Cortisol Diurnal Profile (Biovis)
Salivary cortisol curve tracking daily stress response and adrenal rhythm.
Table of contents
Basic data
The Cortisol Diurnal Profile (Biovis) is a salivary test that evaluates the natural fluctuations of cortisol across the day — typically measured at morning, midday, and evening timepoints. This curve reveals how well the body’s stress system (HPA axis) is functioning, and whether chronic stress, burnout risk, or circadian disruption may be present.
Cortisol should normally peak in the morning and gradually taper off throughout the day. Deviations from this pattern — such as low morning levels or elevated evening cortisol — can indicate impaired stress resilience, fatigue, or dysregulation of the circadian rhythm.
Category: Hormonal panel
Level: Intermediate
Usefulness: Medium
Level
Intermediate
Usefulness
Medium
Identifies burnout risk and chronic stress
Flattened or inverted cortisol curves are strongly associated with exhaustion syndromes. Early detection allows for targeted interventions before full burnout manifests.
Maps circadian disruption
Misaligned cortisol peaks (e.g. high evening levels) may signal disrupted sleep-wake cycles, jet lag, night shift effects, or HPA axis dysregulation.
Supports individualized stress protocols
Results can guide recovery planning (e.g. adaptogens, cold exposure timing, light therapy) and align with personalized chronobiology interventions.
How it works
Saliva collection at key timepoints
Typically involves morning (e.g. 8:00), midday (12:00), and evening (20:00) samples to map the full cortisol curve.
ELISA-based analysis
Samples are analyzed using immunoassays like ELISA to determine cortisol concentrations in ng/ml, benchmarked against population reference ranges.
Measures
Morning cortisol (e.g. 8 a.m.)
Should be highest — reflects overnight adrenal activity and readiness for daily stress.
Midday cortisol (e.g. 12 p.m.)
Indicates slope of decline. Elevated values here may suggest prolonged activation.
Evening cortisol (e.g. 8 p.m.)
Should be lowest. Elevated levels may impair sleep and indicate poor HPA downregulation.
Reliability
High validity for free cortisol
Reflects unbound cortisol — the biologically active portion — more relevant than total serum cortisol.
Timing sensitivity
Deviation from protocol (e.g. delayed sampling, food/drink contamination) can distort results.
Limitations
Requires strict protocol adherence
Eating, drinking, or brushing teeth before sampling can skew results.
Isolated results may be misleading
One-day sampling doesn't capture variability across stress cycles or lifestyle shifts.
Frequency
Suggested cadence
Once per year for individuals managing chronic stress or fatigue; more often if symptoms are acute or during protocol-driven recovery.
Cost
Typical costs
Approx. 400–600 PLN in Poland; includes 3–4 salivary timepoints and lab analysis.
Availability
Where available
Offered by advanced diagnostic labs like Biovis, available via some functional medicine clinics or direct-to-consumer lab providers.
Preparation
How to prepare
Avoid food, drink (except water), and oral hygiene 30 minutes before sampling. Follow precise timing instructions to ensure valid curve interpretation.
Interpretation
Flattened or inverted curve
May indicate chronic stress, burnout, or adrenal fatigue. Requires lifestyle and recovery focus.
Elevated evening cortisol
Common in insomnia, overtraining, or disrupted circadian rhythm. Suggests poor HPA axis shutdown.
Alternatives
Serum cortisol (morning draw)
Measures total cortisol in blood, typically at 8 a.m. Less useful for curve or dynamic rhythm analysis.
24-hour urinary free cortisol
Useful for identifying cortisol excess (e.g. Cushing’s), but doesn’t capture circadian rhythm.
FAQ
Can this test diagnose adrenal fatigue?
Not formally — “adrenal fatigue” is not a recognized medical diagnosis. However, abnormal curves may reflect HPA axis dysregulation and energy/stress imbalances.
Should I stop supplements or medications before testing?
Only under guidance of your physician. Some substances (e.g. corticosteroids) may affect results.