Diagnostic testing
Adrenal Stress Index (ASI)
When stress, energy, sleep, and weight do not add up, your adrenals may be asking for support.
The Adrenal Stress Index is a saliva-based hormone assessment that evaluates how your body responds to stress across a full day. Unlike a single blood draw that captures one moment, it measures your diurnal cortisol rhythm, showing how your stress response behaves from morning to night.
This matters because cortisol does far more than manage stress. It plays a direct role in energy production, blood sugar regulation, inflammation, sleep quality, immune health, mood, and fat storage. When cortisol patterns are disrupted, the body often adapts in ways that feel confusing, especially when you are doing everything right.
PhotographyAdrenal Stress Index collection kit, laid out on a clean surface.
What it measures
Inside the ASI
Cortisol, four points across the day
Assesses your natural rhythm, including the morning rise and evening decline.
DHEA-S
A foundational adrenal hormone involved in resilience, recovery, immune function, and healthy aging.
Cortisol to DHEA-S ratio
Helps show whether your stress response is adaptive or leaning toward depletion.
This combination shows whether cortisol is high or low and whether the rhythm is arriving at the right times.
Who this test is for
It may be a fit if you are experiencing
- Persistent fatigue, or wired-but-tired energy patterns
- Trouble sleeping, or waking unrefreshed
- Weight loss resistance, especially around the midsection
- Cravings, blood sugar crashes, or energy dips
- Anxiety, low mood, or reduced stress tolerance
- Difficulty recovering from exercise or illness
- Perimenopause or menopause symptoms that do not respond to lifestyle changes
This test is frequently used when symptoms are present but standard lab work appears normal.
Why saliva
What saliva shows that a single blood draw cannot
Saliva testing measures free, bioavailable hormones, which is what your tissues are actually responding to. That matters particularly for cortisol, which follows a daily rhythm and is highly sensitive to timing, stress, and lifestyle.
The lab we use has been trusted for decades by our pharmacist and master of holistic medicine, particularly for complex hormone cases. The methodology is well established, reproducible, and clinically actionable.
How results are used at LivBTR
Your results are never read in isolation
They are interpreted alongside your intake, symptoms, lifestyle, nutrition, movement, and any other findings. From there we build a personalized support plan.
- Nervous system regulation strategies
- Nutrition and blood sugar guidance
- Lifestyle and sleep rhythm adjustments
- Supplement protocols when appropriate
- Exercise and recovery recommendations aligned with your stress physiology
The aim is to reduce the demand on your system so it can recover.
Adrenal Stress Index questions
Is the ASI a medical diagnosis?
No. It is a functional hormone assessment. It does not diagnose disease, but it gives insight into patterns of stress response and adrenal function that may be contributing to how you feel.
How is the test collected?
You collect saliva samples at home at specific times through the day using a provided kit. No blood draw is required.
Why are multiple samples needed?
Cortisol follows a daily rhythm. Multiple samples show whether that rhythm is arriving at the right times, which a single reading cannot.
Can this explain weight loss resistance?
It can provide important context. Disrupted cortisol patterns influence insulin sensitivity, fat storage, appetite regulation, and metabolic adaptation, particularly during chronic stress or hormonal transitions.
Is it useful during perimenopause or menopause?
Yes. Hormonal transitions significantly affect adrenal demand and cortisol regulation, and this helps show how your stress response is adapting.
Do I need to stop supplements before testing?
Some supplements and medications can affect results. You will get clear instructions before you collect so results stay accurate.
If you suspect stress, fatigue, or hormone imbalance is playing a role in how you feel, the Adrenal Stress Index can provide clarity and direction.
Understanding the pattern comes before deciding what to change.