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Reference Guide
Genova Diagnostics
Adrenocortex Stress Profile

Adrenocortex Stress Profile

Genova Diagnostics
Adrenocortex Stress Profile
Genova Diagnostics
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Adrenocortex Stress Profile
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About the Test

The Adrenocortex Stress Profile measures cortisol and DHEA through carefully timed saliva samples. It assists in understanding a patient's natural diurnal rhythm and the diagnosis of HPA imbalances. This test DOES NOT include the cortisol awakening response.

What is the Adrenocortex Stress Profile by Genova Diagnostics?

This test analyzes the levels of two adrenal hormones, cortisol and DHEA, in four saliva samples taken throughout the day.  The timing of samples is:

Sample 1: upon waking

Sample 2: around lunchtime

Sample 3: in late afternoon/early evening

Sample 4: at bedtime


Cortisol is the body's primary stress hormone, playing a key role in the "fight or flight" response. It increases blood sugar levels and limits non essential processes in a crisis, such as the immune response, digestion, and reproduction. 

Cortisol's production follows a diurnal rhythm, with levels peaking in the early morning and gradually tapering off throughout the day, reaching their lowest at night. This pattern helps regulate various bodily functions, including sleep-wake cycles and energy management. [11.]


Dehydroepiandrosterone (DHEA) is another adrenal hormone that serves as a precursor to sex hormones such as estrogen and testosterone. DHEA is the most abundant steroid hormone in the human body and is involved in a myriad of physiological processes including immune function, energy metabolism, stress response, and the maintenance of muscle and bone mass. DHEA levels typically decrease with age.  [10.]

Unlike cortisol, DHEA levels do not fluctuate significantly throughout the day, making them a reliable marker for long-term adrenal function.

The DHEA/Cortisol Ratio

Both cortisol and DHEA are essential for health and well-being, with each hormone playing distinct roles in the body's response to stress and in maintaining physiological equilibrium. The balance between these hormones is critical, as imbalances can lead to a range of health issues. [1.]

The ratio of DHEA/Cortisol demonstrates the ratio of anabolic to catabolic processes in the body.  An elevated ratio favors anabolic activity, while a decreased ratio favors catabolic activity.  

An imbalanced ratio may indicate HPA axis dysfunction.  

What is the Clinical Relevance of the Adrenocortex Stress Profile by Genova Diagnostics?

The Adrenocortex Stress Profile by Genova Diagnostics provides valuable insights into the functioning of the adrenal glands and the body's response to stress. 

By assessing cortisol and DHEA levels throughout the day, this profile allows healthcare providers to identify patterns of adrenal dysfunction, such as adrenal fatigue or dysregulation, which may contribute to various health issues. Additionally, diurnal cortisol testing illuminates the body's natural circadian rhythm and how it may be impacted by chronic stressors.

Treating adrenal gland dysfunction from a functional perspective requires assessment of the individual’s current stage of stress and developing a treatment course that may include diet, lifestyle, supplement, and hormone measures according to the individual’s unique test results.  

Selye's 3 stages of stress, known as the General Adaptation Syndrome, begin with the alarm stage where the body initially reacts to stressors by activating the fight-or-flight response. This is followed by the resistance stage, where the body attempts to adapt and cope with ongoing stress, and finally, the exhaustion stage, where resources are depleted, leading to increased vulnerability to illness and fatigue.  [4.] 

Each stage of stress requires different therapies.  The Adrenocortex Stress Profile can help uncover an individual’s current stage of stress and inform treatment decisions.

Who should get an Adrenocortex Stress Profile by Genova Diagnostics?

Ideal candidates for the Adrenocortex Stress Profile by Genova Diagnostics are individuals experiencing symptoms indicative of adrenal imbalance or dysfunction, often as a result of prolonged exposure to stress. 

This test is particularly suited for those who have been unable to find relief through general medical care or who suspect that their symptoms may be related to adrenal gland issues. Key groups of people who might benefit from this test include:

Individuals Under Continuous Stress: Those who face chronic emotional stressors such as marital, financial, or occupational challenges, as well as physical stressors like sleep deprivation, excessive caffeine intake, pain, or rigorous exercise routines. [12.]

Patients with Symptoms of Adrenal Imbalance: Symptoms can range widely and include immune dysfunction, persistent fatigue, allergies, sleep disturbances, unexplained muscle loss, and other signs of hormone imbalance. [9.]

People with Chronic Fatigue Syndrome (CFS) or Fibromyalgia: Since these conditions are often linked with hormonal imbalances and stress, the test can help in understanding the role of adrenal function in their symptomatology. [9., 12.] 

Individuals with Difficulty Managing Weight: As cortisol plays a significant role in metabolism and fat storage, those struggling with weight issues without clear dietary or physical activity-related causes might find the test insightful.  [6.]

Patients with Anxiety or Depression: Since adrenal hormones can impact mood and stress responses, individuals with psychological conditions such as anxiety or depression may benefit from assessing their adrenal function. [3.]

Those Experiencing Sleep Disorders: Given cortisol's influence on sleep-wake cycles, people with insomnia or disturbed sleep patterns may undergo this test to evaluate if adrenal hormones contribute to their condition. [7.]

Women with Reproductive Health Issues: Since DHEAS is a precursor to sex hormones, women facing infertility, menstrual irregularities, or menopause-related symptoms might find the test useful in uncovering underlying hormonal imbalances.  [5.]  Additionally, chronically elevated cortisol levels have also been associated with infertility.  [8.]

Individuals Looking to Optimize Health and Well-being: Even in the absence of specific symptoms, people interested in a comprehensive approach to health and wellness might use this test to ensure their adrenal glands function optimally, especially in today's fast-paced, high-stress environments.

By identifying specific hormonal imbalances, the Adrenocortex Stress Profile allows healthcare providers to develop targeted treatment plans.  These can include lifestyle modifications, dietary changes, supplementation, and other therapies tailored to address the unique needs of each individual, thereby offering a pathway to improved health and quality of life.

Collection and Shipping

Click here for full instructions on collecting and shipping your saliva samples for the Adrenocortex Stress Profile.  

Additional Resources for Practitioners

Article: Integrative Treatment Options for Adrenal Disorders: Specialty Testing, Nutrition, Supplements 

Article: The Functional Medicine Protocol For Beating Burnout with Adrenal Support

Article: The Top 10 Evidence-Based Herbs to Support Adrenal Health


[1.] Di Luigi, L., Guidetti, L., Baldari, C. et al. Cortisol, dehydroepiandrosterone sulphate and dehydroepiandrosterone sulphate/cortisol ratio responses to physical stress in males are influenced by pubertal development. J Endocrinol Invest 29, 796–804 (2006).

[2.] El-Farhan N, Rees DA, Evans C. Measuring cortisol in serum, urine and saliva - are our assays good enough? Ann Clin Biochem. 2017 May;54(3):308-322. doi: 10.1177/0004563216687335. Epub 2017 Mar 16. PMID: 28068807.

[3.] Fiksdal A, Hanlin L, Kuras Y, Gianferante D, Chen X, Thoma MV, Rohleder N. Associations between symptoms of depression and anxiety and cortisol responses to and recovery from acute stress. Psychoneuroendocrinology. 2019 Apr;102:44-52. doi: 10.1016/j.psyneuen.2018.11.035. Epub 2018 Nov 24. PMID: 30513499; PMCID: PMC6420396.

[4.] Fink G. Stress: Definition and History. ScienceDirect. Published January 1, 2009.‌

[5.] Gleicher N, Barad DH. Dehydroepiandrosterone (DHEA) supplementation in diminished ovarian reserve (DOR). Reprod Biol Endocrinol. 2011 May 17;9:67. doi: 10.1186/1477-7827-9-67. PMID: 21586137; PMCID: PMC3112409.

[6.] Hewagalamulage SD, Lee TK, Clarke IJ, Henry BA. Stress, cortisol, and obesity: a role for cortisol responsiveness in identifying individuals prone to obesity. Domest Anim Endocrinol. 2016 Jul;56 Suppl:S112-20. doi: 10.1016/j.domaniend.2016.03.004. Epub 2016 Mar 31. PMID: 27345309.

[7.] Hirotsu C, Tufik S, Andersen ML. Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Sci. 2015 Nov;8(3):143-52. doi: 10.1016/j.slsci.2015.09.002. Epub 2015 Sep 28. PMID: 26779321; PMCID: PMC4688585.

[8.] Karunyam BV, Abdul Karim AK, Naina Mohamed I, Ugusman A, Mohamed WMY, Faizal AM, Abu MA, Kumar J. Infertility and cortisol: a systematic review. Front Endocrinol (Lausanne). 2023 Jun 29;14:1147306. doi: 10.3389/fendo.2023.1147306. PMID: 37455908; PMCID: PMC10344356.

[9.] Klimas NG, Broderick G, Fletcher MA. Biomarkers for chronic fatigue. Brain Behav Immun. 2012 Nov;26(8):1202-10. doi: 10.1016/j.bbi.2012.06.006. Epub 2012 Jun 23. PMID: 22732129; PMCID: PMC5373648.

[10.] Neunzig J, Bernhardt R. Dehydroepiandrosterone sulfate (DHEAS) stimulates the first step in the biosynthesis of steroid hormones. PLoS One. 2014 Feb 21;9(2):e89727. doi: 10.1371/journal.pone.0089727. PMID: 24586990; PMCID: PMC3931814.

[11.] Rohleder N. Stress and inflammation - The need to address the gap in the transition between acute and chronic stress effects. Psychoneuroendocrinology. 2019 Jul;105:164-171. doi: 10.1016/j.psyneuen.2019.02.021. Epub 2019 Feb 20. PMID: 30826163.

[12.] Tomas C, Newton J, Watson S. A review of hypothalamic-pituitary-adrenal axis function in chronic fatigue syndrome. ISRN Neurosci. 2013 Sep 30;2013:784520. doi: 10.1155/2013/784520. PMID: 24959566; PMCID: PMC4045534.

About the Test

The Adrenocortex Stress Profile measures cortisol and DHEA through carefully timed saliva samples. It assists in understanding a patient's natural diurnal rhythm and the diagnosis of HPA imbalances. This test DOES NOT include the cortisol awakening response.

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Lab Test Information
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Sample Type
Shipping Time
5 - 10 days
Turnaround Time
21 days
Test Preparation Starts
Up to 1 hours before collection
Number of Collection Days
1 day
Methods Used For Processing
Lab Certifications
CLIA Certified
CAP Accredited
ISO 15189
COLA Accredited
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