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

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

This test measures cortisol levels in your saliva and urine over 24 hours to assess your body’s natural cortisol production and stress response.

Quick summary

["Helps evaluate adrenal function and potential stress-related hormone imbalances."]

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

Key facts at a glance

LOINC
57692-6
Short code
Cortis sp5 Sal-mCnc
Synonyms
Cortis sp5 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 healthcare provider may order this test if you have symptoms like fatigue, weight changes, or mood swings that could indicate hormonal issues. It’s also used to diagnose conditions like Cushing’s syndrome or adrenal insufficiency.

What to Expect Before the Test

You’ll need to collect saliva samples throughout the day and urine over 24 hours. Follow your provider’s instructions carefully to ensure accurate results. Avoid caffeine and certain medications that may affect cortisol levels.

How the Test Works

Saliva samples are collected at regular intervals, while urine is collected in a container over a full day. Both samples are analyzed to measure cortisol concentration, which helps assess cortisol rhythms and total production.

Common Conditions Monitored

This test helps diagnose or monitor conditions like Cushing’s disease (excess cortisol), adrenal insufficiency (low cortisol), or evaluate stress responses in chronic illnesses.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

Clinical Significance: Cortisol is a steroid hormone produced by the adrenal glands, regulating metabolism, immune response, and stress reactions. Abnormal levels can indicate underlying endocrine disorders or chronic stress.

Short name

Saliva & Urine Cortisol

Frequently asked questions

What does a high cortisol level mean?
High cortisol may suggest overproduction from conditions like Cushing’s syndrome, prolonged stress, or certain medications. Your provider will review your symptoms and test results to determine the cause.
What does a low cortisol level mean?
Low cortisol could indicate adrenal insufficiency, where the body fails to produce enough cortisol, or other hormonal imbalances. This may require further evaluation, including blood tests or imaging.
Do lifestyle factors, like diet or sleep, affect cortisol levels?
Yes, diet (e.g., caffeine, alcohol), sleep patterns, and stress levels can influence cortisol. Your provider will guide you on how to prepare for the test to get the most accurate results.
  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