Genova Adrenal Saliva Test Changes: Genova have... - Thyroid UK

Thyroid UK

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Genova Adrenal Saliva Test Changes

lynmynott profile image

Genova have informed us today that they changed their adrenal saliva test ordering.

Please be aware that both the Adrenal Stress Profile (ASI) and the Comprehensive Adrenal Stress Profile now include an option to order a Cortisol Awakening Response test. The kits will include an extra two blue phials for saliva collection. The cost of this will be an additional £40. Please do not use the blue phials unless you wish to pay for the Cortisol Awakening Response test.

If you wish to order this test, you will need to tick the relevant boxes on the requisition form.

If you want to include the Cortisol Awakening Response test but don't tick the form Genova Diagnostics may not run the test, even though you have filled the blue phials.

Thyroid UK is now changing their Genova Diagnostics information sheet to include the above information.

For more information about the Cortisol Awakening Response test go here:

8 Replies

It's also worth pointing out that the instructions for ordering tests from Regenerus have changed too. People have to use the website to order instead of phone or email as it was previously :

One comment I'd like to make about people doing additional saliva samples to the normal four samples is that unless someone knows what is optimal it will be difficult (or impossible) to interpret the results.

For the standard four part test these are the optimal levels according to a couple of different websites :

• 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

Source :


8 am (or when you normally wake up): at the tip top part of the range (if top of range is 9.5, people are right there, or 9.4, etc)

11 am-noon (or approx. 4 hours after you woke up): in the upper quarter (though not at the very top of provided range)

4-5 pm (or approx. 4-5 hours after the above): right “around” mid-range

Bedtime: at the very bottom (Literally. So if range is 1-4, people are at 1, not even 2)

Source :

I’m a bit confused by this test. Will they give optimal levels with the results or will we need to ask knowledgeable members like yourself to try and work it out please?

Some companies that sell saliva cortisol testing provide just one set of reference ranges - one for each sample. These ranges can be very wide. The patient isn't told anything about where their result should be. There is an unspoken assumption that anywhere in range is fine. I don't believe that and I'm sure many people on this forum don't believe that.

Another issue with saliva testing for cortisol is that some companies provide reference ranges that show the fourth, and sometimes the third sample as well, in a set of four, should be "less than 6 or "less than 1.5". This implies that having zero cortisol is "healthy", which is nonsense. Sometimes results themselves are given as "less than 2" or something similar.

Some companies supply a standard set of reference ranges and a second (narrower) set of reference ranges contained within the standard ones that are allegedly "optimal". But they are still quite wide, and in my view only of use to someone who feels fairly well and isn't interested in optimising their levels - and in that case why bother getting tested anyway?

I always use the results from that I gave above as the optimal level to aim for. Whether this is the right thing to do I simply don't know.

Another issue with saliva testing is that DHEA is important in interpreting results. As a very coarse interpretation I think that a high DHEA with high in range or over the range cortisol is suggestive of early stage adrenal fatigue. The later stages usually show low DHEA and low levels of cortisol. Some people can test and discover that their cortisol is high but their DHEA is low. They are in the intermediate stage - the DHEA shows that the cortisol levels may plunge soon if people don't do something to stop the rot.

If you want to know more, read all six parts listed "In this section" on this page :

Rather more heavy going and may take a while to get to grips with :

Other links :

In the above link, click on the blue squares to the right of the helpline phone number.

Thank you so much for the information, it’s all very interesting.

SeasideSusie profile image

Oh my goodness, the times of the first 3 samples for CAR:


30 minutes post waking


I'm lucky to be up by 8.30-9am :D

You can borrow my children for the night, they’ll have you up by 6am sharp!

SeasideSusie profile image
SeasideSusieAdministrator in reply to CornishChick

What! There are two 6 o'clocks in a day? Crikey!

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