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.
Cortisol can also be measured using a blood or saliva test.
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.
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.
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:
The test involves only normal urination. There is no discomfort.
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:
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.
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.
A higher than normal level may indicate:
A lower than normal level may indicate:
There are no risks with this test.
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.
BACK TO TOPReview 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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06/01/2025
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