Cortisol

The measurement of the level of hormone cortisol in the blood is performed in the cortisol test. Cortisol hormone indicates the problems related to adrenal or pituitary gland. Adrenal gland produces hormone cortisol. There is increase in the levels of the hormone cortisol when the hormone adrenocorticotropic (ACTH) is released by pituitary glands. Cortisol functions in various ways. The breaking down of the food in energy (metabolism) and managing the body stress are the functions of cortisol. Physical or emotional stress, injury, infection or strenuous activity may affect the levels of cortisol in the body. In the early morning hours and in midmorning, (around 7 a.m.) level of cortisol rises. In the evening and in early sleep phase these levels drop down. This pattern may reverse in case you sleep in day and up in the night period. The test requires two blood samples one in the morning and other in the afternoon. This test can be performed in combination with 24 hour urine test.

Need

To diagnose the following conditions, cortisol test is useful.

• Problems related to pituitary and adrenal gland like producing to much or too little hormones.
• Cushing's syndrome: 24 hour urine test is done in combination with this test

Procedure

Blood sample collecting process is similar to other blood tests. 24-hour urine sample collection process includes the urine sample collection except the first urine after waking up. You have to record the time of starting the urine sample collection and you have to preserve that urine in a clean flask. Take precaution not to mix stool or toilet paper in the urine sample.

Result

Normal results of the cortisol test may vary lab to lab.

• Cortisol blood (morning): 5-25 micrograms per deciliter(µg/dL)
• Blood (afternoon): 3-16µg/dL
• Urine: Less than 10 µg per 24-hour urine sample

A level of cortisol in the blood is the indication of the Cushing's syndrome. This disorder is caused by overactive adrenal glands, tumor to a pituitary or adrenal gland, some cancer types or long term use of corticosteroids. If there is high level of cortisol in the urine then it strongly indicates Cushing's syndrome. If there is noncancerous tumor of the pituitary gland (adenoma), the adrenocorticotropic hormone (ACTH) is produced at large extent. It will cause more production of cortisol hormone by adrenal gland. Severe liver or kidney disease, depression, or obesity is indicated by the high cortisol levels in the blood. Hyperthyroidism is also responsible for elevating the high levels of cortisol in the blood and urine. Addison's disease is indicated by the low levels of cortisol in the blood. This condition is caused by the injury or damage to adrenal or pituitary glands. Damage to pituitary gland results in the low levels of ACTH and it leads to low cortisol levels. Internal bleeding due to shock also lowers the level of cortisol.

Consideration

There are not much considerable risks in the process of taking blood sample except slight bruising, or swelling or infection in rare cases. No risk involved in the process of collecting urine sample.