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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.

Cortisol can also be measured using a blood or saliva test.

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Female urinary tract
Male urinary tract

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How 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.

Because cortisol level rises and falls throughout the day, the test may need to be done three or more separate times 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:

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:

Different diseases, such as Cushing syndrome and Addison disease, can lead to either too much or too little production of cortisol. Measuring urine cortisol level can help diagnose these conditions.

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:

A lower than normal level may indicate:

Risks

There are no risks with this test.

Related Information

ACTH blood test
Cushing syndrome
Addison disease
Hypopituitarism
Congenital adrenal hyperplasia
Cushing syndrome due to adrenal tumor

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.

Stewart PM, Newell-Price JDC. The adrenal cortex. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016:chap 15.

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Review Date: 5/7/2017  

Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, 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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