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Cortisol in Saliva (Free Cortisol)

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 related to stress or adrenal issues."]

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

Key facts at a glance

LOINC
57691-8
Short code
Cortis sp9 Sal-mCnc
Synonyms
Cortis sp9 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

Saliva cortisol testing is often used to evaluate chronic stress levels or conditions like Cushing’s syndrome or adrenal insufficiency. Unlike blood tests, saliva cortisol reflects natural hormone levels over time without interference from stress-induced spikes during blood draws.

What to Expect Before the Test

No special preparation is needed. You’ll provide a saliva sample, typically collected in the morning when cortisol levels are highest. Avoid caffeine, nicotine, or brushing your teeth 30 minutes before collecting the sample.

How the Test Works

A small amount of saliva is collected into a special container. The test measures free cortisol, which is the active form of the hormone. Results are compared to reference ranges that vary by lab but generally reflect baseline stress hormone levels.

Possible Results and Interpretation

Low cortisol levels may indicate adrenal insufficiency or overuse of steroid medications. High levels could suggest Cushing’s syndrome or excessive stress. Your doctor will interpret results in the context of your symptoms and medical history.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

Saliva Cortisol

Frequently asked questions

What does a low cortisol level mean?
Low cortisol in saliva may signal adrenal fatigue, autoimmune adrenal disease, or conditions like Addison’s disease. It can also occur with long-term stress or certain medications. Your doctor may recommend further testing or adjustments to treatment plans.
What does a high cortisol level mean?
Elevated cortisol in saliva is often linked to Cushing’s syndrome (overactive adrenal glands) or chronic stress. It can also result from certain medications, pituitary tumors, or other hormonal imbalances. Additional tests may be needed to identify the cause.
How often should I get this test?
Saliva cortisol testing is typically done once or twice to confirm results. Your doctor may recommend follow-up testing if initial results are abnormal or if symptoms persist. Frequency depends on your diagnosis and treatment plan.
  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