RT3-Adrenals Cortisol Testing

Saliva cortisol testing

• Provides four measures to show diurnal curve

• Done at home

• Measures free (unbound) cortisol

How to order and complete

• Order a ZRT Labs 4x saliva cortisol kit www.canaryclub.org

• Stop meds/supplements affecting cortisol or HPA axis for two weeks

• Use normal waking and bedtimes*

• Do not exercise day prior or day of test

• Freeze each sample as it is done

• Overnight kit late in the day Monday to Thursday for weekday

morning delivery

Note: The lab says the samples are stable for two weeks, but we believe the

most accurate results are obtained when the samples are frozen and the kit is

overnighted.

*Someone who has an unusual sleep schedule for an extended period of

months or years, may need to use his or her normal wake up time and normal

bedtime, with second and third samples each approximately four to five hours

apart, rather than the standardized times identified in the kit.

Results overview

Example 1

Optimal levels

• Morning at the top of the range

• Noon approximately 75% of the range

• Evening close to 50% of the range

• Nighttime at the bottom of the range

Example 2

Morning and noon low (not less than 50% of range); nighttime and

possibly evening high

• High nighttime level is direct result of low daytime levels

• Adrenals try to catch up production

• Correct low daytime levels to correct high nighttime

• Correct with less intensive support than hydrocortisone

Example 3

Morning less than 50% of range; all other levels low

• No evidence adrenals can no longer catch up production

• Usually requires a physiologic replacement dose of hydrocortisone

Example 4

Morning high over range; all other levels below range

• Incipient crash or adrenal crisis

• Requires a physiologic replacement dose of hydrocortisone

Example 5

Morning at bottom or below range; other levels at or below range at

most times; nighttime may be above range

• Seek diagnosis of adrenal insufficiency from qualified physician

Example 6

High levels at most or at all times

• Frequently a precursor to low levels

• From stress, internal and/or external.

• Can be caused by systemic conditions such as

• long term hypothyroid

• high glucose

• gastrointestinal issues

24-hour cortisol urine test

• Measures the amount of unbound cortisol excreted in 24 hours

• Cannot show diurnal variation

ACTH stimulation test

• Used to diagnosis primary adrenal insufficiency or pituitary issues

• Only indicates whether adrenals are capable of producing cortisol

• Does not reflect availability of free cortisol

Cortisol testing