Cortisol, Saliva


Send Email

Recipient(s) will receive an email with a link to 'Cortisol, Saliva' and will have access to the topic for 7 days.

Subject: Cortisol, Saliva

(Optional message may have a maximum of 1000 characters.)



  • Serum free cortisol freely diffuses into saliva. Therefore, measurements of salivary cortisol (hydrocortisone) more accurately reflect the serum free cortisol. The salivary cortisol concentration is independent of salivary flow rate.

  • Normal range: varies diurnally, with concentrations about 5.6 ng/mL at 8:00–9:00 am and about 1 ng/mL at 11:00 pm.


  • Screening for Cushing syndrome.

  • Diagnosis of Cushing syndrome in patients presenting with symptoms or signs suggestive of the disease.

  • Assessing cortisol secretion serially in ambulatory patients. Measurements are helpful in patients with cyclical Cushing syndrome.


  • Late evening levels are increased in Cushing syndrome.

  • Morning levels are decreased in adrenal insufficiency.


  • Several factors influence analytical measurement and accuracy of salivary cortisol levels, including collection processes, devices, sample handling, processing and storage, and choice of analytical method.

  • Changes in cortisol-binding globulin and albumin affect total cortisol levels but not free levels in serum and saliva.