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Cortisol in urine test

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Cortisol is a steroid hormone produced primarily by the adrenal gland. Additionally, it could be secreted by the pituitary gland also under the effect of another hormone known as adrenocorticotropic hormone (ACTH). The latter condition leads to rise in cortisol levels.

In order to measure the level of hormone cortisol, a cortisol test is suggested. The test involves measuring the quantity of cortisol in urine during 24 hour cycle. Let us learn more about the test and answer questions related to cortisol in urine test.

Why is cortisone-urine test done?

Very high or low levels of cortisol in urine can account to a wide range of health abnormalities, which could be

  • Malfunctioning of pituitary (hypopituitarism) and adrenal glands
  • Cushing syndrome and Addison's disease (low cortisol)
  • Irregular periods
  • Congenital adrenal hyperplasia
  • Severe depression
  • Growth of acne
  • Tumor in the adrenal gland
  • Growth of excessive facial hair in female
  • High BP and blood glucose
  • Retarded growth in children

Severe pain in lower back, abdomen and legs, weight loss and weakness are also symptoms of underlying cortisol deficiency.

How is the test done?

The test involves collecting 24 hour urine. The same procedure applies to infants and older children.

Your doctor will give you a large container to hold the urine. Get up in the morning and urinate. Do not collect the first urine. Start storing your urine thereafter, till 24 hours. Keep the urine in a cool, dry place or in the refrigerator.

Make sure your urine is free from hair, traces of semen, blood or any other particles.

Cap the bottle, label it and hand it over to the lab for quantitative analysis of cortisone.

For infants

You will be given a urine collection bag which your baby needs to wear throughout 24 hours. Secure it properly with the adhesive paper, so that the urine flows directly into it. Monitor the position of bag closely so that he/she doesn’t throw it away. You need to change the bag every time after urination. Displace the urine in the container and attach the bag again.

Label the container and deliver it to the laboratory.

How to prepare for the test?

During your appointment, you must tell your doctor the medicines you take

Your food will be normal, but drink enough water throughout the day

Avoid physical activities while collecting urine sample.

You need to clean your baby’s private parts before attaching the bag.

How does the test feel like?

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The test is absolutely painless as you don’t need to do anything other than collecting the urine. Infants might feel a bit uncomfortable with the bag attached to them.

What to expect from the test?

The normal range of cortisol in 24 hours should be between 10 - 100 micrograms for adults, 5–55 mcg for teenagers and 2–27 mcg for children. However, the reference range for cortisol levels can vary from one laboratory to the other.

Any value below or above normal can indicate a complication in hormonal glands, bones, circulatory, nervous and immune system and metabolism of fats, carbohydrate or protein.

What interferes with the test results?

  • Medications- glucocorticoids, antidepressants, diuretics, etc.
  • Emotional or physical stress
  • Failing to collect urine sample properly within 24 hours

Are there any disadvantages of the test?

The test is quite safe and easy to do. The only disadvantage could be a human error in collecting the urine same. To get better accuracy, the test may be repeated or a cortisol-blood test might be chosen.

Furthers tests (e.g. adrenocorticotropic hormone (ACTH) and dexamethasone suppression tests) may be needed to confirm the presence of abnormality.

You should visit the doctor for proper interpretation of the results. Based on the cortisol in urine test results, the doctor will suggest treatments. Follow the doctor’s advice and overcome any problems with the pituitary gland or adrenal glands.

Written by: Saptakee sengupta
Date last updated: April 28, 2015