Do I Really Need a Saliva Cortisol Test?

I recently received a question through my contact page, asking about the importance of a Saliva Cortisol Test for people who suspect they have adrenal fatigue. The writer expressed confusion over conflicting information, with some websites not mentioning saliva testing at all she wondered if I was only promoting home hormone test kits for my own financial gain. Here is my response:

Please Note: I am not a doctor, so I cannot make a "diagnosis" or "prescription" and cannot advise you specifically on your own situation. I am merely discussing some of the common reasons people will choose to order their own lab tests.

I appreciate your concern, and want to assure you that my priority is indeed helping others to feel better, not merely making a profit. Before I had that page (24-hour Hormone Saliva Test) up, many people would contact me asking if I knew of a source for a saliva hormone testing kit  that did not require a doctor's order, either because they were not working with a doctor, or the doctor would not order one for them and they didn't know where to look to find one on their own.

While some who are familiar with Adrenal Fatigue don't always feel the saliva cortisol test is essential to Adrenal Fatigue diagnosis or treatment for cases on the mild to moderate end of the spectrum, it can reveal useful information and provide yet another piece of evidence to support a diagnosis in cases where it is not clear from symptoms alone. 

It can  help determine if your symptoms are from too much cortisol (early adrenal fatigue) or if you have progressed to the point where your body cannot produce enough cortisol (more advanced adrenal fatigue).

 The saliva cortisol test will show you what your cortisol pattern is throughout the day, and how it either follows or differs from an optimal cortisol pattern, and also how it corresponds to your symptoms throughout the day. This information can be helpful in developing a personalized treatment plan.

Of course, this is only a snapshot of one day, and depending on your stress levels, how well you slept, etc., results can be very different from another day.  The test alone cannot "tell you" if you have adrenal fatigue, but is one more piece of corroborating evidence to be considered, in conjunction with your symptoms, and possibly other tests to assess thyroid function as well as other hormones (estrogen, progesterone, testosterone).

Do I Need a Doctor to Order my Saliva Cortisol Test?

Many people with adrenal fatigue do not have doctors that are familiar with the condition, and wish to take things into their own hands, and that is who is most likely to order a cortisol test themselves. Every case is different, and every patient has a different comfort level and knowledge level as far as understanding their condition and taking charge of their own health. Many people just want the confirmation that "The Test" reflects what they've known all along--that there really is something causing their problems. Peace of Mind is a valid reason!

If you want a salivary cortisol test and are seeing a doctor, check with them first, the test may be covered by insurance if it is ordered through their office or lab. However, it is possible that not all insurance companies recognize adrenal fatigue as a valid diagnosis, and they may refuse to pay for the test. It may also be cheaper to get it online than to pay for it out-of-pocket from the Dr.'s office.  Every situation is different, and it is up to you to do your own due diligence as far as investigating whether or not that would be the case for you.

Regardless of whether you get the cortisol test online or if you get the hormone testing kit from your doctor's office or lab, the collection of saliva samples is still done by you at home, and mailed in to the lab. Many doctors use the hormone testing kits from ZRT labs, so you could very well be getting the exact same test kit either way. 

 Where to Order Lab Tests Online 

Another factor to consider is turnaround time. Many people want to expedite the receipt of their results, and ordering the test online, you can have your results within two weeks, as opposed to two months or more by the time you get an appointment to ask the doctor for the test, take the test, and then wait for another appointment to go over the results. Having the test results with you when you go to that first doctor visit can be advantageous, because as with any meeting, the more prepared you are when you go in, the more productive your conversation can be.  If you do not have a doctor,  True Health Labs offers a one-on-one test results review with a doctor after you receive your results, for a fee.

In short, the cortisol test is available on the website because it is one of the options available to aid in the diagnosis and treatment of Adrenal Fatigue, and people are looking for information and resources for this test. I merely make it available for those who want it. For people who are confident of their diagnosis by symptoms and are at the mild-moderate end of the adrenal fatigue spectrum, moving directly into a treatment strategy is a common and valid course of action. Some will decide to take the saliva test later on, and many never take it at all. The test, in conjunction with medical treatment becomes more important the further towards the extreme end of the spectrum you are.

 Where to Order Lab Tests Online 

Questions to Ask Yourself:

  1. What do I hope to achieve by taking the test?
    • Confirm or rule out an adrenal component to my physical problems?
    • Getting "documented proof" that I have a problem ?
    • Convince my doctor/my spouse/my self that it's not "all in my head"?
    • Gaining insight into why I exhibit certain symptoms at certain times of day?
  2. What will I do with the information I receive?
    • Take it to my doctor?
    • Use it to help plan my own strategy of treatment?
  3. Will my doctor order it for me?
    • Will it be covered by my insurance?
    • Or will it be cheaper to order online myself?
    • How quickly do I want the results?
  4. How extreme are my symptoms?
    • Is my level of Adrenal fatigue something I am comfortable addressing on my own?
    • Do I know enough about my condition to utilize the information from the test results?
  5. What if I don't take the test?
    • Am I comfortable with just starting to making some changes in my life to see if they help relieve my symptoms?

Remember, you don't need to take the test before you start making changes. Learning more about adrenal fatigue and making  lifestyle changes to reduce stress and support your adrenals is the key to feeling better.  Even if adrenal fatigue is not your primary diagnosis, your adrenal glands play an important role in recovering from ANY physical dis-ease, and a little stress relief never HURT anybody!

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For additional insight into your test results, check out pages 56-57 of Overcoming Adrenal Fatigue, by Kathryn Simpson