24-Hour Adrenal Hormone Saliva Test

The best way to get a good, well-rounded picture of your adrenal function is to do a 24-hour saliva cortisol test.

This is a test kit that you can order directly from the lab yourself, or your doctor can provide you one which you then take home and complete. These home hormone saliva test kits have you collect a saliva sample in a small vial at 4 specific  times of day (approximately 7 am, 11 am, 4pm and 11 pm).  After you have collected your 4 specimens, you mail the kit to the lab for analysis.  The test kit usually costs around $145., and includes the cost of analysis.  Tests ordered from True Health Labs typically have a 5-7 day turnaround before you are emailed your test results. You can also book a consultation with their staff physican to review your results for an additional fee.

**Please note that unfortunately, due to state laws, many of these home hormone tests are NOT available for purchase by residents of the state of New York, and possibly others.**

 Where to Order Lab Tests Online 

Saliva Test vs. Blood

To measure the levels of cortisol hormone, saliva test results are far superior to blood tests. Saliva testing measures the active form of hormones, referred to as  "free hormones". Blood tests measure both the active form of the hormone, as well as the inactive form, making it look as if you have enough of the hormone, even though some of it is unavailable to your body. For your purpose, you want to look at just the active levels of adrenal hormones.


Your cortisol level fluctuates according to a certain pattern during the course of a day, and taking 4 samples will help you and your doctor to see if cortisol is spiking and dropping at the correct times.  Some saliva tests will also measure DHEA levels, and graph the relationship of DHEA and Cortisol.

The book Overcoming Adrenal Fatigue has a very good section on interpreting test results, not only from the saliva cortisol test, but also many of the other hormone tests your doctor may request. The author, Kathryn Simpson, tells you exactly what "normal ranges" are, and in the case of the cortisol saliva test, tells you that each of the test times reflects a different aspect of adrenal dysfunction. (for example, the 8 a.m. measurement reflects the condition of the adrenal glands themselves,  a high cortisol level would indicate enlarged adrenal glands that are overproducing, while a low cortisol level indicates underproduction).

It will be most helpful to you to have these test results with you when you go to your first appointment with your doctor, so that you can get right down to business and present him with as much information as possible to start with.  Otherwise, you'll probably leave that visit with nothing more than "Well, first let’s run some tests and see what we're dealing with…"

If you ordered your test from True Health Labs, you can also schedule a one-on-one consultation with one of their doctors to discuss your test results for an additional fee.

 Where to Order Lab Tests Online 

 About "Normal Ranges" for Cortisol Test Results

Remember, Adrenal Fatigue and it's frequent companion, Low Thyroid, are hard conditions to quantify by tests alone.  The best way to diagnose is by the presence of classic symptoms, and treat until those symptoms abate.  The "normal range" for test results is so broad, that you can have a result that's HALF of somebody else's, and still be considered normal.  If you're told that your test results are "the low end of normal", there's still LOTS of room for improvement.  And if you don't have previous results for yourself during a time when you felt better, it may not even be "normal" for you! What if you used to be at the high end of normal back when you used to feel good? If your level has dropped by 25/30/50 percent, it doesn't matter if it still falls into the "officially normal" range, it's not normal for YOU.

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Read More about Testing for Adrenal Fatigue

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