Saliva Cortisol Test Collection Guidelines

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A saliva cortisol test is done to measure the level of cortisol, a hormone in saliva. Cortisol is made by the adrenal gland, located on top of each kidney. Cortisol has many functions. It helps the body use sugar (glucose) and fat for energy (metabolism). It also helps the body manage stress. Many conditions can affect cortisol levels, such as physical or emotional stress, strenuous activity, infection or injury.

To do a saliva cortisol test, you will need a Salivette® collection device kit. Do not collect saliva in any other container. 

Before the Collection

  • The collection time is usually between 11 p.m and 1 a.m. Your healthcare provider may ask you to collect the specimen at a different time. You may need to do more than one test in a day or to skip a day between doing them.
  • Before you collect saliva, do not let your child:
    • Eat for 60 minutes.
    • Have any alcohol less than 12 hours before.
    • Brush or floss teeth or do anything that would cause the gums to bleed.
  • Ask your child to rinse their mouth thoroughly with water 10 minutes before collecting saliva.
  • Your child may have to repeat the test if the pH value(s) is more than 9.0 or less than 3.5. Your health care provider will let you know.
  • Saliva must be clear. If you see blood, mucus or bits of food or debris, your child will need to do the test again.

How to Collect the Specimen

  1. Use a permanent marker to write your child’s full legal name, date of birth and date and time of the collection on the label in the kit. Attach it to the outside tube (D) of the Salivette collection device (Picture 1).parts of the salivette collection device
  2. Wash your hands with soap and water, rinse and dry well before starting the test.
  3. Take the cap or stopper (A) off the container to get to the swab (B). Never touch the swab with your hands. Always leave the insert (C) inside of the tube (D). The insert is needed to process the specimen at the lab (laboratory).
  4. Tip the tube (D) directly inside the child’s mouth. The swab (B) should fall on top of or under the tongue so that it can move freely in the mouth. Do not let the swab go in between the cheek and gum.
  5. Please watch your child closely to be sure that they do not choke on or swallow the swab.
  6. Ask your child to roll the swab inside their mouth for 2 to 3 minutes. It is OK to gently chew it. The swab must be completely wet to do the test right. (It needs have about ¼ teaspoon of saliva.)
  7. Ask your child to carefully spit the wet swab back into the insert (C) without touching it.
  8. Put the stopper (A) back on tightly. The cap will click when closed correctly.
  9. Look at the swab to make sure that there is no blood, mucus or bits of food or debris. The specimen should be clear.
  10. Put the specimen in the refrigerator.

Specimen Storage and Transport

  • All specimens need to be kept cold in the refrigerator until you take them to the nearest Nationwide Children’s Hospital laboratory.
  • If you have more than one specimen, double check to be sure that each tube is clearly labeled with the child’s full legal name, date of birth, and collection date and time.

For questions about saliva collection for this test or directions to the Laboratory Service Center nearest you, please call Laboratory Services at (800) 934-6575, or visit

Saliva Cortisol Test Collection Guidelines (PDF)

HH-III-143 ©2017, Revised 2020, Nationwide Children ’s Hospital