Quick Facts
- Sample: Four saliva samples collected at home throughout one day
- Fasting: No eating, drinking (except water), or brushing teeth 1 hour before each sample
- Turn-around: 7-9 business days once the lab receives the specimen. May take longer based on weather, holiday, or lab delays.
Benefits
- Convenient home collection - no clinic visits or blood draws required
- Reveals daily stress hormone patterns - four-point cortisol rhythm assessment
- Identifies "adrenal fatigue" - screens for HPA axis dysfunction affecting energy
- Private and confidential - order online without insurance requirements
- Clinical-grade accuracy - over 90% sensitivity for detecting abnormal stress patterns
- Actionable insights - results guide personalized wellness plans
Who Is This Test For?
- Individuals experiencing chronic fatigue or unexplained low energy
- People with persistent stress symptoms affecting daily performance
- Those struggling with sleep disturbances or difficulty waking up
- Individuals with mood issues like anxiety or depression
- People seeking preventive wellness tracking for high-stress lifestyles
- Anyone wanting to monitor stress resilience and hormone balance
How It Works – Just 3 Steps
- Order online and receive your test kit with prepaid shipping and detailed instructions
- Collect four saliva samples at specific times throughout one day at home
- Get results in 7-9 business days analysis of your stress hormone patterns
FAQ
What hormones does this test measure? Cortisol at four time points (morning, midday, evening, bedtime) and DHEA in the morning sample.
Is saliva testing as accurate as blood testing? Yes, salivary cortisol reflects free, biologically active hormone levels and is clinically validated for circadian rhythm assessment (Cleveland Clinic 2023).
Can I take medications before testing? Continue regular medications unless taking steroids or DHEA supplements – consult your provider first.
How do I collect samples properly? Collect at precise times: upon waking, midday, late afternoon, and bedtime. Freeze each sample immediately for 2+ hours.
What if my results are abnormal? Share results with your healthcare provider for interpretation and personalized treatment recommendations.
Do I need a doctor's order? No, you can order this test directly online without a physician's prescription.
More Details
What is the purpose of this test?
This test evaluates your hypothalamic-pituitary-adrenal (HPA) axis function by measuring daily cortisol and DHEA patterns. The HPA axis regulates your stress response, energy levels, immune function, and metabolism. Normal cortisol follows a circadian rhythm – highest in morning, gradually declining throughout the day. Disrupted patterns indicate HPA dysfunction, often called "adrenal fatigue," linked to chronic stress, poor sleep, mood disorders, and metabolic issues (Johns Hopkins Medicine 2023).
Who would benefit from this test?
Anyone experiencing symptoms of HPA axis dysfunction should consider this test. Up to 80% of primary care visits involve stress-related complaints (APA 2022). This test particularly benefits individuals with unexplained fatigue, poor stress tolerance, insomnia, anxiety, depression, weight gain, brain fog, or frequent illness. It's also valuable for preventive wellness monitoring in high-stress careers or during major life transitions.
When should I order this test?
Order this test if you're experiencing persistent low energy despite adequate sleep, difficulty managing daily stressors, mood changes, or disrupted sleep patterns. It's also recommended for monitoring chronic conditions related to stress or immune dysfunction, or when implementing lifestyle changes to improve stress resilience. Consider testing every 3-6 months if actively addressing HPA dysfunction (Endocrine Society 2023).
How do I interpret the results?
Normal rhythm
- What it means: Healthy HPA axis function
- Typical action: Maintain current lifestyle
Flattened curve
- What it means: Chronic stress, possible burnout
- Typical action: Stress management, lifestyle changes
Inverted pattern
- What it means: Severe HPA dysfunction
- Typical action: Medical evaluation, comprehensive treatment
High throughout day
- What it means: Acute stress response
- Typical action: Stress reduction techniques, monitoring
Low DHEA
- What it means: Adrenal insufficiency
- Typical action: Nutritional support, medical consultation
Early detection and management of HPA axis dysfunction can reduce healthcare costs by an estimated $2,000 per patient annually (Johns Hopkins Medicine 2023).
Pre-test preparation
Maintain normal routine but avoid eating, drinking (except water), brushing teeth, or tobacco use for one hour before each sample. Continue regular medications unless taking steroids, DHEA, or similar hormones – consult your provider first. Avoid excessive alcohol or caffeine before collection. Plan collection times in advance: upon waking, midday (11am-1pm), late afternoon (3-5pm), and bedtime (10pm-midnight).
How often should I get tested?
- Initial screening: Baseline test, then as needed
- Active treatment monitoring: Every 3–6 months
- Preventive wellness: Annually or during high-stress periods
- Chronic conditions: Every 6–12 months
- Lifestyle changes: 3–6 months after implementation
Why early detection matters
Disrupted cortisol rhythms increase risk of metabolic syndrome, depression, and immune dysfunction (Endocrine Society 2023). Roughly one in five adults report chronic stress symptoms warranting evaluation (CDC 2022). Early identification allows for targeted interventions like stress management, sleep optimization, nutritional support, and lifestyle modifications before serious health complications develop. Proactive monitoring helps maintain optimal stress resilience and prevents progression to more severe HPA dysfunction.
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