The Adrenocortex Stress Profile (ASP) is a salivary assessment offered by Genova Diagnostics that evaluates hypothalamic-pituitary-adrenal (HPA) axis output across a single day. Four timed saliva samples are analyzed for cortisol, and the morning sample is additionally analyzed for dehydroepiandrosterone (DHEA). A DHEA to cortisol ratio is calculated from these values. (Genova Diagnostics n.d.)
Cortisol in saliva reflects the unbound, biologically active fraction of circulating cortisol rather than the protein-bound total measured in serum, which is one reason salivary sampling has been used as an alternative to serum free cortisol measurement. (El-Farhan 2017)
Because the profile captures multiple timed samples rather than a single value, it is generally used to characterize the shape of the diurnal cortisol curve, not simply whether cortisol is high or low. Cortisol typically peaks in the morning and declines across the day to a nighttime nadir, and the steepness of that decline has been studied as a marker of HPA axis regulation. (Adam 2017)
Providers may consider this profile in patients presenting with persistent fatigue, disrupted sleep, low stress tolerance, mood symptoms, or other presentations in which HPA axis dysregulation is being considered as a contributing factor. (Genova Diagnostics n.d.)
Results are not diagnostic on their own. Salivary cortisol values vary with sleep-wake timing, acute stressors, exercise, blood sugar status, pain, and medication exposure, and consensus methodology for interpreting rhythm parameters in clinical practice is still developing. (Ryan 2016) All findings should be interpreted within the full clinical context, including history, examination, and any conventional endocrine testing that may be indicated.
Quick Facts
- Laboratory: Genova Diagnostics
- Test code: 4300
- Specimen: Saliva
- Technology / methodology: Enzyme immunoassay (EIA)
- Turnaround time: Approximately 7 days from receipt of specimen at the laboratory
- Collection method: At-home collection of four timed saliva samples across a single day
- Ordering availability: Available to healthcare providers licensed to order laboratory testing in their state
Turnaround times are estimates and may vary. (Genova Diagnostics n.d.)
