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Late Night Cortisol Tests (Saliva)

Does anyone know where I can get late night Cortisol test? I don't mean Cortisol x 4 or Cortisol x 6

9 Replies

Hi. You can do a home cortisol blood test (via pin prick sample - sent back to lab) anytime of the day (or night). You choose the time & simply tell them when the sample was taken. Medichecks offer such a test for £39.

IMHO you're wasting you're money by getting such a test, it will tell you very little. Instead a 24hr 4 x sample saliva adrenal test, is far more effective at identifiying a wide number of problems/patterns of adrenal dysfunction - that a single sample blood test never can. So well worth the extra £20 or so getting this done instead. All the best.


Thanks Mike

I meant to say 'saliva' in my original post and will go back and edit the heading if I can. I've already had blood tests for Cortisol which I agree are useless. I don't think I can cope with pinprick but think saliva will be more useful.

So do you think 4 x adrenal would be more use than 4 x Cortisol? The reason I wanted late night Cortisol saliva is because I am much more alert at night than in the day and thought this might pick it up, first off. Then follow up with adrenal saliva.


Hi Kirby. I think there's a bit of confusion here. Both the blood test & the 24hr saliva test (called an adrenal stress profile test) measure cortisol levels (i.e cortisoll is the stress hormone). In fact a saliva adrenal stress test often tests the hormone DHEA (usually 1 sample only) in additon to cortisol.

The 4 x saliva test typically requires you take 4 samples during the day. Very first thing on waking (around 6am-7am), at luchtime (12-1pm), mid afternoon (4-5pm), and finally just before bed (approx 10-midnight). I would have thought that would pick up any patterns/concerns you have regarding possible elevated cortisol levels at night. Note you could get an even better picture if you did a 6 x sample 24hr saliva test, doing the four routine sample times (as given above), plus a further two tests during the 'night proper' (12 midnight to 6am) with the exact time of the extra two samples at times during the night of your choosing.

Basically, while in an adrenal stress profile test, the samples are usually taken at standardised times (so they can be compared with the wider populations results i.e. the lab's reference range), you can if you wish, choose take them at anytime of the day. If you do so you must notify the lab of the exact times you took the sample.

So if you want a full accurate profile of what's going on, I'd personally do a 6 x sample test. And as suggested do 4 samples with the normal timings, and use the extra two samples to see what's happening in the middle of the night. Hope that helps, Mike.


Hi Mike, sorry for being vague. Yes, I wanted to measure Cortisol first off as I have heard that late night Cortisol saliva is a good indication of Cushings and one of the tests that's used. I could as you say do the Cortisol saliva x 4 or 6 which Blue Horizons and Medichecks offer, although not at any time. I asked them and you have to stick to their times eg 9 am for the first one but I'm not up at that time, that's sort of the point! But their labs will only stick to their set times. I see what you're saying about the Cortisol x 6 but again I don't think they offered a 24 hour one through the night (that would have been helpful!) but I will look into it again as I may be mistaken. It was a while since I enquired.

I was then going to investigate the adrenals next if the Cortisol indicated something or even if it didn't. But are you saying that I could kill the two birds with one stone so to speak and that the adrenals saliva test would do both ie I could skip the Cortisol x 4/6 altogether and go instead for the adrenals?

Many thanks :)


May I ask what makes you think you've got Cushing's (i.e. extremely high levels cortisol)?

A regular 24hr adrenal stress profile (4 samples) should easily pick up on very high levels at night. Just do the 1st sample of the day at 5-6am, and the final one at 12 midnight. You could complement it by doing a single sample cortisol blood test in the middle of the night (3am).

Just to reassure you, many people with a disturbed HPA axis will have raised (above norm) cortisol levels during the night. [they'll typically regularly wake up in the early hours of the morning and struggle badly to go to sleep] That doesn't though mean they have Cushings (the levels of which are very high) which is pretty rare.

Sounds like you now have an action plan. Hoping the tests prove helpful to you. Best, Mike.


Hi Mike - having researched a bit around Cushing's it's not as rare as made out and there is also of course, cyclical Cushings. The reason I wanted to investigate it was that my bloods have shown a low but within range TSH and T3 which can point to a pituitary problem. Also my Cortisol was raised a bit and they were going to do the Dex suppression but then my Cortisol came back within range and has since been on a downward trend but still within range.

Also, I have out on loads of weight in ten years, especially around the middle, my metabolism is very odd, I am always cold, and very fatigued. I have Fibro and Chronic Fatigue which also have the same symptoms but just trying to rule out all other possibilities which I think I seem to have done. I am also perimenopause which is messing up the hormones and metabolism so this will of course cause weight gain as will being on a/depressants which I have been for a number of years.


Hi Kirby

How did you get on with the 4 or 6 point saliva test? Did you find one that tested in the night? I have awful problems with night waking. Usually get to sleep ok which would suggest cortisol normal I suppose? Then wake up with a start like I’ve been shook in night and can’t get back to sleep


Apologies LKaye, I've only just seen this. I did have a private Cortisol x 4 saliva test last year. They said I could change the times on the samples but that it was mainly for day time. Alas, it didn't really show up what I felt was happening. So the Cortisol was highest in the second sample of the day but not lowest in the morning and teat time and highest at night which was what i was expecting. Best wishes


I also am in Peri and have CFS.


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