Adrenal Stress Index Test (ASI)

Adrenal Stress Index Test (ASI)

The Adrenal Stress Index Test (ASI Test) is an easy-to-use home salivary test which evaluates adrenal function and fluctuations in the circadian rhythm. It is an easy and comprehensive tool to Assess the HPA (Hypothalamus Pituitary Axis which is associated with stress response and resiliency.

The adrenal stress test checks levels of cortisol and DHEA, the two steroid hormones that assist the body in managing stress. These hormones also influence metabolism, thyroid function and female and male hormones.

Imbalances in these hormones can result in a wide range of symptoms from low energy and exhaustion to loss of drive and motivation, depression and hormonal problems.

Two add-ons are also available with this test;
CAR – Cortisol Awakening Response

What is adrenal stress and adrenal fatigue?

The adrenal glands sit on top of the kidneys and help us deal with life’s stresses by releasing the hormones cortisol and DHEA. These hormones are not released constantly throughout the day but are instead secreted in a cycle called the circadian rhythm (sleep/wake cycle), with the highest levels secreted in the morning and the lowest at night.

Sometimes in periods of longterm or severe mental or physical stress these glands can go into overdrive. If this occurs for too long or too often, the adrenals later become exhausted. When this happens, the hormonal levels of cortisol and DHEA in the bloodstream become imbalanced.

Having balanced stress hormones is important because they

  • Maintain emotional and physical energy
  • Strengthen the immune system against colds, coughs, flu and possibly more serious illness
  • Improve metabolism, helping reduce fat storage and controlling appetite
  • Slow down the ageing process
  • Decrease PMS and menstrual difficulties
  • Aid dietary protein synthesis (helping mood)
  • Prevent osteoporosis
  • Maintain healthy blood pressure levels
  • Lower LDL (“bad”) cholesterol levels


Factors that may contribute to adrenal stress and adrenal fatigue include negative dietary and lifestyle habits (including over-consumption of stimulants such as sugar and caffeine), excessive exercise, injury, bereavement, marriage, divorce, debt, attitudes such as perfectionism and obsessive – compulsive behaviours, isolation and loneliness – and of course, every day life can be a source of stress.

At Smart Nutrition we pride ourselves in offering the best cost possible for the adrenal stress index test.

As we are all individuals, we all respond to stress differently. Symptoms may include:

  • Low energy / fatigue
  • Insomnia
  • Depression
  • Loss of libido
  • Loss of motivation and drive
  • Irregular menstrual cycle
  • Infertility
  • PMS
  • Menopause / hot flushes
  • Cravings
  • Weight gain
  • Weight loss
  • Mood swings
  • Anxiety
  • Panic attacks
  • Nervousness and / or irritability
  • Digestive disturbances (diarrhoea, constipation, bloating, stomach aches/pains)
  • Abdominal obesity
  • Inexplicable hunger
  • Increased number of minor infections and viruses (eg thrush, cystitis, colds, flu)
  • Poor concentration and memory
  • Headaches
  • Increased sensitivities to food
  • Alcohol intolerance
  • Skin problems (eczema, psoriasis)
  • Loss of skin elasticity

The adrenal stress index test measure the following adrenal hormones;

Four cortisol samples measured throughout the day give insight into the natural circadian diurnal cortisol rhythm, and help clinicians address specific daily stressors.

DHEA is measured once in the 7:00 AM – 9:00 AM sample.

Ratio of DHEA to cortisol is calculated to provide insight into anabolic/catabolic balance.

Add ons that are available with the adrenal stress test. 

Cortisol Awakening Response (CAR) measures the immediate rise in cortisol that happens upon awakening and is distinct from the diurnal rhythm. CAR reflects a person’s ability to cope with anticipated challenges and their perception of control around chronic stress. This provides insight into the resiliency of the stress response and the HPA axis.

Secretory IgA –  An important marker for the immune function associated with the mucous membranes in the body and helps to show how stress may be impacting on immune function.

The adrenal stress index test requires saliva samples collected:

Immediately upon waking (within 5 minutes)
30 minutes after waking
7:00 am and 9:00 am
11:00 am and 1:00 pm
3:00 am and 5:00 pm
10:00 pm and 12:00 am

On the day of the adrenal stress index test: avoid caffeine, alcohol, and nicotine.

Do not eat, brush or floss teeth, use mouthwash, or chew gum 1 hour before you take each sample.

No steroid medication including hormones, inhalers and creams are to be taken or used for 48 hours before the test unless you want to monitor the medication, as long term use of steroid medication or creams may influence the results.

Please check with your health provider before stopping any medication.


The adrenal stress index test is suitable for adults;  18 years +


The saliva samples for the the adrenal stress index test must be frozen a minimum of 2 hours prior to shipping. Keep sample frozen until ready to ship.

Please return your adrenal stress index test samples via a next day service Monday – Thursday only. A courier option is sent with your test kit. You pay the laboratory directly for this test and also the return courier if you use the service. You can also make your own arrangements for returning your samples via a next day service.

Your adrenal stress index test results will take 10 working days.


Your adrenal stress index test results will be emailed to you.

Adrenal Stress Index Test (ASI)

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Please do not return samples to the laboratories that may arrive after Wednesday 27th March and up to and including Monday 2nd April.

The laboratories are closed from the 28th March – 2nd April for the Easter Holiday.