A cortisol test is done to measure the level of the hormone cortisol in a 24-hour sample of urine. The cortisol level may show problems with the adrenal glands or the pituitary gland. Cortisol is made by the adrenal glands. Cortisol levels get higher when the pituitary gland releases another hormone called adrenocorticotropic hormone (ACTH).

Cortisol has many functions. It helps the body break down food for energy (metabolism), and it helps the body manage stress. Cortisol levels can be affected by many conditions, such as physical or emotional stress, strenuous activity, infection, or injury.

Why It Is Done

A cortisol test is done to find problems of the pituitary gland or adrenal glands, such as making too much hormone which happens in Cushing's syndrome.

How To Prepare

You may be asked to avoid strenuous physical activity the day before a cortisol test. You may also be asked to lie down and relax for 30 minutes before the blood test is done.

Be sure to drink enough fluids during the 24-hour urine test to prevent dehydration.

Many medicines may change the results of this test. Be sure to tell your doctor about all the nonprescription and prescription medicines you take.

Talk to your health professional about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?).

How It Is Done

24 hour urine

• You start collecting your urine in the morning. When you first get up, empty your bladder but do not save this urine. Write down the time that you urinated to mark the beginning of your 24-hour collection period.
• For the next 24 hours, collect all your urine. Your doctor or lab will usually provide you with a large container that holds about 1gal. The container has a small amount of preservative in it. Urinate into a small, clean container and then pour the urine into the large container. Do not touch the inside of the container with your fingers.
• Keep the large container in the refrigerator for the 24 hours.
• Empty your bladder for the final time at or just before the end of the 24-hour period. Add this urine to the large container and record the time.
• Do not get toilet paper, pubic hair, stool (feces), menstrual blood, or other foreign matter in the urine sample.

How It Feels

There is no pain while collecting a 24-hour urine sample.

Risks

There is no chance for problems while collecting a 24-hour urine sample.

Results

A cortisol test is done to measure the level of the hormone cortisol in a 24-hour sample of urine.

Normal

Normal results may vary from lab to lab.

Cortisol level in a 24-hour urine sample

Adult	Less than 100 micrograms (µg) or less than 276 nanomoles (nmol)
Teen	5–55 µg or 14–152 nmol
Child	2–27 µg or 5–75 nmol

High values

• One cause of Cushing's syndrome is Cushing's disease, a condition caused by a noncancerous tumor of the pituitary gland (adenoma). An adenoma causes the pituitary gland to make too much of the hormone adrenocorticotropic hormone (ACTH), which in turn causes the adrenal glands to make too much cortisol.
• ACTH can be made by other conditions, such as cancer of the lung. This high ACTH level causes the adrenal glands to make more cortisol.
• The adrenal gland can develop tumors (benign or cancerous) that make cortisol and cause Cushing's syndrome.
• A high blood cortisol level can be caused by severe liver or kidney disease, depression, hyperthyroidism, or obesity.
• Conditions such as recent surgery, illness, injury, or whole body infection (sepsis) can cause high cortisol levels.