Cortisol in Saliva (Free Cortisol)

Why This Test Is Done

Saliva cortisol testing is typically ordered to diagnose conditions related to the adrenal glands, such as Cushing’s syndrome (overproduction of cortisol) or Addison’s disease (underproduction). It can also help evaluate chronic stress responses or rule out hormonal imbalances. Unlike blood tests, saliva cortisol measures free (unbound) cortisol, which reflects your body’s natural hormone levels throughout the day.

How the Test Works

You’ll collect saliva samples at specific times (often morning and evening) using a provided collection device. The test measures cortisol concentration in your saliva, which is then analyzed in a lab to provide results.

What to Expect Before the Test

No special preparation is usually needed, but you may be asked to avoid caffeine, alcohol, or smoking for a few hours before collecting samples. Follow your healthcare provider’s instructions carefully for accurate results.

What the Results Mean

Results are compared to reference ranges for cortisol in saliva, but these can vary by lab. Elevated levels may indicate Cushing’s syndrome or excessive stress, while low levels could suggest adrenal insufficiency or other hormonal issues. Your doctor will interpret results in the context of your symptoms and medical history.