This is a sensitive and convenient test for measuring the proper functioning of the adrenal glands through a 12 hour day. Based on measuring the concentration of hormones in the saliva, the technique was developed at Harvard in the 1980s and has a very high correlation with free unbound blood serum cortisol.

The adrenals are glands located on top of the kidneys and have four primary functions. They are the primary energy producers of the body; help control inflammation; help balance blood pressure; and help balance blood sugar.

It is well established that the adrenals can become fatigued and dysfunctional in response to prolonged, elevated secretion of cortisol that can result from chronic tissue pain, chronic inflammation, and/or chronic mental or emotional stress. The most prominent sign of adrenal exhaustion or dysfunction is fatigue, although this symptom could also indicate low blood pressure, blood sugar problems, or inflammation that is somewhat out of control. Despite the fact that adrenal dysfunction is very common within Western society, it is not generally recognized by physicians. This is because Western practice focuses on the disease states of either adrenal failure or Addison’s Disease. Both are indicated by very low cortisol levels that are not improved by intravenous stimulation. Diagnosis of adrenal dysfunctions, however, requires tracking an individuals actual diurnal secretion on cortisol, something the stimulation test cannot do.

The adrenals secrete cortisol. The output is very high in the morning and gradually decreases throughout the day. To track this pattern, the Adrenal Stress Index is measured using saliva samples taken at four particular times of the day. The test is done in comparison with DHEA, which is like a companion hormone. The results provide a very good assessment of how strong or weak your adrenals are. Although blood serum could be used in such a test, it would require a patient to visit a lab many times a day, while the saliva test can be self-administered. Numerable tests show that the free cortisol measured in saliva has a 97% correlation with the free cortisol in the blood. This assessment of specific imbalance, dysfunction, or lack of output at particular times of the day allows more specific diagnosis and treatment.

The treatment for adrenal dysfunction is based upon the findings, and is both supportive and physiological. It uses small doses of cortisol large enough to replace what is needed but not large enough to suppress the functions of the gland.