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Cortisol, Saliva (Free)

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

This test measures the amount of cortisol, a natural steroid hormone, in your saliva. It helps assess your body’s stress response and adrenal gland function.

Quick summary

["Saliva cortisol testing can help diagnose conditions linked to stress or adrenal issues."]

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

Key facts at a glance

LOINC
28046-1
Short code
Cortis sp2 Sal Ql
Synonyms
Cortis sp2 Sal Ql
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

Saliva cortisol testing is often used to evaluate chronic stress, adrenal insufficiency (such as Addison’s disease), or Cushing’s syndrome. Unlike blood tests, saliva cortisol reflects natural hormone levels over time without interference from medications or stress-induced spikes.

What to Expect Before the Test

No special preparation is needed. Simply collect saliva into a provided container—usually by letting saliva pool in your mouth for a few minutes. The test is quick and painless.

How the Results Are Interpreted

Results are compared to reference ranges for cortisol in saliva, which vary by age and health status. Abnormal levels may indicate overproduction (e.g., Cushing’s) or underproduction (e.g., adrenal fatigue).

Common Conditions Linked to Cortisol Testing

Saliva cortisol is particularly useful for diagnosing conditions like chronic stress-related cortisol dysregulation, primary adrenal insufficiency, or certain pituitary disorders. It avoids the variability of blood cortisol, which can spike with stress or medication.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

Clinical significance: Saliva cortisol provides a more stable measure of baseline hormone levels, reducing false positives from acute stress or circadian fluctuations. It’s especially valuable for detecting subtle or chronic adrenal dysfunction in patients with symptoms like fatigue, weight changes, or unexplained stress.

Short name

Saliva Cortisol

Frequently asked questions

What does a high saliva cortisol level mean?
A high level may suggest chronic stress, Cushing’s syndrome (excess cortisol production), or other conditions causing prolonged cortisol elevation. Your doctor will consider your symptoms and other test results to diagnose the cause.
What does a low saliva cortisol level mean?
A low level may indicate adrenal insufficiency (e.g., Addison’s disease), where the adrenal glands don’t produce enough cortisol. This can lead to fatigue, low blood pressure, or salt cravings. Further testing may be needed to confirm the diagnosis.
Can I take medications before this test?
Some medications (e.g., steroids, certain antidepressants) can affect cortisol levels. Your doctor will provide specific instructions based on your treatment plan. Avoiding caffeine or alcohol for 24 hours before testing may also improve accuracy.
  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