Are Test Results Accurate
Cortisol tests are likely to accurately reflect your cortisol level at the time the test was taken, though no test is without some potential for error.
Accurate testing requires proper sample collection, and some patients who are collecting 24-hour urine samples may find it difficult to follow collection instructions precisely. If too little or too much urine is collected, test results can be affected.
To try to get the most accurate results, a doctor will make careful selection of initial and, if needed, repeat or follow-up testing. To interpret your results, your doctor will take individual factors into account, including your symptoms, the medications you take, and your sleep schedule.
Cortisol tests are complex to interpret, so any questions about their accuracy or significance should always be addressed in consultation with a medical professional.
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What Does It Mean If You Have A High Cortisol Test Reading
High cortisol levels can point to a number of factors that you might be up against.
The most obvious reason is that you are experiencing too much stress. Consistent stress increases cortisol levels. This is due to the bodys constant readiness for a flight or fight response1.
Cortisol is produced by the adrenal glands, but the levels are controlled by another hormone called Adrenocorticotropic hormone . This hormone is made in the pituitary gland. So if either of the glands develops any tumors, whether cancerous or not, the levels of cortisol could increase1.
When To Call A Doctor
While home testing is a convenient method for checking your cortisol, it may be best to see a doctor first if youre experiencing severe symptoms of possible low or high cortisol. These may include sudden, unexplained weight changes, darkened areas of your skin, or significant changes in mood.
You should also see a doctor if you decide to take an at-home cortisol test and you receive abnormal results. They may order follow-up tests and determine an appropriate treatment plan. Its also important to communicate any at-home test results with a doctor if youre currently being treated for Cushing syndrome or Addison disease.
Finally, if you receive normal at-home cortisol results but still dont feel right, make an appointment with your doctor to help determine what could be the underlying cause of your symptoms.
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How Does A Cortisol Test Work
Cortisol can be measured in the blood, urine, saliva or a combination. Your healthcare provider will tell you which test they recommend for you.
- Blood test: In an office, clinic or lab, a healthcare provider inserts a thin needle into a vein in your arm. The needle collects a small sample of blood into a tube. You might feel a slight sting when the needle goes in.
- Saliva test: You or a healthcare provider puts a swab in your mouth and waits a few minutes until the swab is saturated with spit. If you do the test yourself at home, your healthcare provider will give you a special kit. Theyll tell you what time to perform the test and how to return the sample.
- Urine test: Your healthcare provider gives you a container to collect your pee. Most urinary cortisol tests collect all the pee you produce in 24 hours. Your healthcare provider may ask you to store the urine in a cold place, then return it to their office or a lab.
You may need to repeat cortisol testing twice in one day or multiple times over several days because cortisol levels vary.
Can You Control Your Cortisol Levels With Diet

Having a balanced diet is always essential to maintaining a healthy body.
Unhealthy food can cause an increase in cortisol production. In fact, sugar intake is a trigger for cortisol production8. If you have a regular, high intake of sugar, your cortisol levels will be constantly elevated9.
However, sugar intake can be beneficial in moments of extreme stress10. If you are facing a threat, elevated cortisol levels are exactly what you need. Interestingly, sugar can be beneficial in times of stress when the cortisol need is increased.
Unfortunately, thats one of the reasons behind stress eating. When your body detects a threat, it knows it needs more energy to be able to respond as fast as possible. This results in sugar cravings which in the long run have their own side effects.
Here is a list of foods that can be eaten at the onset of sugary cravings. Eating these instead of sugary foods will still provide your body with healthy sources of immediate energy. This will help reduce your overall cortisol levels if they are high.
- Drinking water whilst exercising11
- Fruits particularly bananas and pears13
- Black tea & green tea14
Probiotics are bacteria found in yogurts. They are good for you. Prebiotics are foods that these bacterias consume. Increasing levels of both will also help reduce cortisol levels in your body15.
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How To Test Cortisol
The Cortisol Test allows you to accurately check your levels of Cortisol in a fingerprick blood sample.
You can check your Cortisol levels by buying a home finger-prick blood test kit below. Your sample is then professionally analysed in an accredited laboratory for total reassurance. The Vitall Cortisol Home Test Kit includes a Cortisol test and is available for just£49.
Please see the following test kit:
Diagnosis During An Adrenal Crisis
If Addisons disease is left untreated, it eventually leads to an adrenal crisis. This is where the symptoms of Addisons disease appear quickly and severely.
During an adrenal crisis, theres not enough time to perform a synacthen stimulation test to confirm Addisons disease.
If possible, blood will be taken and tested for any abnormalities. While youre waiting for the results, treatment may be started with steroid injections, and fluids containing salt and glucose.
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How Is The Cortisol Level Test Done
A blood sample is used to measure cortisol levels. Most blood samples are collected using this process:
- The flow of blood in the arm is stopped by wrapping an elastic band around your upper arm. This also causes the veins in your arm to become more visible, making it easier to insert the needle.
- Alcohol is used to clean the site on your skin where the needle will be inserted.
- The needle is inserted into the vein. This may cause a brief pinching or stinging sensation.
- Your blood is collected in a tube thats attached to the needle. More than one tube may be needed.
- The elastic band is removed after enough blood has been collected.
- As the needle is removed from your skin, cotton or gauze is placed on the site of the needle insertion.
- Pressure is applied to the area using cotton or gauze. A bandage is used to secure the cotton or gauze.
At-home cortisol testing kits are also available. You can purchase a test kit online from LetsGetChecked here.
There are few risks associated with the cortisol level test. The test is done by taking a blood sample from your vein, which may result in some bruising at the site where the needle was inserted.
In rare cases, the following risks may be associated with having blood drawn from your vein:
- excessive bleeding
- an accumulation of blood beneath your skin, which is called a hematoma
- lightheadedness or fainting
Cortisol levels are sometimes decreased by:
- drugs containing androgens
Higher-than-usual cortisol levels may indicate that:
When To Talk With A Doctor
Some conditions or complications can develop as a result of a hormone imbalance. If youre suddenly losing or gaining weight without trying, have joint pains, severe fatigue, or abdominal pain that doesnt go away, schedule an appointment to talk with your doctor.
You may also want to see a doctor if youre trying to get pregnant and are unable to for some time, or if youre experiencing other reproductive issues.
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This Post May Help To Explain Why Sometimes We Might See An Inconsistency Between The Result For An : 00 Am Morning Cortisol Blood Test Compared To The Free Cortisol Measured In A Cortisol Saliva Test
It is very important to realise that cortisol saliva testing and cortisol blood testing measure entirely different things. A cortisol blood test measures all the cortisol contained in the blood, i.e. both the free/unbound cortisol and the cortisol bound to protein . A cortisol saliva test only measures the free cortisol. In some cases, a person may have very high or very low bound cortisol . This can make the cortisol blood test result appear either high or low in the range compared to cortisol measured in saliva.
Clearly, every situation is different and the entire history and situation with an individual needs to be taking into account.
The link explains that the amount of cortisol produced and the amount of free cortisol available can be very different in some scenarios. Measuring both allows for insight into the rate of cortisol clearance/metabolism. Here are two examples:
Here is the link:
The bottom line is that I am a great believer in testing both free cortisol in saliva and total cortisol in blood at 8-9:00 am, as you get the whole picture. Relying on free saliva cortisol only is not sensible. There can be inconsistent results between blood cortisol testing and saliva cortisol testing and this needs to be assessed properly. This position is very clear in all my books, including the latest one, The Thyroid Patients Manual.
What Are Hormonal Imbalances
Your hormones, which your endocrine system makes, are your bodys messengers. They travel throughout your body, helping control the functions of your major processes and maintain balance within your body. They help manage energy levels, metabolism, reproduction, and more.
If your endocrine system makes too much or too little of a hormone, you develop a hormonal imbalance. Even small imbalances can create problems, such as health issues, early onset menopause, or ovarian cancer. There are many signs and symptoms of hormonal imbalances in women, as well as many different causes. Diagnosing the imbalance and finding the cause can lead to a treatment that restores proper balance and health.
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What If Cortisol Test Levels Are High
Physical and emotional stress can increase cortisol levels. When you are ill levels are also increased in response. Obesity, pregnancy and a number of drugs – particularly oral contraceptives – can also increase concentration within the bloodstream.
Since there are a number of conditions including hyperthyroidism or Cushing’s syndrome that also increase cortisol concentrations, further investigation with your G.P. is recommended.
What Do Cortisol Test Results Mean

The outcome of cortisol testing can indicate several different things. Your healthcare provider will explain your results and what they mean.
High levels of cortisol might indicate:
- Effects of large amounts of certain medications.
- Tumor in your pituitary gland thats producing adrenocorticotropic hormone , which stimulates the production of cortisol.
- Tumor in your adrenal gland thats producing too much cortisol.
- Tumor elsewhere in your body, such as small cell lung cancer.
Low levels of cortisol might indicate:
- Tumor in your pituitary gland tumor that slows ACTH production.
- Underactive or damaged adrenal glands.
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What Are The Treatment Options
Hormone replacement therapy is one of the most common treatments of low hormone levels.
For people experiencing menopause, premature menopause, or primary ovarian insufficiency as well as after oophorectomy or chemotherapy estrogen therapy can offer some relief. Estrogen therapy alone is recommended for those who have had a hysterectomy. You can take estrogen in different forms, generally estrogen pills and estrogen patches.
Taking A Cortisol Test
Cortisol can be measured in the blood, saliva, or urine. Because cortisol levels change throughout the day, your doctor will likely recommend that your test be conducted at a specific time, depending on the tests purpose.
Blood samples for cortisol tests are often collected early in the morning when the cortisol level in your blood should be at its highest. The blood sample is usually taken from your arm at a medical office, hospital, or lab.
Saliva for a cortisol test may be collected at a medical office or home. When testing for high cortisol, your doctor may instruct you to collect a saliva sample late at night while at home.
For a cortisol urine test, you will be provided with containers and detailed instructions on collecting all the urine you produce in 24 hours, after which you will return it to a lab. For convenience, you may choose a 24-hour period when you expect to be at home.
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What The Test Addresses
A dexamethasone suppression test measures how your cortisol levels are affected by taking dexamethasone. Dexamethasone is a manmade corticosteroid similar to one produced naturally by your adrenal glands. Its prescribed to replace the natural chemical if your body isnt producing enough of it. It may also be prescribed as an anti-inflammatory agent thats used to treat arthritis and various blood, kidney, and eye disorders.
Your adrenal glands are located on top of your kidneys. In addition to producing cortisol, they produce steroid hormones such as:
- androgens, which are male sex hormones
The test is also used to determine how well the adrenal glands respond to adrenocorticotropic hormone . ACTH is a hormone produced by the brains pituitary gland. It has a number of functions, including the production of corticosteroids. Too much ACTH can cause Cushing syndrome. In a healthy person, as the pituitary glands make less ACTH, the adrenal glands make less cortisol. Dexamethasone should decrease the amount of ACTH, which should then cause the amount of cortisol to decrease.
If youre currently taking the corticosteroid medicine dexamethasone, your doctor may recommend a dexamethasone suppression test to determine how its affecting cortisol levels in your blood.
Before the test, your doctor will tell you to stop taking certain prescription medications that may affect the results. These include:
- birth control pills
Why Is Cortisol Blood Test Done
A Cortisol blood test may be advised to diagnose disorders of the adrenal glands such as Addisons disease or Cushings syndrome or to monitor the effectiveness of therapy for these disorders. Disorders of the adrenal glands may have serious complications if not addressed and treated timely since cortisol directly or indirectly acts on every organ or tissue of the body.
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How Do You Prepare For A Cortisol Test
It depends on the type of test youre taking and what your doctor tells you to do.
If youre getting a salivary test, dont eat, drink, or brush your teeth beforehand. If youre getting a blood test, its important to be well hydrated.
Try to relax and get some rest, as stress may affect your cortisol levels. Your doctor may ask you to avoid any strenuous physical activity the day before a cortisol test too.
Signs Of Low Estrogen Levels
Its clear that estrogen is closely linked with womens emotional well-being. Estrogen is also linked to mood disruptions that occur only in women. WebMD
Estrogen is one of two vitally important hormones in women . It turns out that this hormone is not only responsible for a normal functioning of a womans body, but also for proper mental functioning.
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What The Results Mean
When a technician carries out the cortisol level test between 6 a.m. and 8 a.m., the results will typically be within the range of 1020 micrograms per deciliter in a healthy person.
A doctor will generally consider measurements outside of this range to be abnormally low or high. However, testing techniques vary between facilities. People should discuss their results with their doctor to confirm what their score may mean.
When test results are low, it may indicate one of the following:
- Addisons disease
- Hypopituitarism, a condition in which the pituitary gland does not stimulate the adrenal gland to produce cortisol
Certain medications, including phenytoin and androgen drugs, may also reduce the levels of cortisol.
When test results indicate high cortisol levels, this may be because the person has a tumor in a part of the body that impacts the production of cortisol, such as the adrenal or pituitary gland.
Some drugs may also elevate levels of cortisol, including estrogen-containing drugs and synthetic glucocorticoids, such as prednisone.
Physical and emotional stress can cause raised levels of cortisol too, as can certain illnesses.
Women may have increased levels of cortisol during pregnancy.
How To Test Cortisol Levels

Cortisol levels are measured with lab tests. These may be blood tests, which measure levels of the hormone in the bloodstream, or saliva tests, which measure cortisol levels in a saliva sample. Cortisol testing is typically done early in the morning, when levels are normally highest. Often, to produce the most accurate results, testing is repeated in the afternoon of the same day. Cortisol testing is often done in conjunction with ACTH level tests, since this pituitary gland hormone works to regulate cortisone levels. ACTH tests measure levels of the hormone in the bloodstream.
Getting tested can be done through your health care provider, who can order your tests for you, take your blood or saliva samples or send you to a lab to have them done. Then, your provider will let you know your results once they are delivered to his or her office.
You can also order these lab tests yourself online or over the phone from independent testing services, like Health Testing Centers. Ordering your own tests is generally less expensive, since you skip the cost of an office visit, and more efficient, since the results are delivered directly to you.
However, it is important to note that if your tests show that your cortisol and/or ACTH levels are abnormal too high or too low following up on those results with a visit to your healthcare provider is essential. Abnormal levels of these important hormones require further examination and testing.
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