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Test Code Billings Clinic: 8173 Mayo: SALCT Cortisol, Saliva

Reporting Name

Cortisol, Saliva

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Screening for Cushing syndrome

 

Diagnosis of Cushing syndrome in patients presenting with symptoms or signs suggestive of the disease

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)


Necessary 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 Type

Saliva

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

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

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

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.

Day(s) Performed

Monday through Friday

Report Available

2 to 5 days

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

Forms

If not ordering electronically, complete, print, and send General Request (T239)