Endocrinology CORT

Cortisol & Cortisone.

Quantitative determination of cortisol and cortisone from saliva by LC-MS/MS. Non-invasive assessment of adrenal function and HPA axis activity.

Quick Reference
Method
LC-MS/MS
Sample Types
Saliva
Analytes

2 analytes

Turnaround

3–5 working days

Enquire About This Test

What does this test assess?

This method provides non-invasive measurement of salivary cortisol and cortisone for evaluation of adrenal function, circadian rhythm assessment, and diagnosis of Cushing's syndrome and adrenal insufficiency.

Clinical indications include:

  • Diagnosis of Cushing's syndrome (late-night salivary cortisol)
  • Assessment of adrenal insufficiency
  • Evaluation of HPA axis function and circadian cortisol rhythm
  • Monitoring of hydrocortisone replacement therapy
  • Stress response evaluation in research settings
  • Occupational health and performance assessment

Measured analytes

Analyte / GroupComponentsClinical Significance
Cortisol Hydrocortisone Primary glucocorticoid; regulates metabolism, immune response, and stress adaptation
Cortisone 11-Dehydrocortisol Inactive metabolite of cortisol; reflects local tissue cortisol inactivation by 11β-HSD2
Note

The cortisol:cortisone ratio provides additional information about 11β-hydroxysteroid dehydrogenase (11β-HSD) enzyme activity.

About cortisol

Cortisol is the primary glucocorticoid hormone produced by the adrenal cortex, regulated by the hypothalamic-pituitary-adrenal (HPA) axis. It follows a pronounced circadian rhythm, peaking in the early morning and reaching its nadir around midnight.

Late-night

Low late-night salivary cortisol helps exclude Cushing's syndrome

Circadian

Cortisol follows a predictable diurnal pattern

Non-invasive

Saliva collection avoids venepuncture stress artefacts

Salivary cortisol measurement offers a significant advantage over serum cortisol: saliva collection is non-invasive and stress-free, avoiding the cortisol elevation that venepuncture itself can cause. Salivary cortisol reflects the free (unbound) fraction of circulating cortisol, which is the biologically active form.

Late-night salivary cortisol has become a first-line screening test for Cushing's syndrome, as the loss of normal circadian nadir is one of the earliest biochemical abnormalities in this condition.

Analytical technique

Both analytes are measured simultaneously by isotope-dilution LC-MS/MS, providing superior specificity compared to immunoassay methods. LC-MS/MS eliminates cross-reactivity with synthetic corticosteroids and other steroid metabolites that can cause false results in immunoassays.

Sample information

Saliva samples are collected using a Salivette device at specified times (typically morning and late-night). The non-invasive collection method enables home sampling and is particularly valuable for paediatric patients and circadian rhythm studies.

Testing process

From enquiry to results in a few simple steps — no clinic visit required.

1
Get in touch
Contact us to discuss your testing requirements
2
Collect your sample
Collect a saliva sample using the provided collection tube — non-invasive, at home or in clinic
3
Post to our lab
Saliva samples are stable for transport — ship to our laboratory by courier or post
4
Receive results
Results delivered within 3–5 working days of sample receipt

Where this test is available

This test is available to healthcare professionals, wellness brands, clinics, and research institutions worldwide. We currently serve partners in:

  • Europe (EU & non-EU)
  • United Kingdom
  • Asia & Southeast Asia
  • Australia & New Zealand
  • United States

Whether you need testing services for your patients, white-label kits for your brand, or method transfer to your own laboratory — get in touch to discuss how we can work together.

Literature

  1. Nieman LK, et al. “The diagnosis of Cushing's syndrome: an Endocrine Society clinical practice guideline.” Journal of Clinical Endocrinology & Metabolism, 2008, 93(5):1526-1540. 10.1210/jc.2008-0125
  2. Raff H. “Utility of salivary cortisol measurements in Cushing's syndrome and adrenal insufficiency.” Journal of Clinical Endocrinology & Metabolism, 2009, 94(10):3647-3655. 10.1210/jc.2009-1166

Frequently Asked Questions

What does this cortisol test measure?

This test simultaneously measures cortisol and cortisone from saliva by LC-MS/MS. The cortisol:cortisone ratio provides additional insight into 11β-HSD enzyme activity.

Why use saliva instead of blood for cortisol testing?

Salivary cortisol reflects the free (biologically active) fraction, not total cortisol. It's non-invasive, easy to collect at specific times of day, and is the recommended method for screening Cushing's syndrome.

How is the sample collected?

Collect saliva into a provided tube — no eating, drinking, or brushing teeth for 30 minutes beforehand. Collection can be done at home.

How long does it take to get results?

Results are typically delivered within 3 to 5 working days from the time your sample arrives at our laboratory. The analysis is performed by LC-MS/MS.

When should I collect my saliva sample?

Depends on the clinical question. Late-night salivary cortisol (around 11 PM) is used to screen for Cushing's syndrome. Morning cortisol assesses adrenal function. Your clinician will advise the best collection time.

Which countries is this test available in?

Masdiag's cortisol test is available worldwide through our partner network. We currently serve healthcare professionals, wellness brands, and clinics in Europe, the United Kingdom, Asia, Australia, New Zealand, and the United States. Contact us to discuss testing services, white-label kits, or method transfer to your laboratory.

Interested in this method?

Whether you need testing services, method transfer, or white-label kit development — we'd love to hear from you.