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Blood test

Salivary cortisol test

Salivary cortisol test: what it measures, why a doctor orders it, how to prepare, and what a high or low result can mean - with private and NHS access routes in the UK.

Key facts

At a glance

  • What it measures: cortisol in a saliva sample collected late at night, when levels should naturally be at their lowest.

  • Why it is ordered: as one of the first-line screens for Cushing syndrome, because the loss of the normal midnight dip is an early signature.

  • You collect saliva at home around 11pm on two separate nights, avoiding food, drink and tooth-brushing for 30 minutes beforehand - shift work skews the result.

  • Reference ranges: the test relies on your body clock, so it suits people with a regular sleep pattern. Every laboratory publishes its own interval, so the range printed on your report is the one that applies to you.

  • A raised result or unsuppressed late-night level supports Cushing syndrome and leads to confirmatory testing. A low result or appropriately low midnight level is reassuring against it.

  • Results typically take a few days to two weeks, because the sample is analysed in batches at a specialist laboratory.

The full picture

What this test tells you, and how to get it

The salivary cortisol test measures cortisol in a saliva sample collected late at night, when levels should naturally be at their lowest. Doctors most often request it as one of the first-line screens for Cushing syndrome, because the loss of the normal midnight dip is an early signature. You collect saliva at home around 11pm on two separate nights, avoiding food, drink and tooth-brushing for 30 minutes beforehand - shift work skews the result. The test relies on your body clock, so it suits people with a regular sleep pattern, and reference intervals genuinely differ between laboratories, so no single number should be treated as a universal cut-off - your result is always read against the range printed on your own report. Broadly, a raised result or unsuppressed late-night level supports Cushing syndrome and leads to confirmatory testing, while a low result or appropriately low midnight level is reassuring against it, and either finding is interpreted alongside your symptoms, medication and other results rather than in isolation. Results typically take a few days to two weeks, because the sample is analysed in batches at a specialist laboratory.

In the UK there are two routes to this test. Your NHS GP can arrange it free of charge when it is clinically indicated, though getting the appointment, the blood draw and the follow-up discussion can add days to weeks depending on local demand. Privately, the salivary cortisol test can usually be booked within days - through a private GP, a walk-in phlebotomy clinic or a self-request home-testing service - usually requested by an endocrinologist with kits sent to your home. A private result still deserves a clinician's interpretation: an isolated number without context is where most confusion about blood tests begins.

A quiet reminder

This guide is for information, not medical advice.

Your own clinician knows your history and can tell you which parts apply to you. Reference ranges vary between laboratories - always read your result against the interval printed on your own report. Next review of this page: 2027-09-27.

Frequently asked

Common questions about Salivary cortisol test.

Quick, plain-English answers to what people ask us most.

  • What is Salivary cortisol test?

    Salivary cortisol test is a blood test that measures a specific substance or marker in your blood, giving your doctor useful information about how a particular system in your body is functioning. It is one of many tools used alongside your symptoms and history to build a fuller clinical picture. Your doctor can explain exactly why it is relevant in your case.

  • Why would a doctor order Salivary cortisol test?

    This test is typically requested to investigate specific symptoms, monitor an existing condition, or check for a deficiency or imbalance that could explain how you are feeling. It may also be used as part of a broader panel of related tests rather than in isolation. The result helps guide whether further tests, treatment, or simple monitoring is appropriate.

  • Do I need to prepare for this test?

    Some blood tests require fasting, a specific time of day, or pausing certain medications or supplements beforehand, while others need no special preparation at all. You will usually be told what applies to your specific test when it is booked. If you are unsure, it is worth checking with the clinic or lab in advance.

  • What happens during the test?

    A small blood sample is taken, usually from a vein in your arm, in a process that takes only a few minutes. It is generally straightforward and similar to any other routine blood draw. You can normally return to your usual activities straight afterwards.

  • Does this test hurt or carry any risks?

    A standard blood draw involves brief discomfort from the needle but is otherwise low-risk. Minor bruising at the site is the most common side effect and usually settles quickly. Let the person taking your sample know if you have a needle phobia or have had problems with blood tests before, as they can help make it more comfortable.

  • How long do results take?

    Results are typically available within a few days, though turnaround can vary depending on the specific test and laboratory used. You will usually be told when and how to expect your results at the time of testing. More specialised tests may occasionally take longer.

  • What do abnormal results mean, and what happens next?

    An abnormal result can have several possible explanations, from common and benign causes to conditions that need further assessment, and is best interpreted by a doctor alongside your symptoms and history. Depending on the finding, next steps might include repeating the test, further investigation, or referral to a specialist. Try not to draw firm conclusions from a number alone before speaking to a clinician.

  • Is this test available on the NHS, or is it better to go private?

    This test can often be arranged privately within days, with results reviewed by a specialist, whereas routine NHS access may depend on your GP agreeing it is clinically indicated and can involve a longer wait. Cost for private testing varies by provider. Many people choose the private route for speed and convenience, particularly if they are self-funding for reassurance rather than an urgent clinical concern.

  • Is this test accurate and reliable?

    Blood tests like this are well established and generally reliable when carried out by an accredited laboratory. Results can occasionally be affected by factors such as timing, recent illness, medication, or hydration, which is why doctors interpret a single result in context rather than in isolation. If a result seems unexpected, repeating the test is sometimes recommended.

  • How do I book this test privately, and how quickly can I be seen?

    You can typically book privately with or without a GP referral, and appointments, including blood draw and results review, are often available within a few days. A doctor will explain what your result means and advise on any next steps.