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Salivary cortisol is a good stress index, with increased levels of cortisol correlating positively with increased levels of stress. Cortisol levels rise slowly over time and take a while to return to base level, indicating that cortisol is more associated with chronic stress levels. [ 12 ]
Exercise is a great way to manage stress and lower your cortisol levels, according to Baptist Health. You should aim for at least 150 minutes of low- to moderate-intensity exercise per week.
The average level of salivary cortisol upon waking is roughly 15 nmol/L; 30 minutes later it may be 23 nmol/L, though there are wide variations. [3] The cortisol awakening response reaches a maximum approximately 30 minutes after awakening though it may still be heightened by 34% an hour after waking. [3]
Cortisol follows a circadian rhythm, and to accurately measure cortisol levels is best to test four times per day through saliva. An individual may have normal total cortisol but have a lower than normal level during a certain period of the day and a higher than normal level during a different period.
To confirm inappropriately low cortisol secretion, testing can include baseline morning cortisol level in the blood or morning cortisol level in the saliva. [2] Cortisol levels typically peak in the morning; thus, low values indicate true adrenal insufficiency. [2] Urinary free cortisol can also be measured, but are not necessary for diagnosis. [2]
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