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 | Collect Sample At Home: No Clinic Visit Required
What Does This Test Measure?
Saliva — Adrenal Profile: DHEAS plus Morning, Midday, Evening and Bedtime Cortisol.
This at-home profile measures two hormones through five results: one DHEAS measurement and four cortisol measurements collected throughout the day.
- DHEAS is produced mainly by the adrenal glands and normally decreases with age. Your result adds information about adrenal androgen production.
- Cortisol participates in energy regulation, the stress response and your sleep–wake cycle. Four measurements show how your levels change across your collection day.
Your report includes numerical results, reference ranges, graphs and specialist laboratory comments to help you understand the findings.
Related Symptoms
- Persistent tiredness or fluctuating energy
- Difficulty becoming alert in the morning
- Afternoon energy dips
- Feeling tired but unable to relax in the evening
- Difficulty falling asleep, staying asleep or waking refreshed
- Feeling stressed, tense or overwhelmed
Who Should Consider This Test?
Men who want to understand their measured DHEAS level and daily cortisol pattern, particularly when tiredness, changing energy levels and sleep difficulties occur together.
The profile provides more information about cortisol across the day than a single morning measurement, with DHEAS adding a separate hormone result for interpretation.
How Your Results Can Help With Your Symptoms
Morning Tiredness or Difficulty Becoming Alert
Relevant result: Morning cortisol
Your morning measurement shows whether cortisol falls within the laboratory’s expected morning range.
Practical next steps: Compare the result and specialist comments with your waking time, sleep duration and morning energy. Use this information to review consistent sleep and waking times, morning daylight exposure and recovery. If the report identifies a finding needing investigation—or tiredness persists—arrange a medical review.
Afternoon Energy Dips
Relevant results: Midday and evening cortisol
These measurements show your cortisol levels later in the day and how they compare with the morning result.
Practical next steps: Keep a brief record of energy dips, meals, caffeine and activity. Review regular meals, adequate hydration, caffeine timing and workload. The report adds hormone information to this review; it does not prescribe a particular diet.
Feeling Tired but Unable to Relax
Relevant results: Evening and bedtime cortisol
Cortisol generally decreases towards bedtime. These measurements show whether your sampled evening levels follow that pattern.
Practical next steps: Review late caffeine, demanding evening exercise, work carried into bedtime and opportunities to wind down. Choose manageable changes and track whether settling at night becomes easier.
Difficulty Sleeping or Waking Refreshed
Relevant results: Bedtime cortisol and the overall daily profile
The bedtime result provides information that a morning measurement alone cannot offer.
Practical next steps: Use your report alongside a sleep diary. Consider a consistent sleep schedule, morning daylight and a quieter evening routine. Persistent insomnia, loud snoring or marked daytime sleepiness warrants further assessment even if cortisol results are within range.
Feeling Stressed or Overwhelmed
Relevant results: The daily cortisol profile
Your results show the measured cortisol pattern rather than relying on how stressed you feel alone.
Practical next steps: Review your workload, rest, exercise intensity and relaxation habits. Use the laboratory comments to identify any findings that need follow-up, while tracking changes in stress, sleep and energy.
What Does the DHEAS Result Add?
DHEAS provides additional information that must be interpreted with age, medication and supplement use.
A low result does not automatically mean low testosterone. In men, most testosterone is produced by the testes. If sexual symptoms are your main concern, testosterone assessment is more directly relevant.
How the Specialist Comments Help You
The sample report demonstrates three useful features:
- Results and ranges: Show each measured level and highlight findings outside the displayed range.
- Graphs: Display cortisol across the day and DHEAS in an age-related context.
- Laboratory comments: Explain how the measurements relate to age and the information supplied on your symptom form.
Complete your symptom checklist and record medicines, supplements and collection times carefully. This helps make the interpretation more relevant to you.
What Should You Do Next?
Read the comments, note any recommended follow-up and choose practical sleep, nutrition and recovery habits to review. Track your symptoms so you can judge whether changes help.
If results are clearly abnormal, symptoms continue or the comments suggest hormone supplements, seek medical advice before starting treatment. Laboratory interpretation helps you understand the findings; it is separate from a prescribing consultation.
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 — following the detailed instructions provided
- 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 male-specific reference ranges
- Visual chart showing your complete daily cortisol rhythm curve and DHEAS status
- Written interpretation by a Hormone Specialist PhD Doctor including DHEAS–cortisol adrenal reserve assessment and testosterone impact analysis
- 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
What does this test measure?
DHEAS and Cortisol at four points throughout the day (morning, noon, evening, night) — 5 markers providing a complete picture of adrenal function, DHEAS status, and their combined impact on testosterone in men.
Why is DHEAS important for men?
DHEAS is the primary adrenal precursor to testosterone. Low DHEAS directly reduces testosterone availability, libido, muscle mass, and stress resilience, and is a key driver of andropause-like symptoms in men of all ages under chronic stress. It is never measured by standard NHS panels.
Can I use this test if I am on TRT?
Yes. This test is particularly valuable for men on TRT wanting to understand whether adrenal dysfunction — low DHEAS or cortisol dysregulation — is undermining the effectiveness of their testosterone therapy.
Why use saliva rather than blood?
Saliva LC-MS/MS measures free, bioavailable cortisol and DHEAS — the fractions actually 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.
