12-Hour Fasting Required: NO
CPT Codes for this test: 82530
Testing Lab: ZRT Laboratory
The Diurnal Cortisol (Cortisol 4x Saliva Testing) is tested through ZRT Laboratory is a
collection of 4 saliva samples and will test ONLY Cortisol.
This is a test kit that will be shipped directly to your home address.
DO NOT GO TO LABCORP FOR THIS TESTING.
ZRT Labs information for this test:
STRESS & ADRENAL HORMONES
The adrenal glands, otherwise known as the “stress glands,” enable
our bodies to cope with stress and survive. Shaped like two tiny
pyramids, they sit atop the kidneys and from this central location
mobilize the response to changes in our environment.
Whether stress comes from outside in the form of a natural disaster,
or from within like the anxiety we experience before public speaking,
it’s the adrenals’ job to help us adapt to the situation.
They accomplish this by secreting key hormones:
Epinephrine / Norepinephrine - Neurotransmitters that mobilize the body’s natural “fight or flight” response in an emergency
Patients can conduct a saliva cortisol test or a urine cortisol test
to assess adrenal hormones. This involves collecting four non-invasive
samples over the course of one day, from which ZRT is able to generate
results with a diurnal cortisol curve. This four-point graph reveals
cortisol levels throughout the day and allows health care providers to
pinpoint issues with adrenal gland function.
Diurnal cortisol curves – understanding HPA axis dysfunction
Diurnal curves for chronic stress - understanding epinephrine and norepinephrine patterns
Adrenal glands that are in balance produce adequate amounts of
hormones to power us through the day. These hormones impact just about
every process in the body, from energy production and immune activity to
cellular maintenance and repair. They are key regulators of glucose,
insulin and inflammation, and play a major role in bone and muscle
building, mood and mental focus, stamina, sex drive and sleep cycles.
Adrenal glands that are out of balance can lead to:
High Cortisol - Results in insomnia, anxiety, sugar cravings, feeling tired but wired, increased belly fat & bone loss
Low Cortisol - Causes chronic fatigue, low
energy, food and sugar cravings, poor exercise tolerance or recovery
& low immune reserves
Ideal Ways to Assess Adrenal Hormones:
has long been used as an accurate and reliable method for measuring
cortisol because it’s simple and non-invasive, and patients can collect
these samples multiple times per day. It’s easy to assess DHEA in these
A newer method that’s just as reliable as saliva testing has also been gaining ground – dried urine testing.
Studies show that urine is just as effective for measuring cortisol and
DHEA levels, and it’s also simple enough for patients to collect
multiple times per day.
Due to the nature of the sample collection, there are some difference between saliva and urine testing for diurnal cortisol.
The added benefit to dried urine testing is that epinephrine and
norepinephrine can be measured at the same time, so patients who want a
complete adrenal assessment can now get all four key markers together.
Cortisol Awakening Response:
The Cortisol Awakening Response – also called CAR – reveals more
detailed clues that help in assessing adrenal hormone/HPA Axis
dysfunction. This testing is often useful for cases of PTSD, major
depression, chronic fatigue syndrome and other severe stress conditions.
During a normal cortisol awakening response, adrenal hormone levels
should increase 50% in the first 30 minutes after waking for the day and
then begin to progressively drop through the afternoon and evening. To
capture this response, three – rather than one – morning saliva
collections are needed to properly chart the diurnal cortisol curve.
Cortisol Awakening Response Sample Collection
4-Tube Collection: Alternately, CAR can be assessed with four
cortisol collections in 24 hours. When using this method, collect a
sample immediately upon waking, 30 minutes after waking, then at noon or
evening, and night.
BLT System code: ZRT Lab - Saliva Kit - Diurnal Cortisol