Cortisol 24 Hour Urine

What is Cortisol and the Cortisol 24-hour urine test?

Cortisol is a glucocorticoid that is formed by the cortex of the adrenal glands. It is the primary hormone that is linked to stress; and, is part of the fight-or-flight hormone. When you are doing something that your body is perceiving as a threat, your body releases into your brain a hormone called the adrenocorticotropic (ACTH). This hormone triggers your adrenal glands and leads to the formation and release of both cortisol and adrenaline. Cortisol release is a very normal reaction of the body; and, can be triggered by something as little as hearing a dog barking at you or a fire alarm in your apartment. This hormone production is how your body reacts to such a stimulus, which will give it more energy and strength.

When your body is experiencing a fight or flight response, this means that adrenal glands are releasing their cortisol. As a result, unnecessary and detrimental functions of the body, that are not need it for this response, get suppressed. Responses normally involve having a rapid heart rate, dry mouth, upset stomach and diarrhea, and panic. In addition, during a fight or flight response, cortisol can also suppress any processes related to growth, your digestive system, your reproductive system, and make alterations to your immune system functions.

The cortisol 24-hour urine test measures the amount of cortisol in your urine. While the levels of this hormone keep changing throughout the day: they are high in the morning and low in the evening, a 24-hour urine test is a comprehensive way to measure the total amount of cortisol that is secreted within 24 hours.

Why is the Cortisol 24-hour urine test ordered?

The cortisol urine test helps diagnosing Cushing syndrome as well as primary and secondary adrenal insufficiency. It is also used to detect any conditions that may be altering the proper functioning of the pituitary and adrenal glands. The cortisol urine test is performed if you are having symptoms related to rise or fall in the levels of your cortisol.

High cortisol levels are accompanied by symptoms such as increased urination, intensive thirst, noticing fatty tissue deposits and the abdominal section of your body and upper back, gaining weight for no reason, being tired all the time, having a skin that bruises very easily, as well as having pink and purple stretch marks on your skin. Having irregular periods and a lot of facial hair are also experienced in women with high cortisol levels.

Low cortisol levels show symptoms that tend to emerge gradually. The first symptoms are normally experienced tuning a time of high stress. With time, the symptoms start accentuating in intensity. These include weight loss, fatigue, dizziness, abdominal pain and diarrhea, constipation, muscle weakness and even painting. If the levels of cortisol drop dramatically, they might lead to what is called an acute adrenal crisis. This latter is normally accompanied by the darkening of the skin, extreme weakness, vomiting, diarrhea, fainting, fever, chills loss of appetite and severe pain in the lower back, abdomen and legs that appears sharp and suddenly. In that case, you need to dial 911 and go to the emergency room for immediate treatment.

What affects the results of the cortisol 24-hour urine test?

Food does not have any effect on the levels of cortisol in your urine. However, you need to share with your doctor if you are taking medications whether prescription drugs or over-the-counter medicines. These may have an effect on the accuracy of the results. Medications that may sabotage your results include diuretics, estrogens, glucocorticoids, ketoconazole, lithium, or tricyclic antidepressants. You will be instructed to stop taking such medications before the test.

What your Cortisol 24-hour urine results mean?

The cortisol 24-hour urine test involves the collection of all passed urine within a period of 24 hours. When you take the sterilized container, you will need to discard the first urine sample after waking up; then, you start collecting all the passed urine. During the second day, and within the 24-hour framework, you will need to urinate straight into the container after waking up. This will constitute the last sample.

The 24-hour cortisol urine test results will be in the normal ranges if the cortisol level is between 3.5 and 45 mg for the 24 hours sample. These results might vary slightly. If the levels are below 3.5 mg; then, your cortisol levels are low. This indicates that the adrenal glands are not making enough cortisol; and, it may indicate that you have a condition referred to as Addison disease . Of the cortisol levels are above 45 mg; then, the levels are high and you may have Cushing syndrome that can be caused by many factors. These include having a tumor at the adrenal gland, having drank alcohol or caffeine, being under a lot of stress, or being depressed.

Where can I get a Cortisol 24-hour urine test near me?

A 24 hour urine collection container must be picked up from the lab before the collection process begins. On the day of the test, do not collect your first morning void. Collect all urine including the final specimen voided at the end of the 24-hour collection period.

Please use our Lab Locator to find find a convenient testing location.

Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Mar 12, 2020