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Recommended TestingHormonesUpload Compatible
Adrenal Stress Index
Complete HPA axis assessment with cortisol, DHEA, and insulin
$200–$350
7–10 business days
The Adrenal Stress Index (ASI) combines 4-point cortisol rhythm testing with DHEA, insulin, and secretory IgA to provide a complete picture of your hypothalamic-pituitary-adrenal (HPA) axis function, metabolic health, and immune resilience.
This is the gold standard for assessing adrenal function and stress resilience. Beyond just cortisol, the ASI reveals how chronic stress is affecting your blood sugar regulation, immune function, and anabolic-to-catabolic hormone balance.
What It Measures
4-point cortisol curve (morning, noon, afternoon, evening)
DHEA (anabolic reserve hormone)
Cortisol-to-DHEA ratio (catabolic vs. anabolic balance)
Insulin (fasting and post-challenge)
Secretory IgA (mucosal immune function)
Total cortisol burden (sum of 4 points)
Why Gabriel Recommends It
The ASI is the most comprehensive adrenal assessment available. It reveals not just your cortisol rhythm but how stress is affecting your metabolic health (insulin), immune resilience (sIgA), and hormonal balance (DHEA). A patient with low DHEA and high insulin alongside disrupted cortisol is in a completely different physiological state than someone with normal DHEA and insulin — requiring very different interventions. Gabriel uses ASI data to design personalized adrenal restoration protocols addressing HPA axis dysfunction, blood sugar dysregulation, and immune support simultaneously.
What to Expect
Collect saliva samples at home at four times throughout one day, plus a fasting insulin challenge (optional with some panels). Simple collection process — spit into tubes. Mail in the prepaid envelope. Results arrive in 7–10 business days with comprehensive HPA axis analysis. Upload to Gabriel for complete adrenal restoration protocols.
How Gabriel Interprets This
Conventional practitioners read these results through a disease-focused lens — looking for what's broken. Gabriel reads them through a holistic lens — looking for what's out of balance and how to restore it. We see optimal ranges, not just "normal" ranges. We connect findings across all your diagnostics to reveal patterns that siloed specialists miss.
Related Conditions
$200–$3507–10 business days
Frequently Asked Questions
It's a 4-point saliva test that measures cortisol and DHEA at four times throughout the day: morning, noon, afternoon, and bedtime. This reveals your diurnal cortisol curve, showing whether your adrenals are producing too much, too little, or the right amount of stress hormone at each time point.
Healthy cortisol peaks in the morning and gradually declines through the day. A flattened curve (low morning, still elevated at night) suggests chronic stress or adrenal dysfunction. Reversed patterns (low morning, high evening) often correlate with insomnia, anxiety, and burnout.
The term 'adrenal fatigue' isn't recognized in conventional medicine. However, HPA axis dysregulation is well-documented. The adrenal stress index measures this dysregulation objectively. Whether you call it adrenal fatigue or HPA axis dysfunction, the cortisol pattern data is clinically useful.
You spit into collection tubes at four specific times throughout one day. Samples are mailed to the lab. No blood draw needed. Avoid eating, drinking, or brushing teeth 30-60 minutes before each collection.
Typically $150-250. Labs like ZRT, Diagnos-Techs, and Precision Analytical offer it. The DUTCH test includes cortisol metabolites as part of its broader panel, which some practitioners prefer for more complete data.
Not sure which test is right?
Tell Gabriel your symptoms and health goals. Get personalized diagnostic recommendations backed by evidence, not guesswork.