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Cortisol in Saliva (Free Cortisol)

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

This test measures cortisol, a natural steroid hormone produced by your adrenal glands, in your saliva. It helps assess your body’s stress response over a 24-hour period.

Quick summary

["Saliva cortisol testing can help diagnose conditions related to cortisol levels, such as Cushing’s syndrome or adrenal insufficiency."]

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

Key facts at a glance

LOINC
58693-3
Short code
Cortis sp6 p chal Sal-sCnc
Synonyms
Cortis sp6 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 Is Done

Your doctor may recommend this test if they suspect an issue with your body’s natural cortisol production or regulation. Saliva cortisol is often used to evaluate chronic stress responses or to confirm diagnoses like Cushing’s syndrome or adrenal insufficiency, which can’t always be detected by blood tests alone.

How the Test Works

A small sample of your saliva is collected, usually in the morning, and analyzed to measure free cortisol levels. Unlike blood tests, saliva cortisol reflects natural hormone levels without interference from blood proteins.

What to Expect Before the Test

No special preparation is needed. You may collect saliva samples at home over a 24-hour period, often starting in the morning, or a single morning sample may be taken in a clinical setting.

Possible Results and Interpretation

Results are compared to reference ranges for healthy individuals, though exact values can vary by lab. High cortisol levels may indicate overproduction (e.g., Cushing’s syndrome), while low levels may suggest adrenal gland issues or stress-related suppression.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

Clinical Significance

Short name

Saliva Cortisol

Frequently asked questions

What might cause abnormal results?
Abnormally high cortisol in saliva can be linked to conditions like Cushing’s syndrome (due to excess cortisol from tumors or medications), chronic stress, or certain medications. Abnormally low levels may signal adrenal insufficiency, pituitary disorders, or long-term use of cortisol-suppressing drugs.
How often should I get this test?
Your doctor will determine the frequency based on your symptoms, medical history, and other tests. It may be repeated if initial results are unclear or if you’re being monitored for a known condition.
Can I take anything before or after the test?
No special preparations are required, but avoid smoking or consuming caffeine, alcohol, or certain medications (like some antidepressants or steroids) that could affect cortisol levels before collection. If you’re unsure, ask your doctor.
  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