Test ID: S-121 | Sample Type: Saliva | Technology: LC-MS/MS | Results Time: 3–5 Working Days After Laboratory Receives Sample | Laboratory: ZRT Laboratory – CLIA Certified | Hormone Specialist Doctor Interpretation: Included | Suitable For: Adults and Children
What Does This Test Measure?
Saliva — Adrenal Profile: DHEAS plus Morning, Midday, Evening and Bedtime Cortisol.
This at-home test measures two hormones through five results: one DHEAS measurement and four cortisol measurements across the day.
Cortisol participates in energy regulation, the stress response and your sleep–wake cycle. The four results show how your measured levels change from morning to bedtime.
DHEAS is produced mainly by the adrenal glands and can be converted into other sex hormones in body tissues. Levels normally decrease with age, making age-related interpretation important.
Your report includes hormone levels, reference ranges, graphs and specialist laboratory comments to help explain your findings.
Related Symptoms
- Persistent tiredness or fluctuating energy
- Difficulty becoming alert in the morning
- Afternoon energy dips
- Feeling tired but unable to relax at bedtime
- Difficulty falling asleep, staying asleep or waking refreshed
- Feeling stressed, tense or overwhelmed
Did You Know?
Cortisol normally follows a daily pattern, with higher levels around waking and lower levels towards bedtime. Four measurements provide information that a single morning sample cannot offer.
DHEAS adds a separate measurement of adrenal androgen production. A lower DHEAS result needs to be interpreted in the context of age, medicines and supplements—not assumed to explain symptoms.
The specialist comments help put these findings into context. In the sample report, all four cortisol results fall within their expected ranges, while the DHEAS commentary considers the patient’s age when interpreting the lower measurement.
Who Should Consider This Test?
Women who want to understand their DHEAS level and daily cortisol pattern, particularly when experiencing:
- Tiredness that varies throughout the day
- Morning sluggishness followed by afternoon energy dips
- Difficulty winding down despite feeling exhausted
- Ongoing sleep difficulties alongside stress or changing energy levels
Women in perimenopause or after menopause may also find this profile relevant when reviewing fatigue and sleep concerns. It provides adrenal hormone information rather than directly measuring oestrogen, progesterone or testosterone.
How Your Results Can Help With Your Symptoms
Morning Tiredness or Difficulty Becoming Alert
Relevant measurement: Morning cortisol : Your result shows your cortisol level near waking and how it compares with the laboratory’s morning reference range.
How to use your results: Review the specialist comments alongside your waking time, sleep duration and morning symptoms. Track whether a consistent sleep schedule, morning daylight and adequate recovery improve your energy. Persistent tiredness or a result requiring follow-up is a reason to seek further assessment.
Afternoon Energy Dips
Relevant measurements: Midday and evening cortisol
These results show your cortisol levels during the middle and later parts of the day.
How to use your results: Record when energy dips occur alongside meals, caffeine, activity and sleep. Use this diary with your report to review regular meals, hydration, caffeine timing and rest. The results provide hormone information without assuming cortisol is the cause of each dip.
Feeling Tired but Unable to Switch Off
Relevant measurements: Evening and bedtime cortisol: These measurements show whether your sampled levels fall within the expected later-day ranges.
How to use your results: Review late caffeine, evening work, intense exercise close to bedtime and your wind-down routine. Make manageable changes and track how easily you settle at night.
Difficulty Sleeping or Waking Refreshed
Relevant measurements: Bedtime cortisol and the overall daily profile: Your bedtime result adds information about cortisol near sleep time, while the earlier results provide context.
How to use your results: Keep a sleep diary and review it alongside the laboratory comments. Consider consistent bedtimes, morning daylight and a quieter evening routine. If sleep remains disrupted, further assessment can address causes this panel does not measure, including menopausal night sweats or sleep disorders.
Feeling Stressed or Overwhelmed
Relevant measurements: The four-point cortisol profile: The profile gives you measured hormone levels to consider alongside your experience of stress.
How to use your results: Review workload, exercise intensity, recovery and emotional wellbeing. Your results and comments can help identify findings needing follow-up while you make practical changes to support rest and coping.
What Does DHEAS Add for Women?
DHEAS provides information about an adrenal hormone that contributes to sex-hormone production in tissues, including after menopause.
Your result can identify a measurement that deserves closer review, but it does not directly show your oestrogen or testosterone levels. Low libido, menstrual changes, acne or increased facial hair may need separate hormone assessment.
How the Specialist Laboratory Comments Help
Your report provides more than a hormone number:
- Numerical results and reference ranges show where each measurement falls.
- Graphs make the daily cortisol pattern easier to understand.
- Specialist comments explain findings in the context of age, symptoms and treatment information.
Complete your symptom checklist and record medicines, supplements and collection times carefully so the laboratory has the information needed for interpretation.
What Should You Do Next?
Read your results and comments together, note any recommended follow-up and track your sleep, energy and symptoms.
You can begin reviewing everyday habits such as caffeine timing, regular meals, sleep consistency and recovery. Seek medical advice when results need investigation, symptoms persist or the comments suggest hormone supplements. This helps turn laboratory information into appropriate care.
See Saliva Adrenal Stress Sample Report
Not Sure Which Test Is Right For You?
Email us at info@hormonelab.co.uk with your gender, age, symptoms, medications, and any current treatments. We will forward your enquiry to our doctors and respond within 24 hours.
How It Works
- Order your kit — delivered directly to your door
- Collect saliva at four time points: morning (within 30 minutes of waking, before 9am), noon, evening, and night — cycle timing guidance is included
- Post your samples to ZRT Laboratory using the return instructions provided
- Receive your full report by email within 3–5 working days
What You Receive
- DHEAS result and all four cortisol readings with female-specific reference ranges
- Visual charts showing your complete daily cortisol rhythm curve and DHEAS status
- Written interpretation by a Hormone Specialist PhD Doctor including cortisol–progesterone interaction, DHEAS adrenal reserve assessment, and cycle or life-stage context
- Personalised next-step recommendations
- Laboratory fee included — no hidden charges
Why We Use ZRT Laboratory
All testing is performed by ZRT Laboratory — a globally recognised, CLIA-certified diagnostic laboratory founded in 1998 by Dr. David Zava, PhD. ZRT has performed over 11 million tests and is trusted by healthcare professionals in 96+ countries.
- Pioneers of at-home dried blood spot (DBS) and saliva hormone testing
- Advanced LC-MS/MS technology for clinical-grade accuracy
- Qualified for the CDC Hormone Standardization (HoSt) Program
- Personalised reference ranges based on age and sex
Through our partnership with ZRT Laboratory, Hormone Lab UK delivers internationally recognised, research-backed hormone testing to people across the UK and Europe — from the comfort of home.
Frequently Asked Questions
Why is this test particularly important for women?
Cortisol and DHEAS interact directly with oestrogen, progesterone, and thyroid hormones in women. Chronic cortisol elevation suppresses progesterone, drives oestrogen dominance, and depletes DHEAS — creating a cascade of hormonal disruption that underlies PMS, cycle irregularity, perimenopausal symptoms, and persistent fatigue. After menopause, the adrenals become the primary sex hormone source, making adrenal assessment essential at every life stage.
When should I collect my samples during my menstrual cycle?
This test can be taken at any point in your cycle. Guidance on optimal timing for cycling, perimenopausal, and postmenopausal women is included in your kit.
Can I use this test if I am on HRT or the contraceptive pill?
Yes. This test is suitable for women on HRT, the contraceptive pill, or other hormonal medications. It is particularly valuable for understanding whether adrenal dysfunction is contributing to residual symptoms that hormone therapy is not resolving.
Why use saliva rather than blood?
Saliva LC-MS/MS measures free, bioavailable cortisol and DHEAS — the fractions active at the cellular level. A blood draw also triggers a cortisol spike that distorts results, making saliva the more clinically accurate medium for adrenal rhythm assessment.
Does the price include the laboratory fee?
Yes. The full laboratory analysis fee is included. There are no additional charges. You are only responsible for posting your samples to the laboratory.
How long is the kit valid for?
The kit must be used within 12 months of the purchase date.
Saliva Sample Collection Instructions
Collect your saliva samples at home using the materials provided in your kit. Check your Test Requisition Form and kit instructions to confirm whether your test requires one, two or four samples. You may not need every tube supplied.
Read all instructions before you begin. If you use hormone treatment, also read the Hormone Users section.
1. Check Your Collection Times
| Samples required | When to collect |
|---|---|
| One | Morning |
| Two | Morning and before bed |
| Four | Morning, before lunch, before dinner and before bed |
Use the large 10 mL tube for your morning sample and the smaller 5 mL tubes for any later samples. Collect the required samples on the same day unless your kit instructions say otherwise.
2. Choose Your Collection Day
Mark your collection day on your calendar. List all medicines, supplements and hormone treatments on your Test Requisition Form.
Men, children and women who do not menstruate: Collect on any day of the month. If you use hormones, follow the treatment-timing instructions below.
Women who menstruate: If your test measures estradiol, progesterone or testosterone, use the following schedule:
| Usual menstrual-cycle length | When to collect |
|---|---|
| 23–26 days | Day 17, 18 or 19 |
| 27–30 days | Day 21, 22 or 23 |
| 31–34 days | Day 25, 26 or 27 |
| Shorter or longer regular cycles | 5–7 days before your next expected period |
| Infrequent or unpredictable cycles | Any day when you are not bleeding |
Day 1 is the first day of menstrual flow, not spotting. Follow any different timing instructions supplied for your particular test.
3. Hormone Users
Skip this section if you do not use hormones.
Record every hormone treatment on your Test Requisition Form. This helps the laboratory choose suitable reference ranges and provide relevant comments.
Do not stop prescribed hormone treatment for testing. If collection requires changing your usual dosing time, check with your prescriber first.
Topical and Oral Hormones
- Continue your prescribed treatment on the day before collection.
- Allow at least 12 hours between an evening dose and your morning sample. For example, if collecting at 8 am, take or apply the previous evening’s dose by 8 pm.
- Oral progesterone is an exception: you may take it immediately before bed.
- For at least two days before collection, apply topical hormones using gloves or an applicator rather than bare hands.
- Avoid applying hormones to your face, lips or neck.
Troches and Under-the-Tongue Hormones
Hormones that dissolve in the mouth can contaminate saliva samples. Saliva hormone testing is not recommended while using these treatments. Ask your healthcare professional about an alternative, such as blood spot testing. Contaminated samples may be partially or fully rejected.
Patches, Vaginal Rings, Pellets and Injections
The laboratory advises collecting halfway between doses or replacements. For example, this may be approximately three days after applying a weekly patch or two weeks after a monthly injection.
Check the appropriate collection time for your particular treatment with your prescriber.
Steroid Medicines
If you take glucocorticoids, such as hydrocortisone or prednisone, ask your healthcare professional when to collect your samples.
Prevent Hormone Contamination
Traces of hormone creams or gels can transfer from your hands, towels or household surfaces into your sample.
- Change your sheets, pillowcases and towels the night before collection.
- Avoid touching bathroom surfaces that may contain hormone residue.
- Wash your hands thoroughly and dry them with a clean towel.
4. Prepare for Collection
Three days before collection: Avoid anti-ageing or anti-wrinkle facial creams and biotin/vitamin B7 supplements, including hair and nail formulas.
The night before collection: Stay normally hydrated, but avoid drinking excessive amounts of fluid.
Before your morning sample: Do not eat, drink anything other than water, or brush your teeth.
Before later samples: Do not eat, drink anything other than water, or brush your teeth for at least two hours before collection.
5. Collect Your Samples
- Wash your hands with soap and water, then dry them with a clean towel.
- Rinse your mouth with water and wait five minutes.
- Begin your morning collection within 30 minutes of waking, using the large tube.
- Let saliva pool naturally in your mouth, then transfer it into the tube.
- Fill the tube at least halfway with liquid saliva, excluding bubbles. This usually takes 15–30 minutes, depending on saliva flow.
- Screw the cap on securely.
- Label the tube with your name, collection date and collection time, then place it back in its bag.
- Repeat at each later collection time required for your test, using the smaller tubes.
If saliva flow is slow: Try yawning, smelling food without eating it, or pressing the tip of your tongue against your teeth. To reduce bubbles, securely cap the tube and gently tap it on a hard surface.
6. Complete Your Paperwork and Pack Your Samples
- Complete your Test Requisition Form, including your symptoms, medical history, medicines, supplements and hormone treatments.
- Check that every required tube is clearly labelled, securely closed and at least halfway full of liquid saliva.
- Place your samples, completed form and any additional paperwork inside the plastic kit box.
- Include payment only if required under your kit’s arrangements.
- Close the box securely and place it inside the return packaging.
- Attach the prepaid return label if provided, or arrange the required postage.
- Return your samples using the carrier and return address specified in your kit instructions.
7. Storage and Collection Mistakes
Freeze samples if you will not ship them within 24 hours of collection. Samples remain stable under average shipping conditions, including transit over weekends and holidays.
If you need to repeat a collection, rinse the affected tube with hot water only—do not use soap. Shake out the remaining water and leave the tube to air-dry before collecting again at the correct time.
If you ate or brushed your teeth before collecting your morning sample, restart the following morning.
