What does the Cortisol:DHEA Ratio, Salivary (Derived) test measure?

Why is Cortisol:DHEA Ratio, Salivary (Derived) measured?

The cortisol:DHEA ratio is the primary derived clinical parameter in Genova Diagnostics' adrenocortex interpretive report, synthesising the individual cortisol and DHEA values into a single index of the anabolic-catabolic hormonal balance. Elevated ratio (high cortisol relative to DHEA) — the dominant pattern in chronic stress, advancing age, and HPA hyperactivation — is associated with immune suppression, visceral adiposity, muscle catabolism, cognitive impairment, and reduced resilience to further stressors. It is the primary functional medicine target for adrenal support interventions: adaptogenic botanicals (ashwagandha, rhodiola), DHEA supplementation, sleep optimisation, and stress reduction. A declining ratio over serial assessments — cortisol falling and DHEA rising — is the objective treatment response target in adrenal restoration protocols.

Reference ranges

Standard reference

# REVIEWER FLAG: Confirm whether Genova Diagnostics reports a cortisol:DHEA ratio as a discrete derived value on the Endo+: Adrenocortex panel and what their reference range or interpretive zone thresholds are. The ratio may be calculated from the morning time point values or from an integrated daily AUC calculation — confirm which approach Genova uses.

Functional medicine optimal

# REVIEWER FLAG: Confirm Genova Diagnostics' cortisol:DHEA ratio interpretive thresholds — optimal, borderline, and elevated zones. These are proprietary to Genova's interpretive framework and must be sourced directly from Genova's clinical documentation.

Units

Ratio (unitless)

Reference ranges vary by laboratory and assay platform. Interpret in context of the issuing laboratory's stated range.