Cortisol is a stress-response hormone made by the adrenal cortex. It follows a daily rhythm (highest in the morning, lowest around midnight) and is measured in blood, late-night saliva, or 24-hour urine to evaluate cortisol excess or deficiency. (MedlinePlus)
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ACTH, electrolytes (Na⁺/K⁺), ± DHEA-S; in suspected excess, consider overnight dexamethasone suppression and/or repeat late-night saliva and 24-h urine per guideline pathways; in suspected deficiency, consider ACTH stimulation testing. (endocrine.org)



Acute illness, sleep disruption, pregnancy, and medications (exogenous glucocorticoids, some estrogen therapies) can affect measurements. Oral estrogens raise cortisol-binding globulin and can increase total serum cortisol; salivary cortisol is less affected by binding proteins and may circumvent this issue. Follow your lab’s instructions (e.g., avoid black liquorice; check steroid creams/inhalers). (endocrine-abstracts.org)



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