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Cortisol, Salivary, Free, 24-Hour Composite

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

This test measures the total amount of free cortisol present in your saliva over a 24-hour period. Cortisol is a hormone produced by your adrenal glands that helps regulate metabolism, immune response, and stress reactions.

Quick summary

["This test helps assess how well your body manages stress and hormone balance over time."]

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

Key facts at a glance

LOINC
58660-2
Short code
Cortis sp2 p chal Sal-sCnc
Synonyms
Cortis sp2 p chal Sal-sCnc
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 Might Be Ordered

Your healthcare provider may recommend this test if they suspect conditions like Cushing’s syndrome (too much cortisol), adrenal insufficiency (too little cortisol), or other hormonal imbalances. It can also be used to monitor treatment effectiveness for conditions affecting cortisol levels.

What to Expect Before the Test

No special preparation is needed. You’ll collect saliva samples throughout the day (typically every 2 hours) into a special container provided by your lab. Bring the container back to the lab within 24 hours of collection for analysis.

What Happens During the Test

Saliva samples are analyzed using a sensitive immunoassay method to measure cortisol levels. The test measures free (non-protein-bound) cortisol, which is more accurate for assessing natural hormone fluctuations.

What the Results Mean

Results are reported as the total amount of cortisol excreted in saliva over 24 hours. While reference ranges vary by lab, elevated levels may indicate overproduction of cortisol, while low levels may suggest adrenal gland dysfunction or other hormonal issues.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

Clinical Significance

Frequently asked questions

What does elevated cortisol mean?
Elevated levels may signal conditions such as Cushing’s syndrome (from tumors or prolonged steroid use), chronic stress, or certain medications. Repeated testing may be needed to confirm diagnosis and guide treatment.
What does low cortisol mean?
Low cortisol can indicate adrenal insufficiency (e.g., Addison’s disease), where the adrenal glands fail to produce enough cortisol. This may cause fatigue, weight loss, or low blood pressure. Treatment often involves hormone replacement.
How often should I get this test?
Results may be used to monitor chronic conditions or treatment progress. Follow your healthcare provider’s instructions for follow-up testing, which could be every few months or annually depending on your situation.
  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