Diurnal Cortisol Test (Stress Balance)

• - Fatigue or feeling tired

• - Depression

• - Sleep disturbance

• - Weight gain 

• - Mental fatigue

• - Lack of concentration

• - Increased appetite

For the Diurnal Cortisol Test we analyse:

Cortisol

What is this hormone for?

Cortisol

Cortisol is produced in the adrenal glands. Cortisol is the most important stress hormone besides adrenaline: Stress hormones help the body to react to particular strain. They release energy reserves in order to prepare the body for “escape” or “attack”. During hard, physical work, competitive sports, psychological, physical and mental stress situations, or during a severe illness, the distribution of cortisol is also stimulated. 

Cortisol plays an important role in the different metabolic processes in the body. In immune processes, cortisol helps with its anti-inflammatory and anti-allergic effect, and has an important function in maintaining the health of the body. 

However: Both too low and too high levels can cause unpleasant symptoms.

It is well known that chronic stress is unhealthy – and stress is, in turn, the most important impulse that causes the increase of the distribution of cortisol. If the cortisol levels are too high, symptoms can include immunodeficiency, depression, physical exhaustion, metabolic disorders, diabetes, obesity and sleeping disorders. Excessively high cortisol levels can indeed cause unpleasant symptoms.

Just the same, excessively low cortisol levels can interfere with general well-being: Cortisol is vital. Apart from the provision of energy reserves, it also plays a role in the cardiovascular health,gastrointestinal health, the immune system and brain functions.

Before the saliva collection

General

-Only conduct the saliva test on a day which matches the time schemes for the sample collection.
-We strongly advise patients with gum diseases and gingivitis against using a saliva test.
-Always make sure to thoroughly wash your hands when using hormone creams. Due to the sensitivity of the saliva test we advise wearing disposable gloves for the collection of the samples.
-Please pay attention to the following time requirements referring to the examination of the hormones DHEA, progesterone, estradiol, estriol and testosterone.

Collecting time for women:

-With regular menstruation: On the 19th - 21st day of the cycle (calculated from the first day of the menstruation)

-With irregular menstruation: 5 days before the expected menstruation

-Without menstruation: Every day of the month

-With contraceptives that determine a 21 day cycle with a 7 day pause. In the first two weeks (calculated from the first day of taking the pill)

-With contraceptives determine a long-term cycle Every day of the month

Collecting time for men: Every day of the month

Two to five days before the collection

-From now on please swallow all sublingual hormones such as drops, pastilles and so on directly – and do not allow to remain in the mouth under any circumstances.
-Please stop the use of any hormonol gels or creams 48 hours before the sample collection.

12 to 24 hours before the collection

-Please refrain from the intake of all hormones, in the form of tablets and capsules, 12 hours before the collection of the samples (exception: contraceptive pill).
-No dental measures should be undertaken up to 24 hours beforehand.
-Please do not consume any alcohol as well as sour and very sugary food products from now on.
-The last consumption of animal products should be at least 12 hours before the saliva collection.

 On the day of the collection:

-Please do not brush your teeth before collecting the saliva.

-Do not eat any chocolate, onions, garlic, or cruciferous vegetables such as cauliflower, broccoli, cabbage, as well as milk or egg products.

-If you are collecting the saliva over the day then please adopt to a vegetarian diet.

-Do not drink coffee, tea or other caffeinated beverages.

-Please do not smoke.

During the last 60 minutes before the collection:

-Please do not consume any more meals or liquids (apart from water); please do not consume any more milk products.

-Sublingual hormones are only to be used after a successful collection of the saliva.

-10 minutes before the saliva collection the mouth should be throughly rinsed with water and be completely empty at least 5 minutes before the collection. This step may be ignored when collecting the sample at 2 am or when collecting directly after getting up.

-The mouth should not contain any leftovers from food or drink.

Daytime scheme for obtaining samples

All samples are to be collected on the same day!

Saliva sample 1: Directly after waking up
Saliva sample 2: 30 minutes after waking up
Saliva sample 3: 1 hour after waking up
Saliva sample 4: 2 hours after waking up
Saliva sample 5: 5 hours after waking up
Saliva sample 6: 8 hours after waking up
Saliva sample 7: 12 hours after waking up

During the saliva collection

1. Please label all the sample containers as well as the enclosed sample dispatch note with your first and last name, the date as well as the time of the saliva sample collection.

2. Please take one straw and the sample container out of the packaging. Put the straw in your mouth and use it to transport the saliva into the sample container.

3. Fill the sample container at least half way (preferably ¾), not including the foam. If you have collected too much foam then lightly tap against the sample container so that the foam can separate itself from the saliva liquid.

4. Check whether the sample has taken on a red colouring. If so, then this most likely is blood (for example due to bleeding gums), which would falsify the results. In this case, please dispose the sample, rinse the sample container with tap water and collect another sample (colourless) after 5 – 10 minutes.

5. Now close the lid of the sample container. Dispose the saliva tube in your household trash.

6. Place the sample in the delivered protective bag (clear bag with blue border). Then place everything together with the enclosed sample dispatch note in the grey plastic envelope and seal it.

You can leave the saliva sample stored in the refrigerator until dispatch. 

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Questions about the order

• Which test should I order?
• Can I also order by phone?
• How long does it take for my order to arrive?
• I have not received an order confirmation.
• My package did not arrive or my order was not completely delivered.
• I want to cancel my order.

Questions about sample submission & findings

• How long will it take to receive my findings?
• How do I get my findings?
• Can I get advice for my test result? Can you tell me what remedy to take?
• I forgot to put the sample dispatch note in the package when sending the sample back.
• I take medication. Can this affect the outcome?

Questions about the saliva test

• My cycle is so irregular that I can not determine when being about one week before the menstruation.
• I would like to do the test on a Friday/weekend, but in the instructions it is written that you should send the samples only at the beginning of the week.
• How long can you store or use saliva samples?

• What is the difference between a hormone saliva test and a blood hormone test, and why can the results vary widely?

Which test should I order?

To find the right test for you, click through our additional product information covered in the categories <Details>, <Symptoms> and <Test includes>. You can also call us at (703) 722 6067 (08:00am - 11:30am EST) or write an email to contact@verisana.com.

Can I also order by phone?

Yes. Please call us at (703) 722 6067 (08:00am - 11:30am EST). The payment in this case is only possible via Paypal. We take your order and you will receive the payment request by mail.

How long does it take for my order to arrive?

We process orders on a daily basis (apart from weekends and public holidays). You have the possibility to choose between two shipping options: free standard shipping and two day shipping.

The standard shipping option is for free and you will receive your order in 5-7 days. The two day shipping option is only for free when your purchase amount is higher than 100 $, if this is not the case you will have to pay an additional amount of 5 $. Regardless of the purchase amount you will receive your order in 2 days if you have chosen the two day shipping option.

I have not received an order confirmation.

Please contact us to check if your order was registered. We will gladly send you the confirmation again.

My package did not arrive or my order was not completely delivered.

Please contact our customer service team at (703) 722 6067 (08:00am - 11:30am EST) or write an email to contact@verisana.com.

I want to cancel my order. 

The withdrawal period from the purchase of all our items is 2 weeks from the receipt of the goods. Please inform us via mail about the desired cancellation and note the following information:  Laboratory analyzes can only be canceled if the analysis has not yet been carried out. 

How long will it take to receive my findings?

From the day the sample arrives in our laboratory, it takes:

- saliva tests 2 weeks 
- stool tests 2-3 weeks

until the findings are completed.

If you have not received your report after this deadline, please contact us. Please understand that we can not speed up the processing of your sample.

How do I get my findings?

You will receive your findings via mail.

Can I get advice for my test result? Can you tell me what remedy to take?

For legal reasons, our findings do not include individualized therapy recommendations. 

If you have any questions regarding the understanding of your findings, please contact our laboratory team.

I forgot to put the sample dispatch note in the package when sending the sample back.

Please send us the completed and signed dispatch note, preferably by mail to contact@verisana.com. Unfortunately, we can not complete your sample without a dispatch note.

I take medication. Can this affect the outcome?

That depends on the test you want to carry out and the medications you are taking. In case of doubt, please ask your doctor regarding the areas that are influenced by the medication prescribed by him and do not stop taking your medication without consulting him.

My cycle is so irregular that I can not determine when being about one week before the menstruation.

If you can estimate when you are going to be in the second cycle phase, the test should be carried out in this second cycle phase.

If that also can not be assessed, samples can be taken on any day. However, in this case we can not classify whether progesterone and estradiol are in the normal range as this is dependent on the cycle phase.

I would like to do the test on a Friday/weekend,

but in the instructions it is written that you should send the samples only at the beginning of the week. 

It is best to store the samples in the fridge or freezer and send them out next Monday. So they do not stay at the post office over the weekend.

How long can you store or use saliva samples?

In principle, it is recommended to send the samples back as soon as possible after collection. In the refrigerator the samples last several weeks, frozen they even last months. Samples that are being transported for a longer time can still be used up to two weeks after collection.

What is the difference between a hormone saliva test and a blood hormone test, and why can the results vary widely?

Hormone saliva tests and blood hormone tests are two different test types. In contrast to saliva tests, blood tests are unable to differentiate the protein-bound (inactive) from the freely available and active hormones and thus give an approximate value.Therefore, the results of saliva tests and blood tests are not comparable with each other.

Measuring bio-available, free hormones

In comparison to the measurement of the bound, biological, inactive steroid hormones in blood, the determination of the steroid hormones using a salivary hormone test has the following essential advantages. When using saliva for the determination of the hormones, the free bio-available proportion of the hormones is measured. This is the part of the hormones that is not attached to proteins and which can be actively used by our cells, for example in the brain, the uterus or skin. 

Easy sample collection without supervision

The collection of the saliva sample is neither restricted by a certain place, nor by the consultation hours of your doctor, meaning you can collect the samples everywhere (at home, at work, under way). Hormones are periodically released in bigger amounts over the course of the day and are subject to daytime fluctuations, making it sensible to take mixed samples at different times during the day to obtain an average value.

In comparison to blood tests the saliva samples have a high stability because the accuracy of the results is not manipulated by being stored over several days (about a week) or by room temperature. In the refrigerator (35-46°F) or the freezer (-4°F) the durability of the samples is extended by weeks (refrigerator) or months (freezer). Blood, on the other hand, must be cooled and sent to the laboratory as soon as possible. To avoid a reproduction of the bacteria, the saliva samples should be stored in the refrigerator or freezer until dispatch. A continuous freezing and thawing of the samples has no effect.

Pain-free experience

Due to a non-invasive sample collection, patients experience neither pain nor stress, in contrast to a blood test, where the puncturing of a vein is necessary.
Consequently, the negative associations, such as the fear of needles or seeing blood, and pain or bruises (hematomas), involved with the puncture of the needle are completely eliminated.

This particularly is an advantage when dealing with children, young or frightened patients. Due to the non-invasive sample collection (no puncturing with needles necessary!) no medical assistance is needed.

Flexbility & Round-the-clock collection

Due to the temporal and spatial independence of the sample collection, the saliva sample can be collected at times that may have posed problems with the collection of blood samples, for example several times a day or at night. The salivary hormone test eases the creation of daily, nightly or monthly profiles. In this case the samples can be collected several times a day (for example for the recording of the daily rhythmic fluctuations of cortisol), in the night (e.g. melatonin and cortisol at 2 am in the case of sleeping disorders) or daily over a month (e.g, estradiol and progesterone over the monthly cycle in the case of a pre-menstrual syndrome).

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