Page 2 - Saliva Cortisol Testing

Cortisol tested with a 24-hour urine test helps to understand someone’s total cortisol production.
These tests are effective at tracking the extremes of cortisol abnormality. When cortisol
production is very low, this may indicate Addison’s disease, which is as a result of the adrenal
gland not producing enough hormones. The opposite extreme is high levels of cortisol, resulting
in Cushing’s disease, which can affect weight in many parts of the body.

“It should be noted that the average levels of someone’s cortisol levels over a 24-hour period of
time may be deceiving,” Dr. Bilstrom says. “The average may look good, however, you may be
totally low at the time of day when you’re supposed to be high (the morning) and very high when
you’re supposed to be low (the evening).”

Why saliva testing?
A saliva cortisol test involves testing at four different times during one day in order to see what
the stress hormone rhythm or lack of rhythm is. Saliva testing is also a much better indicator of
what is happening inside of the cells compared with blood work. Blood work focuses on the
liquid carrying the cell around, while saliva cortisol testing looks inside the cells.

“The worst time to check for a stress hormone level is right after you get stabbed with a sharp
object; that’s basically what a blood draw is, stabbing you with a sharp needle and it’s going to
alter the stress hormone level immediately,” Dr. Bilstrom says. “If we were to check somebody’s
cortisol with a blood draw, they come in to see me and I say, ‘Oh by the way your saliva cortisol
levels are quite high.’”

“They would say, “You just stabbed me with a sharp object, wouldn’t that alter my cortisol
levels?”

“And I’d have to say, “Yes.” That’s another reason why it’s so much better to do the saliva
cortisol, plus you don’t have to get stuck four times in a day.”

Stress in the body
The body doesn’t differentiate between different types of stress. To the body, stress is stress,
whether it’s physical, emotional, or spiritual. It’s all just stress. Like a physical stress that occurs
when someone twists their ankle. The body uses cortisol to manage the inflammation and take
the pain away. When someone experiences too much stress, too often or too big of ones, they,
can get stuck in stress mode. ‘Fight-or-flight’ or ‘life or death’ mode. The body is an excellent
manager of all types of stress, but being stuck in a constant state of high stress interrupts the
body’s ability to heal.

“Imagine you’re taking a nice walk and a bear jumps out and wants to eat you,” Dr. Bilstrom
says. “What do you think your stress hormone will do? It’s going to jump up, but not like the
everyday sprain my ankle or tough day at the office. It’s going to go way up. So when people’s
cortisol levels get stuck way up there, it’s the same as if a bear was chasing them—life or death,
fight or flight, 24-hours a day, seven days a week, month after month, year after year,. In the end,
it’s how long can your body sustain high levels of cortisol, or how long you can run from a bear
before your body just gives out?”