Test Code SALCC Cortisol and Cortisone, Saliva
Necessary Information
Collection time is required.
Specimen Required
If multiple specimens are collected, submit each Salivette under a separate order number.
Patient Preparation:
1. Patient should not brush teeth, eat, drink, or take any oral medication for at least 60 minutes before specimen collection.
2. Have patient rinse mouth thoroughly with water for 1 to 5 seconds. Wait 10 minutes before collecting the specimen to avoid contamination of the saliva by an interfering substance.
Supplies: Cortisol, Saliva Collection Kit (T514)
Container/Tube: Sarstedt Salivette
Specimen Volume: 1.5 mL
Collection Instructions:
1. Provide patient with a Saliva Collection Kit (Salivette) containing the Cortisol and Cortisone - Saliva Collection Instructions and ask them to follow the instructions as written.
2. If performing a late-night salivary cortisol (LNSC) test, specimen should be collected immediately prior to going to bed. If patient is undergoing assessment for adrenal insufficiency, specimen should be collected immediately after waking up. The patient should follow their normal sleeping schedule. Record collection time on the Cortisol and Cortisone - Saliva Collection Instructions sheet.
3. Instruct patient to return Cortisol and Cortisone - Saliva Collection Instructions with the appropriately labeled Salivette to the laboratory.
Additional Information: Reference intervals are available for LNSC testing (immediately before going to bed) and immediately after waking for assessment of adrenal insufficiency.
Useful For
Screening and diagnosis of Cushing syndrome/hypercortisolism
Adjunctive evaluation of adrenal insufficiency (using waking salivary cortisone/cortisol)
May be useful to assess for hypercortisolism/other adrenal disorders during pregnancy/oral estrogen therapy (when total cortisol is increased due to increase in cortisol-binding globulin) or in states of low cortisol-binding globulin (critical illness)
Evaluation of suspected contamination from topical steroids
Special Instructions
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Cortisol and Cortisone, SalivaSpecimen Type
SalivaSpecimen Minimum Volume
0.6 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Saliva | Refrigerated (preferred) | 28 days |
| Frozen | 60 days | |
| Ambient | 14 days |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Reference Values
Cortisol:
Immediately after waking: 85-620 ng/dL
Immediately prior to going to bed: <127 ng/dL
Cortisone:
Immediately after waking: 510-2110 ng/dL
Immediately prior to going to bed: 62-624 ng/dL
Cortisol/Cortisone Ratio interpretation:
Cortisol should be lower than cortisone in saliva. A ratio greater than 1 suggests contamination with blood or exogenous cortisol. A ratio greater than 2 indicates contamination is likely. In these cases, recollection is recommended.
Day(s) Performed
Monday through Friday
Report Available
3 to 6 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
82530
82542
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| SALCC | Cortisol and Cortisone, Saliva | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 623629 | Cortisol Saliva | 2142-8 |
| 623630 | Cortisone Saliva | In Process |
| 623631 | Cortisol/Cortisone ratio | In Process |