Salivary cortisol and cortisone in the clinical setting
Abstract
PURPOSE OF REVIEW: A resurgence of interest in salivary biomarkers has generated evidence for their value in assessing adrenal function. The advantages of salivary measurements include only free hormone is detected, samples can be collected during normal daily routines and stress-induced cortisol release is less likely to occur than during venepuncture. We review the use of salivary biomarkers to diagnose and monitor patients for conditions of cortisol excess and deficiency and discuss the value of measuring salivary cortisone versus salivary cortisol. RECENT FINDINGS: Developments in laboratory techniques have enabled the measurement of salivary hormones with a high level of sensitivity and specificity. In states of altered cortisol binding, salivary biomarkers are more accurate measures of adrenal reserve than serum cortisol. Salivary cortisone is a superior marker of serum cortisol compared with salivary cortisol, specifically when serum cortisol is low and during hydrocortisone therapy when contamination of saliva may result in misleading salivary cortisol concentrations. SUMMARY: Salivary cortisol and cortisone can be used to assess cortisol excess, deficiency and hydrocortisone replacement, with salivary cortisone having the advantage of detection when serum cortisol levels are low and there is no interference from oral hydrocortisone.
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Salivary cortisol has been shown to be less affected by CBG alterations than plasma cortisol.
“Analysis of salivary cortisol has been proposed as an alternative to analyzing plasma free cortisol and has been shown to be less affected by CBG alterations (9, 14, 20-25).”
From Salivary Cortisol and Cortisone Can Circumvent Confounding Effects of Oral Contraceptives in the Short Synacthen Test (2024) · cites this paper as [21]
During passage through the salivary gland, most cortisol is inactivated into cortisone by 11β-hydroxysteroid dehydrogenase type 2.
“However, during passage through the salivary gland, most cortisol is inactivated into cortisone by 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) (21, 26).”
From Salivary Cortisol and Cortisone Can Circumvent Confounding Effects of Oral Contraceptives in the Short Synacthen Test (2024) · cites this paper as [21]
Cites
The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline.
Nieman, L. K., Biller, B. M. K., Findling, J. W., Newell-Price, J., Savage, M. O., Stewart, P. M., & Montori, V. M. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-0125 · Cited by 2,718 · see citing works
Measurements of Serum Free Cortisol in Critically Ill Patients
Hamrahian, A. H., Oseni, T. S., & Arafah, B. M. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa020266 · Cited by 726 · see citing works
Tissue-Specific Dysregulation of Cortisol Metabolism in Human Obesity
Rask, E., Olsson, T., Söderberg, S., Andrew, R., Livingstone, D. E. W., Johnson, O., & Walker, B. R. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.3.7453 · Cited by 657 · see citing works
Health status of adults with congenital adrenal hyperplasia: a cohort study of 203 patients
Arlt, W., Willis, D. S., Wild, S. H., Krone, N., Doherty, E. J., Hahner, S., Han, T. S., Carroll, P. V., Conway, G. S., Rees, D. A., et al. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-0917 · Cited by 506 · see citing works
Self-citationPasquali, R., Cantobelli, S., Casimirri, F., Capelli, M., Bortoluzzi, L., Flamia, R., Labate, A. M., & Barbara, L. (1993) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.77.2.8393881 · Cited by 366 · see citing works
Modified-release hydrocortisone to provide circadian cortisol profiles
Debono, M., Ghobadi, C., Rostami-Hodjegan, A., Huatan, H., Campbell, M. J., Newell-Price, J., Darzy, K., Merke, D. P., Arlt, W., & Ross, R. J. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-2380 · Cited by 322 · see citing works
Self-citationDevelopment of cortisol circadian rhythm in infancy
de Weerth, C., Zijl, R. H., & Buitelaar, J. K. (2003) · Early Human Development · doi:10.1016/s0378-3782(03)00074-4 · Cited by 248 · see citing works
Salivary cortisone is a potential biomarker for serum free cortisol
Perogamvros, I., Keevil, B. G., Ray, D. W., & Trainer, P. J. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-1215 · Cited by 222 · see citing works
Self-citationPlasma free cortisol fraction reflects levels of functioning corticosteroid-binding globulin
Lewis, J. G., Bagley, C. J., Elder, P. A., Bachmann, A. W., & Torpy, D. J. (2005) · Clinica Chimica Acta · doi:10.1016/j.cccn.2005.03.044 · Cited by 214 · see citing works
Miller, R., Stalder, T., Jarczok, M., Almeida, D. M., Badrick, E., Bartels, M., Boomsma, D. I., Coe, C. L., Dekker, M. C. J., Donzella, B., et al. (2016) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2016.07.201 · Cited by 203 · see citing works
Late-night salivary cortisol as a screening test for cushing's syndrome
Raff, H. (1998) · Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.83.8.2681 · Cited by 194 · see citing works
Comparison of salivary cortisol as measured by different immunoassays and tandem mass spectrometry
Miller, R., Plessow, F., Rauh, M., Gröschl, M., & Kirschbaum, C. (2013) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2012.04.019 · Cited by 181 · see citing works
‘Normal’ cigarette smoking increases free cortisol in habitual smokers
Kirschbaum, C., Wüst, S., & Strasburger, C. J. (1992) · Life Sciences · doi:10.1016/0024-3205(92)90378-3 · Cited by 176 · see citing works
Charmandari, E., Weise, M., Bornstein, S. R., Eisenhofer, G., Keil, M. F., Chrousos, G. P., & Merke, D. P. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.5.8456 · Cited by 164 · see citing works
Woods, C. P., Argese, N., Chapman, M., Boot, C., Webster, R., Dabhi, V., Grossman, A. B., Toogood, A. A., Arlt, W., Stewart, P. M., et al. (2015) · European Journal of Endocrinology · doi:10.1530/eje-15-0608 · Cited by 152 · see citing works
Walker, B. R., Söderberg, S., Lindahl, B., & Olsson, T. (2000) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2000.00609.x · Cited by 151 · see citing works
Perogamvros, I., Owen, L. J., Newell-Price, J., Ray, D. W., Trainer, P. J., & Keevil, B. G. (2009) · Journal of Chromatography B · doi:10.1016/j.jchromb.2009.09.014 · Cited by 140 · see citing works
Self-citationFilipovský, J., Ducimetière, P., Eschwège, É., Richard, J. L., Rosselin, G., & Claude, J. R. (1996) · Journal of Hypertension · doi:10.1097/00004872-199602000-00012 · Cited by 137 · see citing works
Qureshi, A. C., Bahri, A., Breen, L. A., Barnes, S. C., Powrie, J. K., Thomas, S. M., & Carroll, P. V. (2007) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2007.02784.x · Cited by 133 · see citing works
Debono, M., Harrison, R. F., Whitaker, M. J., Eckland, D., Arlt, W., Keevil, B. G., & Ross, R. J. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-3694 · Cited by 128 · see citing works
Self-citationGuyon, A., Balbo, M., Morselli, L. L., Tasali, E., Leproult, R., L'Hermite-Balériaux, M., Van Cauter, E., & Spiegel, K. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-4254 · Cited by 127 · see citing works
Symptomatic adrenal insufficiency during inhaled corticosteroid treatment
Patel, L. K. (2001) · Archives of Disease in Childhood · doi:10.1136/adc.85.4.330 · Cited by 127 · see citing works
Roland, B. L., Krozowski, Z. S., & Funder, J. W. (1995) · Molecular and Cellular Endocrinology · doi:10.1016/0303-7207(95)03559-p · Cited by 124 · see citing works
Subclinical hypercortisolism: a state, a syndrome, or a disease?
Dalmazi, G. D., Pasquali, R., Beuschlein, F., & Reincke, M. (2015) · European Journal of Endocrinology · doi:10.1530/eje-15-0272 · Cited by 124 · see citing works
Assessment of adrenal function in cirrhotic patients: salivary cortisol should be preferred.
Galbois, A., Rudler, M., Massard, J., Fulla, Y., Bennani, A., Bonnefont-Rousselot, D., Thibault, V., Reignier, S., Bourrier, A., Poynard, T., et al. (2010) · Journal of Hepatology · doi:10.1016/j.jhep.2010.01.026 · Cited by 122 · see citing works
Arafah, B., Nishiyama, F. J., Tlaygeh, H., & Hejal, R. (2007) · Journal of Clinical Endocrinology and Metabolism · doi:10.1210/jc.2007-0181 · Cited by 121 · see citing works
Hansen, Å. M., Garde, A. H., Christensen, J., Eller, N. H., & Netterstrøm, B. (2003) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.1080/00365510310001942 · Cited by 120 · see citing works
New enzyme immunoassay for salivary cortisol
Raff, H., Homar, P. J., & Skoner, D. P. (2003) · Clinical Chemistry · doi:10.1373/49.1.203 · Cited by 116 · see citing works
Antonelli, G., Ceccato, F., Artusi, C., Marinova, M., & Plebani, M. (2015) · Clinica Chimica Acta · doi:10.1016/j.cca.2015.10.004 · Cited by 111 · see citing works
Cortisol and the metabolic syndrome in South Asians
Ward, A. M. V., Fall, C. H. D., Stein, C., Kumaran, K., Veena, S. R., Wood, P. J., Syddall, H. E., & Phillips, D. I. W. (2003) · Clinical Endocrinology · doi:10.1046/j.1365-2265.2003.01750.x · Cited by 108 · see citing works
Morineau, G., Boudi, A., Barka, A., Gourmelen, M., Dégeilh, F., Hardy, N., Al-Halnak, A., Soliman, H. R., Gosling, J. P., Julien, R., et al. (1997) · Clinical Chemistry · doi:10.1093/clinchem/43.8.1397 · Cited by 103 · see citing works
Treatment and health outcomes in adults with congenital adrenal hyperplasia
Han, T. S., Walker, B. R., Arlt, W., & Ross, R. J. (2014) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2013.239 · Cited by 102 · see citing works
Self-citationShimada, M., Takahashi, K., Ohkawa, T., Segawa, M., & Higurashi, M. (2008) · Hormone Research · doi:10.1159/000184628 · Cited by 101 · see citing works
Differentiating between Cushing's disease and pseudo-Cushing's syndrome: comparison of four tests
Alwani, R. A., Schmit Jongbloed, L. W., de Jong, F. H., van der Lely, A. J., de Herder, W. W., & Feelders, R. A. (2014) · European Journal of Endocrinology · doi:10.1530/eje-13-0702 · Cited by 98 · see citing works
McWhinney, B., Briscoe, S. E., Ungerer, J., & Pretorius, C. (2010) · Journal of chromatography. B, Analytical technologies in the biomedical and life sciences · doi:10.1016/j.jchromb.2010.08.044 · Cited by 96 · see citing works
Jönsson, B., Malmberg, B., Amilon, Å., Garde, A. H., & Ørbæk, P. (2002) · Journal of Chromatography B · doi:10.1016/s1570-0232(02)00753-5 · Cited by 94 · see citing works
Jensen, M. A., Hansen, Å. M., Abrahamsson, P., & Nørgaard, A. W. (2011) · Journal of Chromatography B · doi:10.1016/j.jchromb.2011.07.005 · Cited by 92 · see citing works
Elias, P. C. L., Martinez, E. Z., Barone, B. F. C., Mermejo, L. M., Castro, M., & Moreira, A. C. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-4262 · Cited by 90 · see citing works
Localization of 11beta-hydroxysteroid dehydrogenase type 2 in rat tissues: in situ studies.
Roland, B. L., & Funder, J. W. (1996) · Endocrinology · doi:10.1210/endo.137.3.8603583 · Cited by 88 · see citing works
Kenouch, S., Lombes, M., Delahaye, F., Eugene, E., Bonvalet, J. P., & Farman, N. (1994) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.79.5.7962326 · Cited by 87 · see citing works
Epithelial cell localization of type 2 11 beta-hydroxysteroid dehydrogenase in rat and human colon.
Whorwood, C. B., Ricketts, M., & Stewart, P. (1994) · Endocrinology · doi:10.1210/endo.135.6.7988441 · Cited by 85 · see citing works
Salivary cortisol on ROCHE Elecsys immunoassay system: pilot biological variation studies
Chiu, S. K., Collier, C. P., CLARK, A. F., & Wynne‐Edwards, K. E. (2003) · Clinical Biochemistry · doi:10.1016/s0009-9120(02)00471-x · Cited by 85 · see citing works
Ryoji, H. (1981) · Clinica Chimica Acta · doi:10.1016/0009-8981(81)90043-7 · Cited by 85 · see citing works
Update on adrenal insufficiency in patients with liver cirrhosis
Trifan, A. V. (2013) · World Journal of Gastroenterology · doi:10.3748/wjg.v19.i4.445 · Cited by 84 · see citing works
Cortisol levels and measures of body composition in middle‐aged and older men
Travison, T. G., O’Donnell, A. B., de Araújo, A. B., Matsumoto, A. M., & McKinlay, J. B. (2007) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2007.02837.x · Cited by 79 · see citing works
Paton, J. Y. (2006) · Archives of Disease in Childhood · doi:10.1136/adc.2005.087247 · Cited by 78 · see citing works
Thévenot, T., Borot, S., Rémy-Martin, A., Sapin, R., Cervoni, J., Richou, C., Vanlemmens, C., Cléau, D., Muel, E., Minello, A., et al. (2011) · Liver international (Print) · doi:10.1111/j.1478-3231.2010.02431.x · Cited by 75 · see citing works
Ceccato, F., Barbot, M., Zilio, M., Ferasin, S., Occhi, G., Daniele, A., Mazzocut, S., Iacobone, M., Betterle, C., Mantero, F., et al. (2013) · European Journal of Endocrinology · doi:10.1530/eje-13-0159 · Cited by 75 · see citing works
Comparison of Two Methods for Measuring Salivary Cortisol
Raff, H., Homar, P. J., & Burns, E. A. (2002) · Clinical Chemistry · doi:10.1093/clinchem/48.1.207 · Cited by 74 · see citing works
Jones, R. L., Owen, L. J., Adaway, J. E., & Keevil, B. G. (2012) · Journal of Chromatography B · doi:10.1016/j.jchromb.2011.11.036 · Cited by 69 · see citing works
Self-citationVariation in absorption and half-life of hydrocortisone influence plasma cortisol concentrations
Hindmarsh, P. C., & Charmandari, E. (2015) · Clinical Endocrinology · doi:10.1111/cen.12653 · Cited by 66 · see citing works
IDENTIFICATION AND SIGNIFICANCE OF PAROTID FLUID CORTICOSTEROIDS
Katz, F. H., & Shannon, I. L. (1964) · European Journal of Endocrinology · doi:10.1530/acta.0.0460393 · Cited by 63 · see citing works
Immunoassay or LC-MS/MS for the measurement of salivary cortisol in children?
Bae, Y. J., Gaudl, A., Jaeger, S., Stadelmann, S., Hiemisch, A., Kieß, W., Willenberg, A., Schaab, M., von Klitzing, K., Thiery, J., et al. (2015) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2015-0412 · Cited by 60 · see citing works
Parotid fluid cortisol and cortisone
Katz, F. H., & Shannon, I. L. (1969) · Journal of Clinical Investigation · doi:10.1172/jci106042 · Cited by 59 · see citing works
Kataoka, H., Ehara, K., Yasuhara, R., & Saito, K. (2012) · Analytical and Bioanalytical Chemistry · doi:10.1007/s00216-012-6479-4 · Cited by 56 · see citing works
Mezzullo, M., Fanelli, F., Fazzini, A., Gambineri, A., Vicennati, V., Dalmazi, G. D., Pelusi, C., Mazza, R., Pagotto, U., & Pasquali, R. (2016) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/j.jsbmb.2016.04.012 · Cited by 56 · see citing works
Deutschbein, T., Unger, N., Mann, K., & Petersenn, S. (2009) · European Journal of Endocrinology · doi:10.1530/eje-08-0600 · Cited by 52 · see citing works
Gröschl, M., Rauh, M., & Dörr, H. G. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.3.8297 · Cited by 51 · see citing works
Thomson, A. H., Devers, M. C., Wallace, E. M., Grant, D., Campbell, K., Freel, M., & Connell, J. M. C. (2007) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2007.02812.x · Cited by 50 · see citing works
Is physiological glucocorticoid replacement important in children?
Porter, J., Blair, J., & Ross, R. J. (2017) · Archives of Disease in Childhood · doi:10.1136/archdischild-2015-309538 · Cited by 50 · see citing works
Self-citationHuman saliva cortisone and cortisol simultaneous analysis using reverse phase HPLC technique
Palo, E. F. D., Antonelli, G., Benetazzo, A., Prearo, M., & Gatti, R. D. (2009) · Clinica Chimica Acta · doi:10.1016/j.cca.2009.04.006 · Cited by 46 · see citing works
The effect of storage conditions on salivary cortisol concentrations using an Enzyme Immunoassay
Nalla, A. A., Thomsen, G., Knudsen, G. M., & Frokjaer, V. G. (2015) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.3109/00365513.2014.985252 · Cited by 44 · see citing works
Løvås, K., Thorsen, T. E., & Husebye, E. S. (2006) · Journal of Endocrinological Investigation · doi:10.1007/bf03344183 · Cited by 43 · see citing works
Chen, L.-Q., Kang, X., Sun, J., Deng, J.-J., Gu, Z.-Z., & Lu, Z.-H. (2010) · Journal of Separation Science · doi:10.1002/jssc.201000071 · Cited by 42 · see citing works
Šimůnková, K., Stárka, L., Hill, M., Kříž, L., Hampl, R., & Vondra, K. (2008) · Physiological Research · doi:10.33549/physiolres.931505 · Cited by 39 · see citing works
Moreira, R. P. P., Gomes, L. G., Mendonca, B. B., & Bachega, T. A. S. S. (2012) · PLoS ONE · doi:10.1371/journal.pone.0044893 · Cited by 38 · see citing works
Blair, J., Lancaster, G., Titman, A., Peak, M., Newlands, P., Collingwood, C., Chesters, C., Moorcroft, T., Wallin, N., Hawcutt, D. B., et al. (2013) · Clinical Endocrinology · doi:10.1111/cen.12302 · Cited by 38 · see citing works
Self-citationZimmermann, A., Grigorescu‐Sido, P., Alkhzouz, C., Patberg, K., Bucerzan, S., Schulze, E., Zimmermann, T., Rossmann, H., Geiss, H. C., Lackner, K. J., et al. (2010) · Hormone Research in Paediatrics · doi:10.1159/000313368 · Cited by 38 · see citing works
Fustinoni, S., Polledri, E., & Mercadante, R. (2013) · Rapid Communications in Mass Spectrometry · doi:10.1002/rcm.6601 · Cited by 38 · see citing works
Wong, V., Yan, T., Donald, A., & McLean, M. P. (2004) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2004.02062.x · Cited by 37 · see citing works
The effect of cardiopulmonary bypass on the hypothalamic-pituitary-adrenal axis in children*
Wald, E. L., Preze, E., Eickhoff, J., & Backer, C. (2011) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0b013e3181f36d17 · Cited by 35 · see citing works
Determination of salivary cortisol by liquid chromatography-tandem mass spectrometry
Turpeinen, U., Välimäki, M. J., & Hämäläinen, E. K. (2009) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.1080/00365510902890331 · Cited by 35 · see citing works
Assessment of glucocorticoid therapy with salivary cortisol in secondary adrenal insufficiency
Ceccato, F., Albiger, N. M., Reimondo, G., Frigo, A. C., Ferasin, S., Occhi, G., Mantero, F., Terzolo, M., & Scaroni, C. M. (2012) · European Journal of Endocrinology · doi:10.1530/eje-12-0534 · Cited by 34 · see citing works
Multi-matrix assay of cortisol, cortisone and corticosterone using a combined MEPS-HPLC procedure
Saracino, M. A., Iacono, C., Somaini, L., Gerra, G., Ghedini, N., & Raggi, M. A. (2013) · Journal of Pharmaceutical and Biomedical Analysis · doi:10.1016/j.jpba.2013.10.008 · Cited by 30 · see citing works
Serum free cortisol index, free cortisol, and total cortisol in critically ill children
Poomthavorn, P., Lertbunrian, R., Preutthipan, A., Sriphrapradang, A., Khlairit, P., & Mahachoklertwattana, P. (2009) · Intensive Care Medicine · doi:10.1007/s00134-009-1480-x · Cited by 30 · see citing works
Vieira, J. G. H., Nakamura, O. H., & Carvalho, V. M. (2014) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/0004-2730000003347 · Cited by 29 · see citing works
Ruiter, A. F. C., Teeninga, N., Nauta, J., Endert, E., & Ackermans, M. (2012) · Biomedical chromotography · doi:10.1002/bmc.1730 · Cited by 28 · see citing works
Okumura, T., Nakajima, Y., Takamatsu, T., & Matsuoka, M. (1995) · Journal of Chromatography B Biomedical Sciences and Applications · doi:10.1016/0378-4347(95)00132-3 · Cited by 27 · see citing works
Salivary cortisol and cortisone responses to tetracosactrin (synacthen)
Cornes, M. P., Ashby, H. L., Khalid, Y., Buch, H. N., Ford, C., & Gama, R. (2015) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/0004563215577838 · Cited by 27 · see citing works
Al‐Dujaili, E. A. S., Baghdadi, H. H., Howie, F. A., & Mason, J. I. (2012) · Steroids · doi:10.1016/j.steroids.2012.03.001 · Cited by 26 · see citing works
Owen, L. J., Haslam, S., Adaway, J., Wood, P. R., Glenn, C., & Keevil, B. G. (2010) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1258/acb.2009.009053 · Cited by 26 · see citing works
Self-citationCORTISOL AND CORTISONE IN SALIVA OF PREGNANCY
Greaves, M., & West, H. F. (1963) · Journal of Endocrinology · doi:10.1677/joe.0.0260189 · Cited by 25 · see citing works
Cosyntropin-stimulated salivary cortisol in hospitalized patients with hypoproteinemia
Raff, H., Brock, S., & Findling, J. W. (2008) · Endocrine · doi:10.1007/s12020-008-9101-y · Cited by 25 · see citing works
Rauschecker, M., Abraham, S. B., Abel, B. S., Wesley, R., Saverino, E., Trivedi, A., Heller, T., & Nieman, L. K. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-2285 · Cited by 21 · see citing works
Montskó, G., Tarjányi, Z., Mezősi, E., & Kovács, G. (2014) · Analytical and Bioanalytical Chemistry · doi:10.1007/s00216-014-7642-x · Cited by 20 · see citing works
Johar, H., Emeny, R. T., Bidlingmaier, M., Kruse, J., & Ladwig, K. (2016) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2016.04.004 · Cited by 20 · see citing works
Morning salivary cortisol versus short Synacthen test as a test of adrenal suppression
Patel, R. S., Shaw, S. R., McIntyre, H. E., McGarry, G. W., & Wallace, A. M. (2004) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1258/0004563041731646 · Cited by 19 · see citing works
Salivary Cortisol day curves in assessing glucocorticoid replacement therapy in Addison’s disease
Smans, L. C. C. J., Lentjes, E. G. W. M., Hermus, A. R., & ZELISSEN, P. M. J. (2013) · HORMONES · doi:10.1007/bf03401290 · Cited by 17 · see citing works
Antonelli, G., Padoan, A., Artusi, C., Marinova, M., Zaninotto, M., & Plebani, M. (2015) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2015.12.006 · Cited by 17 · see citing works
Ross, I. L., Lacerda, M., Pillay, T. S., Blom, D. J., Johannsson, G., Dave, J. A., Levitt, N. S., Haarburger, D., & der Walt, J. S. V. (2016) · Hormone and Metabolic Research · doi:10.1055/s-0042-118182 · Cited by 16 · see citing works
Parotid Fluid Steroid Responses to ACTH in Surgically Confirmed Cases of Cushing's Syndrome1
Shannon, I. L., Beering, S. C., & Katz, F. H. (1966) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-26-1-11 · Cited by 15 · see citing works
Ansai, T., Soh, I., Ishisaka, A., et al. (2009) · International Journal of Dentistry · doi:10.1155/2009/280737 · Cited by 15 · see citing works
Klein, L. C., Whetzel, C. A., Bennett, J. M., Ritter, F. E., Nater, U. M., & Schoelles, M. J. (2014) · BMC Research Notes · doi:10.1186/1756-0500-7-30 · Cited by 15 · see citing works
Moreira, R. P. P., Jorge, A. A. L., Gomes, L. G., Kaupert, L. C., Filho, J. M., Mendonca, B. B., & Bachega, T. A. S. S. (2011) · Clinics · doi:10.1590/s1807-59322011000800009 · Cited by 14 · see citing works
Steffensen, C., Thomsen, H. H., Dekkers, O. M., Christiansen, J. S., Rungby, J., & Jørgensen, J. O. L. (2016) · Clinical Endocrinology · doi:10.1111/cen.13071 · Cited by 14 · see citing works
Moreira, R. P. P., Gomes, L. G., Madureira, G., Mendonca, B. B., & Bachega, T. A. S. S. (2014) · International Journal of Endocrinology · doi:10.1155/2014/594710 · Cited by 13 · see citing works
Heijsman, S. M., de Vries, T. W., Wolthuis, A. M., et al. (2011) · Pediatric Pulmonology · doi:10.1002/ppul.21474 · Cited by 9 · see citing works
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Raff, H., & Phillips, J. M. (2019) · Journal of the Endocrine Society · doi:10.1210/js.2019-00186 · Cited by 53 · see citing works
Harrison, R. F., Debono, M., Whitaker, M. J., Keevil, B. G., Newell-Price, J., & Ross, R. J. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-01172 · Cited by 27 · see citing works
Self-citationEvans, M., McDonald, A. C., Xiong, L., Crowley, D. C., & Guthrie, N. (2021) · Neurology and Therapy · doi:10.1007/s40120-021-00284-x · Cited by 25 · see citing works
Llorens, M., Barba, M., Torralbas, J., Nadal, R., Armario, A., Gagliano, H., Betriu, M., Urraca, L., Pujol, S., Montalvo, I., et al. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.02.041 · Cited by 17 · see citing works
Bäcklund, N., Lundstedt, S., Tornevi, A., Wihlbäck, A.-C., Olsson, T., Dahlqvist, P., & Brattsand, G. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad763 · Cited by 13 · see citing works
“However, during passage through the salivary gland, most cortisol is inactivated into cortisone by 11 β -hydroxysteroid dehydrogenase type 2 (11 β -HSD2) (21, 26).”
Background
- Authors
- Blair, J., Adaway, J., Keevil, B., & Ross, R.
- Affiliations
- Alder Hey Children's Hospital (GB)
- Manchester University NHS Foundation Trust (GB)
- University of Sheffield (GB)
- Corresponding author
- Ross, Richard
- Venue
- Current Opinion in Endocrinology, Diabetes & Obesity
- Published
- 2017-06
- Volume
- 24
- Issue
- 3
- Pages
- 161-168
- ISSN
- 1752-296X (ISSN-L)
- 1752-2978
- OpenAlex
- W2609095319
- Cited by
- 138
- References
- 97
- Citations by year
- 2026: 13 · 2025: 17 · 2024: 25 · 2023: 17 · 2022: 17 · 2021: 22 · 2020: 13 · 2019: 10 · 2018: 3
- FWCI
- 1.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Endocrinology Diabetes and Obesity (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Keywords
- salivary cortisol, salivary cortisone, salivary biomarkers, adrenal function testing, cortisol excess, cortisol deficiency, hydrocortisone replacement, cortisol binding, adrenal reserve, saliva contamination
- MeSH terms
- Adrenal Insufficiency, Cortisone, Cushing Syndrome, Diagnostic Techniques, Endocrine, Humans, Hydrocortisone, Monitoring, Physiologic, Saliva, Sensitivity and Specificity, Biomarkers
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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