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HelpTest Code SALCT Cortisol, Saliva
Reporting Name
Cortisol, SalivaUseful For
Screening for Cushing syndrome
Diagnosis of Cushing syndrome in patients presenting with symptoms or signs suggestive of the disease
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SalivaNecessary Information
Collection time is required.
Specimen Required
Patient Preparation:
1. Do not brush teeth before collecting specimen.
2. Do not eat or drink for 15 minutes prior to specimen collection.
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 - Saliva Collection Instructions and ask them to follow the instructions as written.
2. Instruct patient to collect specimen between 11 p.m. and midnight and record collection time on the Cortisol - Saliva Collection Instructions sheet.
3. Instruct patient to return Cortisol - Saliva Collection Instructions with the appropriately labeled Salivette to the laboratory.
Additional Information:
1. Reference values are also available for an 8 a.m. (7 a.m.-9 a.m.) or a 4 p.m. (3 p.m.-5 p.m.) collection, however, the 11 p.m. to midnight collection is preferred.
2. If multiple specimens are collected, submit each vial under a separate order.
Specimen Minimum Volume
0.6 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Saliva | Refrigerated (preferred) | 28 days | |
| Frozen | 60 days | ||
| Ambient | 28 days |
Reference Values
7 a.m.-9 a.m.: 100-750 ng/dL
3 p.m.-5 p.m.: <401 ng/dL
11 p.m.-midnight: <100 ng/dL
Day(s) Performed
Monday through Friday
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
82533
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| SALCT | Cortisol, Saliva | 2142-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 84225 | Cortisol, Saliva | 2142-8 |
| 23612 | AM Cortisol | 58674-3 |
| 23613 | PM Cortisol | 58668-5 |
| 23614 | Midnight Cortisol | 58642-0 |
Interpretation
Cushing syndrome is characterized by increased salivary cortisol levels, and late-night saliva cortisol measurements may be the optimum test for the diagnosis of Cushing syndrome. It is standard practice to confirm elevated results at least once. This can be done by repeat late-night salivary cortisol measurements, midnight blood sampling for cortisol (CORT / Cortisol, Serum), 24-hour urinary free cortisol collection (CORTU / Cortisol, Free, 24 Hour, Urine), or overnight dexamethasone suppression testing. Upon confirmation of the diagnosis, the cause of hypercortisolism, adrenal versus pituitary versus ectopic adrenocorticotropic hormone production, needs to be established. This is typically a complex undertaking, requiring dynamic testing of the pituitary adrenal axis and imaging procedures. Referral to specialized centers or in-depth consultation with experts is strongly recommended.
Clinical Reference
1. Raff H, Raff JL, Findling JW. Late-night salivary cortisol as a screening test for Cushing's syndrome. J Clin Endocrinol Metab. 1998;83:2681-2686
2. Papanicolaou DA, Mullen N, Kyrou I, Nieman LK. Nighttime salivary cortisol: a useful test for the diagnosis of Cushing's syndrome. J Clin Endocrinol Metab. 2002;87:4515-4521
3. Lin CL, Wu TJ, Machacek DA, Jiang NS, Kao PC. Urinary free cortisol and cortisone determined by High Performance Liquid Chromatography in the Diagnosis of Cushing’s Syndrome. J Clin Endo Metab. 1997;82:151-155
4. Mohamed RS, Abuelgasim B, Barker S, et al. Late-night salivary cortisol and cortisone should be the initial screening test for Cushing's syndrome. Endocr Connect. 2022;11(7):e220050. doi:10.1530/EC-22-0050
Report Available
2 to 5 daysMethod Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Special Instructions
Forms
If not ordering electronically, complete, print, and send General Request (T239)