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Cortisol and cortisone (salivary)
Test Code: SVC
Tube type: Salivette
Special instructions
Please contact Biochemistry on ext. 4050 for detailed instructions of collection procedure and collection tubes.
Sample type
Saliva
Sent away
to Bristol Royal Infirmary
Contact Laboratory before requesting
Reference range
Please see report, or contact the laboratory.
Turnaround Time
28
days
Department: Biochemistry
Clinical Application
Salivary cortisol and cortisone analysis is useful for the investigation of:
1) Cushing’s: 2 x saliva samples required, 1 x early morning and 1 x late night to assess diurnal variation of cortisol. It may be performed alongside/instead of a 24-hour urine cortisol. In Cushing’s syndrome, the diurnal variation of cortisol is lost.
2) Adrenal Insufficiency: 1 x waking saliva sample for cortisone analysis required. In some patients, performing this test avoids the need to perform a short synacthen test (SST), however around 30% of patients who have a waking salivary cortisone tested may receive results in the equivocal range and will require follow-up with an SST.
WSC should NOT be performed where urgent assessment of adrenal function is required - please perform urgent SST instead.
Limitations:
1) Contamination of the salivary sample with blood will increase salivary cortisol levels relative to cortisone. If contamination is suspected, please repeat or perform an SST.
2) Risk of sample contamination with oral hydrocortisone, which can be mitigated by omitting previous evening dose and delaying morning dose until saliva collected. The laboratory will usually be able to determine if sample contamination is likely due to increased salivary cortisol Vs. cortisone.
Webpage updated: June 2025.
