a high or low salivary cortisol result mean?
Does this test require fasting?
How long will it take to get results?
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