Cortisol, LC/MS, Saliva, 4 Samples

What this laboratory test evaluates

DetailsCortisol, LC/MS, Saliva, 4 Samples – Salivary cortisol level, particularly late-night salivary cortisol (LNSC) level, is useful in screening for endogenous Cushing syndrome. Two or more positive results of LNSC tests may be used to confirm Cushing syndrome. LNSC measurement may also be used to monitor for recurrence of Cushing disease [1].

Normally, the secretion of cortisol has a circadian rhythm. Patients with Cushing syndrome often lose the late-night circadian nadir. Therefore, an elevated LNSC level may provide initial evidence for Cushing syndrome. Two or more positive results of LNSC tests may establish the diagnosis of Cushing syndrome if non-neoplastic hypercortisolism (pseudo-Cushing syndrome) is excluded. Because saliva is convenient to collect, LNSC testing is especially useful for individuals who need to provide multiple specimens over time for the evaluation of cyclic Cushing syndrome [1].

Annual LNSC testing is recommended to monitor for the recurrence of Cushing disease after pituitary surgery. LNSC testing may also be used in assessing treatment outcomes in patients receiving medical therapy for Cushing disease [1].

Non-neoplastic hypercortisolism caused by obesity, psychiatric disorders, alcohol use disorder, and polycystic ovary syndrome may increase LNSC levels. LNSC testing should not be used to screen for Cushing syndrome in individuals without normal day and night cycles. LNSC testing has low sensitivity in patients with adrenal tumors [1].

Other tests, such as urinary free cortisol (test code 14534) and dexamethasone suppression test (test code 6921), may also be used to screen for Cushing syndrome. Choice of tests should be individualized based upon clinical scenarios [1].

The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.

Reference
1. Fleseriu M, et al. Lancet Diabetes Endocrinol. 2021;9(12):847-875.

What type of sample is required for this test?0.5 mL saliva collected in each of four separate Salivette® Cortisol with blue screw-cap

Test ResourcesFor more information, please consult your healthcare provider.

Additional test information

Cortisol, LC/MS, Saliva, 4 Samples – Salivary cortisol level, particularly late-night salivary cortisol (LNSC) level, is useful in screening for endogenous Cushing syndrome. Two or more positive results of LNSC tests may be used to confirm Cushing syndrome. LNSC measurement may also be used to monitor for recurrence of Cushing disease.

Collection and processing

• Sample type: Saliva
• Fasting: No
• Estimated laboratory processing: Results should be available in 2 – 5 business days after the sample is collected

How Sunridge uses laboratory information

Sunridge considers the medical question, symptoms, history, medications, prior results, and whether the finding could change care before recommending testing. A laboratory result is not interpreted in isolation and does not establish a diagnosis by itself.

Before requesting this test

Availability, collection requirements, eligibility, and processing estimates can change. Sunridge reviews each request and, when appropriate, creates the order through Fullscript. Follow the current instructions supplied with the approved order.