Saturday, February 24, 2024

24 Hour Cortisol Urine Test

What Is A Cortisol Urine Test

Cortisol testing: How to collect a 24-hour urine sample

A cortisol urine test is also called a urinary free cortisol test or UFC test. It measures the amount of cortisol in your urine.

Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. Cortisol is often released in response to physical or emotional stress.

Cortisol functions by:

  • playing a role in mood regulation
  • playing a role in the metabolism of carbohydrates, fats, and proteins

Cortisol levels naturally rise and fall throughout the day. Theyre usually highest in the morning and lowest around midnight, but there are also variations that depend on the person.

When this 24-hour cycle is disrupted, however, the body can produce too much or too little cortisol. A cortisol test can be performed to determine the underlying cause of abnormal cortisol levels.

There are different types of cortisol tests that may be performed, including blood, saliva, and urine tests. The urine test is done over a period of 24 hours.

The cortisol urine test tends to be more comprehensive than the other types of cortisol tests. It measures the total amount of cortisol excreted into the urine over a 24-hour period.

Blood tests or saliva tests, however, only measure cortisol levels at a particular time of day. Some people also find blood tests to be stressful, and since the body releases more cortisol during times of stress, the results may not be as precise.

How Do I Get Ready For This Test

Ask your provider whether you need to restrict food, medicine, or activity before this test. Plan to be home for the 24 hours you do the test so you can store the urine sample properly. Be sure your provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don’t need a prescription and any illegal drugs you may use.

Cortisol Urine Test Urinary Free 24

A Cortisol Urine Test, Urinary Free is used in the diagnosis of Cushing syndrome requires evidence of cortisol hypersecretion. While serum cortisol levels fluctuate unpredictably and are strongly dependent on concurrent cortisol-binding globulin levels, a 24-hour urine specimen integrates the cortisol production for an entire day and is not affected by CBG. Urinary cortisol reflects the portion of serum-free cortisol filtered by the kidney, and correlates well with cortisol secretion rate.

Also Known As: Urinary Free Cortisol


Liquid chromatography/tandem mass spectrometry


You must take your lab order to the lab to obtain a proper specimen container before collection. No fasting required. Urinate at 8am and discard the specimen. Then collect all urine in 24-hour period, ending with final collection at 8am the next morning. Refrigerate the collected urine between all voidings or keep it in a cool place. Screw the lid on securely. Transport the specimen promptly to the laboratory. Container must be labeled with full name, date and time collection started, and date and time collection finished.

Test Results:

3-4 days. May take longer based on weather, holiday or lab delays.

Also Known As: Urinary Free Cortisol


Liquid Chromatography/Tandem Mass Spectrometry


Test Results:

4-5 days. May take longer based on weather, holiday or lab delays.


Includes the Creatinine, 24-Hour Urine.

Recommended Reading: How To Get Cortisol Levels Checked

What Is A Urine Cortisol Test

Definition:A cortisol urine test measures the amount of cortisol in the urine.

Alternative Names: 24-hour urinary free cortisol

How the test is performed:A 24-hour urine sample is needed. The health care provider will instruct you, if necessary, to discontinue drugs that may interfere with the test.

On day 1, urinate into the toilet when you get up in the morning. Afterwards, collect all urine in a special container for the next 24 hours. Keep the container in a cool place during the test period.On day 2, urinate into the container when you get up in the morning.Cap the container. Label the container with your name, the date, the time of completion, and return it as instructed. Keep it in the refrigerator or a cool place until returned to the laboratory.FOR INFANTS

This procedure may take a couple of attempts — lively infants can displace the bag. The infant should be checked frequently and the bag changed after the infant has urinated into the bag. The urine is drained into the container for transport to the laboratory.

Deliver it to the laboratory or your health care provider as soon as possible upon completion.

How to prepare for the test:No special preparation is necessary for this test, but if the collection is being taken from an infant, a couple of extra collection bags may be necessary.

How the test will feel:The test involves only normal urination, and there is no discomfort.

Note: mcg/24 h = micrograms per 24 hours

  • ACTH-secreting tumor

How Is A Cortisol Urine Test Performed

Hormone Panels

A cortisol urine test is a safe, painless procedure that only involves ordinary urination.

Cortisol is measured in a urinary sample collected over a 24-hour period. Your doctor will give you special containers to use for collecting urine samples. Theyll also explain how to collect the urine properly.

On the first day of the urine collection:

  • Urinate into the toilet after waking up.
  • Flush this first sample away.
  • After that, collect all urine in special containers and store them in a cool place.
  • On the second day of the urine collection:

  • Urinate into the container right after waking up. This will be the last sample.
  • Return the containers to the appropriate person as soon as possible.
  • If your infant needs to have a cortisol urine test, youll collect their urine in a special bag.

    The collection procedure is as follows:

  • Thoroughly wash the area around your babys urethra with soap and warm water.
  • After your baby has urinated, pour the urine sample in the bag into a collection container. Keep this container in a cool place.
  • Return the container to the appropriate person as soon as possible.
  • Collect urine samples over a 24-hour period. It will be necessary to check the bag often throughout the collection period.

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    Cortisol Free 24 Hour Urine

    Suggests clinical disorders or settings where the test may be helpful

    Preferred screening test for Cushing syndrome

    Diagnosis of pseudo-hyperaldosteronism due to excessive licorice consumption

    Test may not be useful in the evaluation of adrenal insufficiency

    Special Instructions

    A short description of the method used to perform the test

    Liquid Chromatography-Tandem Mass Spectrometry

    NY State Available Indicates the status of NY State approval and if the test is orderable for NY State clients.

    Lists a shorter or abbreviated version of the Published Name for a test

    Lists additional common names for a test, as an aid in searching

    Cortisol Free Urine

    Describes the specimen type validated for testing


    Urine Volume

    Specimen Required Defines the optimal specimen required to perform the test and the preferred volume to complete testing

    Supplies: Urine Tubes, 10-mL

    Submission Container/Tube: Plastic, urine tube

    Specimen Volume: 5 mL

    1. Collect urine for 24 hours.

    2. Add 10 g of boric acid as preservative at start of collection.

    Urine Preservative Collection Options

    Note: The addition of preservative must occur prior to the start of the collection or application of temperature controls must occur during collection.


    Specimen Minimum Volume Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

    3 mL

    Specimen Type

    What Is This Test

    This test measures the level of the hormone cortisol in your urine. Hormones are chemical messengers that travel through your blood. Cortisol helps your body use proteins, fats and carbohydrates. It helps maintain blood pressure, control blood sugar levels, and regulate the immune system. It’s made and released by the adrenal glands, which sit atop the kidneys.

    Another hormone, adrenocorticotropic hormone , controls the release of cortisol. ACTH is made and released by the pituitary gland, which is at the base of your brain.

    Cortisol is released at different times during the day, so the best way to measure it is to collect all the urine you produce over a 24-hour period.

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    What Is Cortisol And The Cortisol 24

    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 . 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.

    What Should I Do After The Test

    24 hours Cortisol Urine Test

    When 24-hour urine collection is complete, close the container and seal the lid tightly. Return the sample in the urine container to the facility or healthcare worker as instructed. If you had the sample in an ice bath, return the sample within two hours after removing the container from the ice bath.

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    How Is The Test Done

    For a 24-hour urine collection, all of the urine that you pass over a 24-hour time period must be collected. If you are in the hospital, a healthcare worker will collect your urine. You will receive a special container to collect the sample in if you are doing the collection at home. The following are directions for collecting a 24-hour urine sample while at home: In the morning scheduled to begin the urine collection, urinate in the toilet and flush away the first urine you pass. Write down the date and time. That is the start date and time for the collection. Collect all urine you pass, day and night, for 24 hours. Use the container given to you to collect the urine. Avoid using other containers. The urine sample must include the last urine that you pass 24 hours after starting the collection. Do not allow toilet paper, stool, or anything else to be added to the urine sample. Write down the date and time that the last sample is collected. The urine sample may need to be kept cool during the 24-hour collection period. If so, keep the closed container in a pan on ice. Do not put ice in the container with the urine.

    What Does A 24 Hour Urine Cortisol Test Show

    A cortisol test measures the level of the hormone cortisol in a 24-hour sample of urine. The cortisol level may show problems with the adrenal glands or the pituitary gland. Cortisol is made by the adrenal glands. Cortisol levels get higher when the pituitary gland releases adrenocorticotropic hormone .

    What does a high 24 hour urine protein mean?

    Protein in the urine may signify kidney damage or disease. Protein levels may also rise temporarily due to factors such as infection, stress, or excess exercise. If the protein is caused by kidney damage, the test results will help to determine the extent of that damage.

    What are normal results for a 24 hour urine test?

    The normal range for 24-hour urine volume is 800 to 2,000 milliliters per day .

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    What Are Normal Results For This Test

    Laboratory test results may vary depending on your age, gender, health history, the method used for the test, and many other factors. If your results are different from the results suggested below, this may not mean that you have a disease. Contact your healthcare worker if you have any questions. The following are considered to be normal results for this test:

    • Radioimmunoassay:
    • Adults: 20-70 mcg/24 hours
  • High-performance liquid chromatography:
    • Low dose dexamethasone suppression test

    Why Is The Cortisol 24 cortisol test kit

    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.

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    Cortisol 24 Hr Urine Test

    A cortisol urine test is also known as urinary free cortisol test or UFC test. This test measures the amount of cortisol in your urine for 24 hours. Cortisol is a hormone produced by adrenal glands that are located on top of kidneys. The glands release this hormone in form of a reaction given by the body for physical and emotional stress. Cortisol levels rise 9and fall naturally throughout the day. Usually the level of the hormone is highest during morning and lowest during midnight. This might vary from person to person. Cortisol urine test is performed to determine the reason of abnormal cortisol levels.

    Before the test is conducted it is important to inform the doctor regarding prescribed drugs or ay over the counter medicines you are taking. There are certain medications that can affect the accuracy of the test. Your doctor may ask you to stop taking the medicines however it is not advised to stop the medicines without doctors consultation.

    What Is Normal Protein Range In Urine

    For a random urine sample, normal values are 0 to 14 mg/dL. For a 24-hour urine collection, the normal value is less than 80 mg per 24 hours. The examples above are common measurements for results of these tests.

    What does a protein level of 30 in urine mean?

    A normal amount of albumin in your urine is less than 30 mg/g. Anything above 30 mg/g may mean you have kidney disease, even if your GFR number is above 60.

    What is a 24-hour urine protein test?

    The 24-hour urine protein test checks how much protein is being spilled into the urine, which can help detect disease or other problems. The test is simple and noninvasive. Urine samples are collected in one or more containers over a period of 24 hours. The containers are kept in a cool environment and then sent to a lab for analysis.

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    Why The Test Is Performed

    The test is done to check for increased or decreased cortisol production. Cortisol is a glucocorticoid hormone released from the adrenal gland in response to adrenocorticotropic hormone . This is a hormone released from the pituitary gland in the brain. Cortisol affects many different body systems. It plays a role in:

    • Metabolism of fats, carbohydrates, and protein
    • Nervous system function

    and Addison disease , can lead to either too much or too little production of cortisol. Measuring urine cortisol level can help diagnose these conditions.

    Where Can I Find A Cortisol Urine Test Near Me

    All About [Ep. 2] | 24 Hour Urine Test!

    Check our lab finder to locate a collection site in your area.

    Note: Result turn around times are an estimate and are not guaranteed. Our reference lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.


    Before beginning collection for this test, the person must receive a specimen container from the lab. Begin by urinating at 8:00 am and discarding the specimen. Then, collect all urine for a 24 hour period. Keep the specimen container at room temperature. After 24 hours, return the container to the lab.



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    How It Is Done

    This test is usually done at home. You must collect all the urine you produce in a 24-hour period.

    • When you first get up in the morning, urinate into the toilet. Don’t save this urine. This marks the start of your 24-hour period.
    • For the next 24 hours, collect all your urine. Your doctor or lab will give you a large container to store it in. Urinate into a separate small, clean container. Then pour the urine into the large container. Don’t touch the inside of the containers with your fingers.
    • Keep the large container in the refrigerator.
    • Empty your bladder for the last time at or just before the end of the 24-hour period. Add this urine to the large container, and write down the time.
    • Do not get toilet paper, pubic hair, stool , menstrual blood, or anything else in your urine sample.

    When To Suspect Cushing Syndrome

    A complete history and physical examination are critical in determining the pretest likelihood of a diagnosis of Cushing syndrome. Patients present with a wide range of clinical features ,2 and no single symptom is necessary to the diagnosis. A high positive likelihood ratio for Cushing syndrome has been found in the presence of ecchymoses , osteopenia or fracture , proximal muscle weakness and hypertension .3 Many of the signs and symptoms of Cushing syndrome are common in the general population. But if they occur at an unusual stage of life or if multiple and progressive features are present , then a diagnosis of Cushing syndrome should be considered.2

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