Stress – Cortisol 4x Test

$169.99 $149.99


Markers testedCortisol (morning, noon, evening, and night)

Diurnal Cortisol Test (4x)

Available across US except in NY, NJ, MD and RI.

The 4x diurnal cortisol saliva test will measure your levels using four saliva samples within 24 hours: morning, noon, evening, and night. A physician will review the results to assess whether your levels follow the natural 24 hour diurnal rhythm.

We also offer a AM-PM cortisol saliva test (2x) using morning and evening samples.

Test Details

What is cortisol?

Cortisol is one of the stress hormones produced in adrenal glands. It has important role in metabolism to break down carbohydrates, lipids, and proteins. A well defined 24 hour circadian pattern is an important characteristic of cortisol. The levels peak around 30 minutes after waking up and then gradually drop throughout the day.

Why measure cortisol levels?

Change in the normal cortisol circadian rhythm can be caused by many issues including chronic stress, adrenal fatigue, burnout, or problems with adrenal glands. Chronically high levels are especially bad as they may result in increased appetite and weight gain. Excessive levels cause muscle loss, immune suppression, water retention, and bloating. Low levels are also bad since deficiency can result in fatigue, sluggishness, and low energy.

Checking cortisol levels can help identify potential problems with adrenal glands. Very high levels are indication of Cushing syndrome and unusually low levels indicate Addison’s disease. Therefore, diurnal cortisol test assessing the circadian rhythm profile is crucial to diagnose issues related to the HPA (hypothalamus, pituitary gland, and adrenal glands) hormone balance.

How to test for cortisol levels?

An easy, low cost method of measuring your levels is by using an cortisol level test at home. Simply order this 4 point salivary cortisol test kit, collect the sample at home, ship it for free to our world class CLIA-certified labs, and find out your levels within days. Unlike a cortisol blood test a saliva sample makes it especially useful for those fearful of needles.

We also offer a cortisol am test and cortisol pm test as an alternative. The Cortisol AM-PM Saliva Test Kit measures levels in the morning and evening.

Be informed, read more…

For a detailed discussion about symptoms of low and high cortisol levels, a comparison of cortisol blood test versus saliva test cortisol, main reasons to get tested, the convenience of an at home saliva cortisol test, the important role it plays in weight gain, adrenal fatigue, muscle loss, and more, please read: All About Cortisol.

You can also read an overview of stress hormone test at and at WebMD. ZRT lab has an excellent discussion and plots of diurnal cortisol curves for healthy individuals as well as patients with chronic stress, chronic fatigue, and burnout symptoms. Finally, you can learn more about the intricate details of a salivary testing cortisol levels for Cushing Syndrome from the experts at Mayo Clinic.

Learn more (1): What are Adrenal Glands?

The adrenal glands are a pair of glands on top of each kidney. They produce five key hormones:

  • Three steroid hormones: testosteroneDHEA, and aldosterone
  • Two non-steroid hormones: adrenaline and noradrenaline

Adrenaline hormones have a classic 4-ring backbone structure derived from cholesterol (examples are testosterone, estrogen, progesterone).

There are two types of steroid hormones:

  • Anabolic hormones: they build muscle tissue and promote fat loss; testosterone is good example
  • Catabolic hormones: they act as a balance to anabolic hormones by accumulating fat and helping raise blood sugar by breaking down muscles and bones; cortisol is a good example

Learn more (2): Cortisol and Pregnancy:

The circadian rhythm of free cortisol in pregnant women starts to change around 20th week of pregnancy. Although the diurnal rhythm remains, mean levels increase 1.5-2-times and morning levels increase several times higher than normal levels. Another important observation is that the peak levels lag behind approximately 90 minutes likely due to delayed activation of the HPA axis. The external stimulation of CRH does not increase ACTH as well as salivary cortisol levels support this observation. The levels return back to normal after 5-7 days of delivery. Original publication: Psychoneuroendocronology, Vol. 19, No. 4, 1999 (page 317).


Q: Can I purchase the test across US?

A: Except New York, New Jersey, Rhode Island, and Maryland our tests are available in all 46 states. State regulations in NY, NJ, RI, and MD do not allow us to ship the tests to their residents.

Q: What does the kit contain and how do I use it?

A: The kit contains four tubes for sample collection, instructions on how to collect the samples, and a form requesting basic information including date and time of collection. The directions are straight forward and easy to follow.

Q: How long does it take to receive the results?

A: You will receive the kit within 3-5 business days with a prepaid return envelope. After you ship the sample and it is received by our lab, you get the results within 5 business days.

Q: What do I expect from the report?

A: The report with your test results will be easy to understand and will have all the necessary details. It will mark your cortisol levels on a healthy range for the time of the day and will specify what are the expected low and high ranges. It will briefly discuss what your numbers mean and next steps you should take to maintain healthy levels.

Q: Can I use my insurance to pay for the test?

A: You can use HSA (or FSA/MSA/HRA) accounts to pay for the tests since these are prescription tests (for further confirmation, please check the IRS publication#969). However, please ensure you are not going outside your specified max and min deductible limits. We do not have the capability to process the insurance claim. Since insurance plans vary for individuals we can not guarantee your HSA payment will always be processed by your plan. We suggest talking to your insurance provider if you have any questions.

Q: How reliable are my tests and how do I ensure my results are accurate?

A: Measuring cortisol levels using saliva is a well researched and thoroughly documented procedure. If fact, it is reliably accurate and one of the best way to testing cortisol levels.

The variations in results are mainly from two sources: the way samples are collected and the variation from lab-to-lab. Levels are highest in the morning, when we are most energetic, and then drop during the day.

To minimize this variation, you should collect the sample within 30-60 minutes of waking up, without eating, brushing or putting anything else in your mouth that might contaminate the sample.

To minimize the variation from labs, we have partnered with CLIA-certified labs that are regulated by the states, as well as Centers for Medicare and Medicaid Services (CMS). Majority of the tests from these labs are FDA approved to ensure they meet the proper regulatory requirements. Additionally, the College of American Pathologists (CAP) requires inter-laboratory tests to ensure the ranges established by each lab do not drift or are not out of acceptable ranges. This is done by regularly testing reference samples between different labs. Finally, the labs test thousands of samples for different age groups and health conditions, and have well established reference data to compare your results against this large pool.

Q: Can you recommend what therapy should I take for cortisol levels high or low?

A: Unfortunately, no. As a lab test provider we can only test and report out data from your sample. We are not authorized to provide any medical recommendations. But we strongly encourage you to discuss the results with your doctor for next steps.

Reasons to Check

5 reasons for testing cortisol levels:

  1. It is the first step to understand why you start to feel tired in the afternoon and evening. Our at home cortisol test kit can help understand your energy levels throughout the day.
  2. Long term mental or emotional stress can raise the stress hormone levels which manifest into weight gain and adrenal fatigue. Stress, anxiety, and depression are commonly observed when levels are high. Cortisol lab test is an easy first step in understanding how your body is handling stress and what life style changes might be required to maintain health.
  3. If you are struggling to loose weight, a strong possibility of cortisol levels high should be assessed. It is also the first step to assess whether a test for low or high ACTH levels might be required. A cortisol saliva test kit is a great way to check adrenal fatigue.
  4. Loss of the natural diurnal cortisol rhythm is a strong indicator of hormone imbalance and serious health issues. As a Cushing’s disease test (or Addison’s disease test) it enables one to assess the risk at a low affordable price.
  5. Better health results in better quality of life, and an at home cortisol test from not only offers insight into various health related symptoms, but it can also serve as a motivation to treat each of these symptoms and have a better quality of life!

Why with Us?

7 reasons to order from

No lab visits or doctor appointments
Saliva test of cortisol (no blood needed)
World class CLIA-certified labs
Physician reviewed results
Fast, secure, and confidential reports
Free shipping
Qualifies for payment using HSA/FSA

Still wondering how do you test cortisol levels?

  • Each at home cortisol test kit from includes a prescription and detailed review of the results by one of our physicians at no extra cost. And all the shipping is free.
  • processes your sample at the same CLIA-certified labs that doctors use. So rest assured your tests are being processed in a world class lab.
  • offers convenient, confidential, and reliable results at one of the lowest prices. And we offer a basic morning and evening test as well as 24 hour saliva cortisol test kit, both are excellent for adrenal gland test.
  • You can order at home saliva cortisol test kit online, without requiring a doctor’s visit or prescription, thus saving time and money. You do not need to take any time off for lab visits which makes the the test very affordable.
  • Our stress hormone test kit is a salivary cortisol elisa kit; it is more convenient than cortisol blood test or serum cortisol test as you don’t need to draw any blood using needles.