Cortisol urine test
24-hour urinary free cortisol (UFC)The cortisol urine test measures the level of cortisol in the urine. Cortisol is a glucocorticoid (steroid) hormone produced by the adrenal gland.
Adrenal gland
The adrenal glands are two small triangle-shaped glands. One gland is located on top of each kidney.
Cortisol can also be measured using a blood or saliva test.
Blood
The cortisol blood test measures the level of cortisol in the blood. Cortisol is a steroid (glucocorticoid or corticosteroid) hormone produced by th...
Read Article Now Book Mark ArticleHow the Test is Performed
A 24-hour urine sample is needed. You will need to collect your urine over 24 hours in a container provided by the laboratory. Your health care provider will tell you how to do this. Follow instructions exactly.
Collect your urine over 24 hours
The urine 24-hour volume test measures the amount of urine produced in a day. The amounts of creatinine, protein, and other chemicals released into ...
Because cortisol production by the adrenal gland can vary, the test may need to be done three or more separate times over a few weeks to months to get a more accurate picture of average cortisol production.
How to Prepare for the Test
You may be asked not to do any vigorous exercising the day before the test.
You may also be told to temporarily stop taking medicines that can affect the test, including:
- Anti-seizure drugs
- Estrogen
- Human-made (synthetic) glucocorticoids, such as hydrocortisone, prednisone, and prednisolone
- Androgens
How the Test will Feel
The test involves only normal urination. There is no discomfort.
Why the Test is Performed
The test is done to check for increased or decreased cortisol production. Cortisol is a glucocorticoid (steroid) hormone released from the adrenal gland in response to adrenocorticotropic hormone (ACTH). This is a hormone released from the pituitary gland in the brain. Cortisol affects many different body systems. It plays a role in:
ACTH
The ACTH test measures the level of adrenocorticotropic hormone (ACTH) in the blood. ACTH is a hormone released from the pituitary gland in the brai...
- Bone growth
- Blood pressure control
- Immune system function
- Metabolism of fats, carbohydrates, and protein
- Nervous system function
- Stress response
Different diseases, such as Cushing syndrome and Addison disease, can lead to either too much or too little production of cortisol. Measuring urine cortisol levels can help diagnose these conditions.
Cushing syndrome
Cushing syndrome is a disorder that occurs when your body has a high level of the hormone cortisol.
Addison disease
Addison disease is a disorder that occurs when the adrenal glands do not produce enough hormones.
Normal Results
Normal range is 4 to 40 mcg/24 hours or 11 to 110 nmol/day.
Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or may test different specimens. Talk to your provider about the meaning of your specific test results.
What Abnormal Results Mean
A higher than normal level may indicate:
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Cushing disease, in which the pituitary gland makes too much ACTH because of excess growth of the pituitary gland or a tumor in the pituitary gland
Cushing disease
Cushing disease is a condition in which the pituitary gland releases too much adrenocorticotropic hormone (ACTH). The pituitary gland is an organ of...
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Ectopic Cushing syndrome, in which a tumor outside the pituitary or adrenal glands makes too much ACTH
Ectopic Cushing syndrome
Ectopic Cushing syndrome is a form of Cushing syndrome in which a tumor outside the pituitary gland produces a hormone called adrenocorticotropic hor...
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Tumor of the adrenal gland that is producing too much cortisol
Tumor of the adrenal gland
Cushing syndrome due to adrenal tumor is a form of Cushing syndrome. It occurs when a tumor of the adrenal gland releases excess amounts of the horm...
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- Rare genetic disorders
A lower than normal level may indicate:
- Addison disease in which the adrenal glands do not produce enough cortisol
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Hypopituitarism in which the pituitary gland does not signal the adrenal gland to produce enough cortisol
Hypopituitarism
Hypopituitarism is a condition in which the pituitary gland does not produce normal amounts of some or all of its hormones.
ImageRead Article Now Book Mark Article - Suppression of normal pituitary or adrenal function by glucocorticoid medicines including pills, skin creams, eyedrops, inhalers, joint injections, chemotherapy
Risks
There are no risks with this test.
References
Chernecky CC, Berger BJ. Cortisol - urine. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:389-390.
Newell-Price JDC, Auchus RJ. The adrenal cortex. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 15.
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Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
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Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
-
Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
-
Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
Review Date: 5/13/2021
Reviewed By: Brent Wisse, MD, Board Certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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