Saliva Cortisol Test and Decision Making Skills

The cortisol test is linked to your decision making abilityA saliva cortisol test can give us a better idea of our bodies respond to stress. A study of 40 healthy females has found that cortisol test levels in saliva are associated with a person’s ability to make good decisions in stressful situations.

Researchers at the University of Granada Department of Personality, Evaluation and Psychological Treatment intentionally exposed the 40 study participants to a stressful situation using a hi-tech virtual reality system. First, they were first asked to perform the “Iowa Gambling Task” (IGT) which is a psychological task thought to simulate real-life decision making and is the standard test for the assessment of decision-making skills under conditions of uncertainty. Next, they were presented a stressful situation in a virtual environment consisting on delivering a speech in front of a virtual audience.

The researchers evaluated the study participants’ response to stress by examining the levels of cortisol in the subjects’ saliva at the following four stages of the stressful public speaking situation: before the challenge, after the challenge, and 10 and 20 min after the task. The researchers tried to find out the responses of the hypothalamic pituitary adrenal axis (HPA) to psychosocial stress which is estimated by means of cortisol saliva measurements (the concentration of cortisol in saliva usually accurately reflects the level of cortisol in blood).

The study concluded that overall cortisol levels were significantly higher in the group with poor performance on the IGT and that good decision-making was associated with a lower HPA axis response to a psychosocial stressor. In other words, the study findings show that people who are not skilled in decision-making have lower baseline cortisol levels in saliva as compared to people skilled in decision making. Professors Isabel Peralta and Ana Santos who are some of the study authors, have suggested that the effects of psychological stress on the healthy people with lower cortisol levels might be milder.

Cortisol, an important hormone in the body, is secreted by the adrenal glands and is normally present in the body at higher levels in the morning, and at its lowest at night. Although stress is not the only reason that cortisol is secreted into the bloodstream, it has been termed “the stress hormone” because it is also secreted in higher levels during the body’s “fight or flight” response to stress.

Views on Cortisol and Cortisol Test

Cortisol is regarded by some health experts to be public health enemy number one because scientists have known for years that high levels of cortisol levels interfere with learning and memory, increase weight gain, blood pressure, cholesterol and heart disease, lower immune function and bone density. Chronic stress and elevated cortisol levels have also been known to be a potential trigger for mental illness, increasing the risk for depression, mental illness, and lowering life expectancy.

Adrenal Fatigue and Cortisol Tests

Cortisol is a key factor when it comes to Adrenal Fatigue Syndrome and the NEM stress Response Model. Adrenal glands produce cortisol and when you suffer from Adrenal Fatigue Syndrome your cortisol levels are low. This is why some of your symptoms of Adrenal Fatigue Syndrome include difficulty with your memory, lack of energy, difficulty maintaining your blood pressure, problems with blood glucose levels, metabolic dysfunction and a whole variety of other health problems. As mentioned, each cortisol test above studied what type of role stress and cortisol had on a woman’s decision making process. It is safe to say that those who suffer from Adrenal Fatigue Syndrome may have issues like memory loss and lack of motivation that can be complicated with Cortisol tests. If your cortisol levels were really high and you have AF it can really take a toll on your whole body.

Cortisol Testing and The NEM Stress Response Model

Your adrenal glands play a significant role in the NEM Stress Response Model, as well. If they are not functioning properly or efficiently it will affect vital systems and organs like your liver and metabolic pathways. There is controversy regarding cortisol tests because of the stress it can put on a person’s body, however, understanding cortisol production, triggering factors and cortisol levels will better help us to understand Adrenal Fatigue Syndrome, Fight or Flight responses and reduce stress levels that can put our bodies completely out of whack. So whether you agree or disagree with cortisol tests, I believe that it is not something that we should avoid. Understanding cortisol better will also give us more insight to the different stress responses we have and how we interact with stress overall. It can actually give us a better look into the NEM Stress Response Model too.


Source: The study titled “Can decision-making skills affect responses to psychological stress in healthy women?” was first published in the journal Psychoneuroendocrinology in December 2012.

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  • Franklin Armstrong says:

    How many saliva tests are needed to have an accurate assessment of a cortisol curve ?

    • Dr.Lam says:

      There is no set number. Usually if you do one every three months x3, that would give you a good assessment better than a snapshot. However, do note that saliva test is not very accurate and can be very confusing. we only use it when needed as you cannot depend on it fully

      Dr Lam

      • Jane says:

        Why is it not very accurate when it seems to be the preferred way to see if one has adrenal fatigue? Blood tests, as you say, will not help you figure out whether you are low or high, only a 24 hour saliva test can do that.