4-Tube Cortisol-Salivary


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This test for adrenal insufficiency includes 4 measurements of your salivary Cortisol level during one day. Cortisol, also known as the "stress hormone" can be either too high or too low which may be a sign of adrenal distress.

This test for adrenal insufficiency includes 4 measurements of your salivary Cortisol level during one day. Cortisol, also known as the "stress hormone" can be either too high or too low which may be a sign of adrenal distress. This is a take-home kit that you pick up at the closest lab location when you take the emailed lab request form, then follow the collection times shown in the table below, and finally, return the kit to the lab. Your test results will be emailed 5 business days later.

salivary-cortisol-4-specimens.jpgIf your order includes additional blood or urine tests, we suggest acquiring the specimen kit from the lab at least two days prior to scheduling an appointment or walking in for your blood draw.

General Preparation:

1.       Wait at least 1 hour after eating to collect the specimen. At least 30 minutes before collecting saliva specimen, rinse mouth to remove residue from food, drinks, candy, etc. so as to avoid sample dilution.

2.       The timing of the first morning collection is critical; it must be collected 30 minutes after awakening.


Specimen 1: collect  30 minutes after waking

Specimen 2: collect before lunch (approximately 3-5 hours after 1st specimen)

Specimen 3: collect before dinner (approximately 3-5 hours after 2nd specimen)

Specimen 4: collect  30 minutes before bedtime


Example format: Collection times should be adjusted to reflect each person’s typical day.

Wake: 6:30am

Specimen 1: collect at 7:00am

Specimen 2: collect at 11:30am

Specimen 3: collect at 4:00pm

Specimen 4: collect at 9:30pm

Sleep: 10:00pm


Consult your physician on the following:

·         If you are prescribed sublingual hormones: It is recommended that you refrain from taking sublingual hormones throughout the entire day of saliva collection. Allow 24-36 hours after the last dose, before collecting your first saliva sample.

·         If you are prescribed topical hormones: It is recommended that you refrain from applying topical hormones throughout the entire day of saliva collection. Allow 12-24 hours before collecting your first saliva sample.

·         Contact your provider on a protocol if you are prescribed cortisol medications for adrenal support


Patient Preparation


1. Do not eat, drink, smoke, or use oral hygiene products for at least 30 minutes, then rinse the mouth with water and discard. Please wait at least 5 minutes after this rinse to start the collection procedure.

2. Saliva should be collected at the time(s) prescribed by your doctor.

3. No food or fluids for 30 minutes prior to collection.

4. Do not use any creams, lotions, or steroid inhalers immediately prior to collection.

5. Avoid any activity that can cause your gums to bleed, including brushing and flossing your teeth. Consult with your doctor if this is a chronic problem.



Chromatography/Mass Spectrometry


Everything You Need to Know About the 4 Tube Cortisol-Salivary Test


According to the American Institute of Stress, more than 30% of the US population feels extreme stress on a regular basis. This could affect their physical and mental health, leading to severe sleep problems in some individuals.

When you feel stressed, your adrenal glands produce too much cortisol. This is usually triggered by the "fight or flight" mechanism. Since most people have to juggle so many responsibilities and tasks every day, no wonder that we feel so stressed every day.

Luckily, stress can be reduced, but you need to learn how to measure it first. You can do this with a 4 tube cortisol-salivary test. This is an accurate way to determine how stressed you are. Keep reading to learn more.

What Is a 4 Tube Cortisol-Salivary Test?

Cortisol is the main stress hormone produced by your body. It's produced every day in direct correlation with various factors that affect your life. For example, if you have a busy career and a lot of responsibilities on your shoulders, your adrenal glands automatically produce more cortisol.

On the other hand, if you live a rather relaxing lifestyle and you routinely spend time in the middle of nature, your stress levels are probably lower. You can scientifically measure this hormone with the help of a 4-tube cortisol-salivary test.

This test is performed with a sample of your saliva. You can purchase this test online and send your samples to a lab. You will receive the results in a few days and they can be interpreted by your doctor. If your stress levels are high, you might need to find ways to relax and get rid of them to prevent more complicated health problems.

How Is the Test Performed?

The reason this test is called a 4 tube cortisol-salivary test is that it involves spitting into 4 test tubes at different times of the day. Your saliva contains a lot of information regarding your levels of cortisol. You should do this at different moments of the day to ensure an accurate reading.

For example, the first collection time is in the morning right after you woke up. This is best done around 8 AM. The second collection time is at noon. In the evening or around 4 PM you should collect another sample. Finally, the last sample should be collected at midnight, preferably between 11 PM and 11:30 PM.

Your cortisol levels vary depending on various factors. Collecting samples at different moments of the day offers a more accurate reading. The timing is crucial, so you will be responsible to set alarms throughout the day, so you can collect the samples at the right moment.

Keep in mind that you might need to interrupt taking sublingual hormones or topical hormones at least 2-3 days before collecting the saliva samples. These hormones might interfere with the end result. Your doctor can tell you more information about this, so don't be afraid to ask what you're allowed and not allowed to do before taking a 4-tube cortisol-salivary test.

How Is the 4 Tube Cortisol Salivary Test Interpreted?

Since cortisol is produced by the adrenal glands, the end result will help doctors to diagnose adrenal insufficiency. This means that you're either producing too much or too little cortisol. Adrenal insufficiency can lead to other health problems and that's why a 4-tube cortisol test is important.

For example, some of the symptoms of adrenal insufficiency include extreme fatigue, low blood pressure, weight loss, and decreased appetite. If you feel that your gym performance has dropped considerably, this might also be caused by adrenal insufficiency.

Keep in mind that alongside this test, your doctor might also check your DHEA levels and other hormones. These will be required to establish a more accurate diagnosis for adrenal insufficiency. Again, a few saliva samples are enough, you are not required to draw blood for this test.

If you are diagnosed with adrenal insufficiency (also known as Addison's disease), you might be prescribed medication to deal with this problem. For example, some of the most common hormones offered as treatment include hydrocortisone and fludrocortisone acetate.

What Are Normal Values for Cortisol Levels?

There are a few reference values for salivary cortisol that help doctors diagnose adrenal insufficiency or other forms of problems with your adrenal glands. Your cortisol levels are usually the highest early in the morning and they drop throughout the day.

For example:

  • Between 0.025 - 0.600 ug/dl in the morning
  • Between 0.010 - 0.330 ug/dl in the afternoon
  • Between 0.010 - 0.200 ug/dl in the evening
  • Between 0.010 - 0.090 ug/dl at night

These are the standard values for salivary cortisol for children and adults. Anything higher or lower would qualify you for adrenal insufficiency. Once you get the results, you can compare them against these values as well as ask for assistance from your primary healthcare provider.

Order Your 4 Tube Cortisol Salivary Test Today!

Remember that many complicated and even life-threatening diseases are usually caused by too much stress. Not only that excessive stress reduces the quality of your life, but it can also make you ill in just a few years.

Fortunately, you can now scientifically measure your stress levels using a 4 tube cortisol-salivary test. Order this type of test from DiscountedLabs.com today and check your cortisol levels. The results are completely confidential and they will be emailed back to you in just a couple of business days!




  1. Go to the "Find a Location" page to find the closest lab location. No need to make an appointment since walk-ins are welcomed. Once you have identified your closest location, go to step 2.

  2. Go to "Choose a Test" and add your selection (s) in the shopping cart. If you prefer to save money on bundled tests, we have created "Lab Test Panels" that can help you decide what to order.

  3. If you have a discount coupon code, add it to your cart.

  4. A $8 lab processing fee will be added to your total.

  5. Pay using a credit card.

  6. You will receive an order confirmation and instructions email on how to download your lab request.

  7. Print lab request form that you downloaded.

  8. Take that form to the closest location. Get your blood drawn.

  9. You will receive an email when the results are ready for you to download.

    Note: You cannot place an order under someone else's profile. The profile person's name will appear on the lab order form.


    If you have further questions, please email [email protected].