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Cortisol, Saliva, 24-Hour Urine Free Cortisol (Mass Concentration)

Published: August 9, 2026Updated: August 16, 2026

This test measures cortisol levels in your saliva over 24 hours and in your urine to assess cortisol production and balance, often used to evaluate adrenal function or Cushing’s syndrome.

Quick summary

["Helps diagnose conditions linked to abnormal cortisol levels, like adrenal disorders or stress-related hormone imbalances."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 16, 2026Editorial policy

Key facts at a glance

LOINC
51493-5
Short code
Cortis sp2 p chal Sal-mCnc
Synonyms
Cortis sp2 p chal 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
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 you have symptoms like unexplained weight gain, high blood pressure, fatigue, or mood changes that could suggest an adrenal gland issue. It may also be used to confirm or rule out conditions like Cushing’s syndrome or adrenal insufficiency.

How the Test Works

You’ll collect saliva samples throughout the day and urine over 24 hours to measure cortisol levels naturally excreted in these fluids. Results help track how your body produces cortisol over time.

Sample Collection Process

Saliva: Use provided collection devices at home for 24 hours, collecting samples at regular intervals. Urine: Collect all urine in a 24-hour period, storing it in a special container. Follow your lab’s instructions precisely.

What to Expect Before the Test

No special preparation is needed for saliva collection, but avoid caffeine or smoking for 24 hours before urine collection. For saliva, avoid eating or drinking right before collection.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

Elevated cortisol levels may indicate Cushing’s syndrome or excessive stress, while low levels could signal adrenal insufficiency or other hormonal imbalances. These tests help diagnose and monitor conditions affecting cortisol production.

Short name

Saliva & Urine Cortisol Test

Frequently asked questions

How long will I need to collect samples?
You’ll need to collect saliva samples every few hours for 24 hours and urine for the full 24-hour period. Your lab will provide detailed instructions to simplify the process.
Can I take medications before or during sample collection?
Some medications may affect cortisol levels. Always inform your doctor or lab technician about any medications you’re taking, including over-the-counter drugs or supplements.
Will I experience any side effects from the test?
No side effects are expected from saliva collection, but urine collection may require emptying your bladder at specific times. Follow your lab’s guidelines to avoid discomfort.
  1. 1
    MedlinePlus — Laboratory TestsSource
  2. 2
    Lab Tests OnlineSource
  3. 3
    Mayo Clinic — Tests & ProceduresSource

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.

Medical Disclaimer

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