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Physicians Adrenal Health Profile

The steroid hormones cortisol and DHEA work together to regulate the body’s response to stress. They are important for many physiological systems and processes, including the sleep-wake cycle, sex hormone balance, thyroid function, the immune system and inflammation, digestion, bone metabolism, glucose homeostasis, and heart health.1

Imbalances in cortisol and DHEA due to a chronically activated stress response can directly affect mood, sleep, immune function, thyroid function, weight, and resistance to stress, and may contribute to the development of various chronic health conditions.1,2,3 Cortisol and DHEA levels can be optimized by diet and lifestyle adjustments that reduce the harmful effects of stress and inflammation on the body.

The Salveo DiagnosticsTM Adrenal Health Assessment measures salivary cortisol and DHEA at 4 time points during a typical day. Saliva testing analyzes cortisol and DHEA in their biologically active state. As cortisol and DHEA release vary over a 24-hour period, measuring their values in saliva collected throughout the day tracks overall production and reveals the degree and timing of any imbalances.


Salivary Cortisol

Cortisol and DHEA are synthesized in the adrenal glands from pregnenolone, the master steroid hormone, which is derived from cholesterol. Cortisol is the primary stress hormone and has potent anti-inflammatory properties. It is a catabolic hormone, readying the body for “fight or flight” by breaking down proteins and fats and raising blood glucose levels.

However, a chronically activated stress response can create “wear and tear” on the body, suppressing the immune system and causing fatigue, depression, anxiety, central weight gain, bone loss, and sleep disturbances. Persistently high cortisol can also increase risk for diabetes, high blood pressure, inflammation, and memory problems.

A low cortisol level may indicate “adrenal exhaustion” and is linked to conditions such as depression, hypothyroidism, arthritis, and chronic fatigue. Low cortisol can be caused by prolonged stress, nutrient deficiencies, some medications, injury to the adrenal glands, or infection. Secondary adrenal insufficiency may stem from pituitary dysfunction or abrupt termination of glucocorticoid therapy. Rare genetic disorders (e.g., congenital adrenal hyperplasia) may also affect production of adrenal hormones.3


Salivary DHEA

DHEA is an anabolic hormone, balancing the body’s stress response by promoting growth and healing. It is the major precursor of estrogen and testosterone, is important for muscle development, fat burning, bone growth, skin health, and immune function, and guards against degenerative age-related conditions.

A high DHEA level is often associated with traditionally “masculine” symptoms (e.g., loss of scalp hair, acne, increased body hair) and can also indicate insulin resistance or metabolic syndrome.

Although DHEA levels decline with age, low DHEA is a warning flag for adrenal exhaustion, and is linked to arthritis, osteoporosis, insomnia, depression, fatigue, and decreased libido. Reduced DHEA levels are also linked to a reduced ability of the body to fight off infections or heal effectively.


  1. Bauer ME. Stress, glucocorticoids and ageing of the immune system. Stress 2005;8(1):69–83.
  2. Collomp K, et al. Altered diurnal pattern of steroid hormones in relation to various behaviors, external factors, and pathologies: A review. Physiol Behav 2016;164:68–85.
  3. Raff H, et al. Physiological basis for the etiology, diagnosis, and treatment of adrenal disorders: Cushing’s syndrome, adrenal insufficiency, and congenital adrenal hyperplasia. Compr Physiol 2014;4:739–769.