MS-LS show to be highly sensitive in the dual identification of testosterone and cortisol in saliva. These hormones were found to be stable up to 28 days at room temperature. This disproves the argument that saliva, as a test medium, has a very short shelf life.
LC-MS/MS shown to be reliable in salivary cortisol evaluation. Obese individuals create special challenges with regards to coritsol levels, due to peripheral cortisol to cortisone conversion.
This study points out that saliva should not be used solely in the diagnosis of Cushing's syndrome due to unreferenced norms. That however, doesn't nullify salivary cortisol. It requires a look at the references. for those that are obese and being evaluated for cushing's. There is no perfect test. T
This study is a little misleading in its conclusion. Salivary testing is valid, but the reference ranges in the obese with suspected cushing's syndrome needs further evaluation: according to these authors.
LC-MS/MS shown to be useful in evaluation in people with suspected elevated cortisol levels. In this study, they found the dexamethasone suppression test was required. The point however is that cortisol is a valid medium and this was with LC-MS/MS instead of the more commonly used ELIZA technique.