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Adrenal Stress Index
Complete HPA axis assessment with cortisol, DHEA, and insulin
$200–$3507–10 business days2 ordering options
What Gabriel reads for
4-point cortisol curve (morning, noon, afternoon, evening)
DHEA (anabolic reserve hormone)
Cortisol-to-DHEA ratio (catabolic vs. anabolic balance)
Cost
$200–$350
Turnaround
7–10 business days
Ordering path
Diagnostechs
Results flow
Upload + interpret in Gabriel
What this test reveals
What this test reveals
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.
People usually reach for this kind of diagnostic when they want a clearer read on 4-point cortisol curve (morning, noon, afternoon, evening), dhea (anabolic reserve hormone), cortisol-to-dhea ratio (catabolic vs. anabolic balance), especially when symptoms or prior testing still leave blind spots.
Once results are back, you can upload them into Gabriel to connect the findings to symptoms, protocols, and next-step testing instead of leaving them as a static report.
Commonly relevant for: Adrenal Fatigue, Chronic Fatigue Fibromyalgia, Anxiety Depression.
Gabriel difference
Why this becomes more useful inside Gabriel
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.
Gabriel interprets results through a functional, root-cause lens: optimal ranges, pattern recognition across multiple diagnostics, and what the findings actually mean for action rather than just classification.
That means this test can feed directly into protocols, practitioner matching, food strategy, and follow-up testing instead of ending as a one-off PDF or lab portal result.
What to expect
What to expect from ordering to results
01
Order
Order directly through Diagnostechs or ask Gabriel whether there is a better path first.
02
Complete
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.
03
Interpret
Upload the results to Gabriel for pattern recognition, protocol suggestions, and next-step guidance.
Frequently asked questions
Questions people usually ask before ordering
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 belongs in your workup?
Tell Gabriel your symptoms, goals, and what you have already tried. You will get a more useful answer than a generic test catalog can give you.