Can Cortisol Levels Be Tested

Best Lower Cost Cortisol Test: Zrt Laboratory Cortisol Saliva Test

• Sample type: This test requires a saliva sample.
• Results time: People receive their results in 57 business days.
• Pro: The test is more affordable than its competitors.
• Con: A person may have to stop taking hormone medications 2 days before taking the test.

This test involves collecting saliva in the morning. ZRT Laboratory indicates that the morning is the peak time for hormone production and the best time to test cortisol levels.

It adds that saliva tests may suit some people because they are noninvasive, and a person can do them in the comfort of their home or in an office or lab.

The company recommends taking the saliva sample after waking up.

People with regular menstruation patterns should take saliva samples on days 19, 20, or 21 of their cycle. If their cycle is irregular, they should take the sample 5 days before their period, if they can anticipate the start date.

According to ZRT Laboratory, people should stop taking hormone medications except birth control and thyroid medication at least 12 hours before collecting the sample.

After collecting their sample, people then ship it to a CLIA certified lab. If they cannot send their saliva sample within 24 hours, they should freeze them until they can do so.

ZRT Laboratory returns results within 57 business days.

This test may be best for people working with a smaller budget.

A person can order the ZRT Laboratory Cortisol Saliva Test online for $86.

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:

What Is A Cortisol Urine Test

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.

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The Diurnal Cortisol Trend

To capture the cortisol variation during the day, a 4-point diurnal cortisol test measures cortisol levels from four different times of the day to assess the daily trend. This requires collecting four saliva samples within 24 hours.

The first sample collection is around 30 minutes after waking up. This is the time when levels are highest and change quickly.

The sketch on top of this page shows the quick change in morning levels. Ideally, several samples should be collected early in the morning to precisely know the peak, but that might be practically difficult and expensive.

Therefore, it is extremely important to ensure proper protocol is followed in sample collection for best results. It helps to know the trend of morning cortisol variation and the factors affecting it.

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.
• Underactive pituitary gland.

If your results are low or high, your healthcare provider may order other tests:

• ACTH stimulation test: This assesses how your adrenal glands respond after you get a shot of artificial ACTH.
• Dexamethasone suppression test: This measures cortisol after you take a medication called dexamethasone, a manufactured version of cortisol.
• Imaging tests: An MRI or CT scan allows healthcare providers to take pictures of your glands and locate a possible tumor.

A note from Cleveland Clinic

A cortisol test measures the level of cortisol in your body. It can help diagnose an adrenal disorder such as Cushings syndrome or Addisons disease. Your healthcare provider will give you specific instructions on the type of test you need and when it should happen.

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How To Prepare For The Test

Your doctor will likely have you do the test early in the morning. This is important, because cortisol level varies throughout the day.

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
• Human-made glucocorticoids, such as hydrocortisone, prednisone and prednisolone

What Causes Low Levels Of Cortisol

Having lower-than-normal cortisol levels is considered adrenal insufficiency. There are two types of adrenal insufficiency: primary and secondary. The causes of adrenal insufficiency include:

• Primary adrenal insufficiency: Primary adrenal insufficiency is most commonly caused by an autoimmune reaction in which your immune system attacks healthy cells in your adrenal glands for no known reason. This is called Addisons disease. Your adrenal glands can also become damaged from an infection or blood loss to the tissues . All of these situations limit cortisol production.
• Secondary adrenal insufficiency: If you have an underactive pituitary gland or a pituitary tumor, it can limit ACTH production. ACTH signals your adrenal glands to make cortisol, so limited ACTH results in limited cortisol production.

You can also have lower-than-normal cortisol levels after stopping treatment with corticosteroid medications, especially if you stop taking them very quickly after a long period of use.

What are the symptoms of low cortisol levels?

Symptoms of lower-than-normal cortisol levels, or adrenal insufficiency, include:

• Low blood pressure .

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What Is Cortisols Role In The Body

One of cortisolâs main functions is regulating your bodyâs response to stressâhence, its nickname of the âstress hormone.â

When you experience stress, your adrenal glands release cortisol into your body which temporarily increases your blood sugar for a boost of energy and curbs nonessential functions. This process helps you perform better in stressful situations, such as when you are in danger.

When your body experiences a cortisol imbalance, the amount of cortisol produced in response to any kind of stress can impact important functions in your body as a result of too much or too little cortisol being secreted. Cortisol secretion is mainly controlled by three inter-communicating regions of the body the hypothalamus in the brain, the pituitary gland and the adrenal gland.

In addition to managing your stress response, cortisol also helps your body regulate a number of other key functions linked to your health.

How To Test Cortisol Levels At Home With The Everlywell Sleep & Stress Test

Order the Everlywell test online.

Once it arrives, register your kit online using the unique ID that comes inside your kit.

Follow the sample collection instructions inside the kit.

Place your sample inside the return bag included within the kit. Then, put the bag back inside the kit box.

Send the box back in the return envelope using the prepaid shipping label provided.

After the lab tests your sample, check your results on our secure, online platform.

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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.

Is There Anything Else I Should Know

Similar to those with adrenal insufficiency, people with a condition called congenital adrenal hyperplasia have low cortisol levels and do not respond to ACTH stimulation tests. Cortisol measurement is one of many tests that may be used to help evaluate a person for CAH.

Heat, cold, infection, trauma, exercise, obesity, and debilitating disease can influence cortisol concentrations. Pregnancy, physical and emotional stress, and illness can increase cortisol levels. Cortisol levels may also increase as a result of hyperthyroidism or obesity. A number of drugs can also increase levels, particularly oral contraceptives , hydrocortisone , and spironolactone.

Adults have slightly higher cortisol levels than children do.

Hypothyroidism may decrease cortisol levels. Drugs that may decrease levels include some steroid hormones.

Salivary cortisol testing is being used more frequently to help diagnose Cushing syndrome and stress-related disorders but still requires specialized expertise to perform.

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How Is Cortisol Measured

Wondering how to test cortisol levels? First off, itâs helpful to know that urine, saliva, and blood are all widely used for measuring cortisol.

Cortisol urine test – The kidneys filter cortisol out of your bloodstream and into urine, making it possible to test cortisol levels with urine samples. This kind of test measures free cortisolâ âor cortisol that isnât attached to proteins. For that reason, this type of test is also known as a urinary-free cortisol test. The Everlywell at-home Sleep and Stress Test is urinary free cortisol test.

Because itâs easy to collect urine samples at different times throughout the day, urinary free cortisol tests are useful for checking how your cortisol levels change over a 24-hour period, which can help provide insight into sleep problems, stressors, and more.

In addition, urinary free cortisol tests are often used for disease monitoring in patients with Cushing’s syndromeâ âa condition in which the adrenal gland makes too much cortisol.

Cortisol saliva test – Saliva measures cortisol because cortisol circulating in the bloodstream can enter saliva through a biochemical process called diffusion. Cortisol saliva tests measure the bodyâs amount of free cortisol. Late-night salivary cortisolâ âmeasurement of cortisol in a saliva sample collected late at night, often around midnightâ âis a reliable way to screen for Cushingâs syndrome.

How To Stop Stress With Exercise

Stress is when a persons body experiences extreme levels of physical and mental tension. This typically occurs when a person is under a lot of pressure and unable to cope with the stress. Even people who lead relatively stress-free lives experience stress at times. Your cortisol level reflects the level of stress youre experiencing. High levels of cortisol can lead to weight gain, fatigue, insomnia and poor memory. The good news is, people can change the level of stress in their lives. They can reduce stress by adopting a healthier lifestyle, including exercise.

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What Does A High Level Of Cortisol Mean

The most common cause of elevated cortisol levels in women is a high level of estrogen in the blood due to pregnancy or estrogen therapyâ´. Excess levels of cortisol can also be indicative of Cushing syndrome, which is a rare disorder. The most common cause of Cushing syndrome is the use of corticosteroidsâµ, though it can also be caused by overproduction of the hormone ACTH.

What Abnormal Results Mean

A higher than normal level may indicate:

• 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
• Ectopic Cushing syndrome , in which a tumor outside the pituitary or adrenal glands makes too much ACTH
• Tumor of the adrenal gland that is producing too much cortisol

A lower than normal level may indicate:

• Addison disease, in which the adrenal glands do not produce enough cortisol
• Hypopituitarism , in which the pituitary gland does not signal the adrenal gland to produce enough cortisol
• Suppression of normal pituitary or adrenal function by glucocorticoid medicines including pills, skin creams, eyedrops, inhalers, joint injections, chemotherapy

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Ashwagandha Supplement To Reduce Cortisol

Ashwagandha is a good supplement to provide support during times of emotional or mental stress. Because of this, ashwagandha supplementation can help reduce cortisol levels.

One study found that taking 300 mg of ashwagandha 2 times a day can help to reduce cortisol levels. In the study, the ashwagandha supplement was able to significantly lower cortisol levels without causing any adverse side effects.

Learn more about the proven benefits and uses of ashwagandha.

Phosphatidylserine As A Cortisol Supplement

The supplement phosphatidylserine has a positive effect on your mind and memory and can help reduce cortisol production.

One small study found that phosphatidylserine supplements of 600 mg a day can lower cortisol levels after intensive exercising. This can be an effective way for athletes or people who enjoy regular intensive exercise to avoid the effects of too much cortisol.

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Role Of Difference In Collection Time

Research shows inaccurate reporting of morning cortisol collection time is more common than realized. The recorded time is often late, and can impact the results.

Careful monitoring of actual wake up time versus self-reported time showed 1 in 5 people actually woke up earlier than what they had reported. This could be anywhere between 5 mins to 30 mins. For 1 in 7 people, this gap was over 30 minutes.

However, any difference over 15 minutes can cause significant variation in results.

Difference of 5 to 10 minutes at the beginning, right after breaking the sleep is likely not critical, since the rise in cortisol levels few minutes after waking up is still small.

But anything after first 15 minutes starts to have an impact due to steep rise in the levels at this time.

Researchers have identified multiple reasons why people collect their morning samples later than expected:

• Avoiding the discomfort of collection.

• Might need to prioritize other responsibilities.

• Sleep inertia, being half-asleep without being fully mentally awake and no body movement. That makes it difficult to identify exact time of waking up, despite well-intentioned efforts.

How Is The Test Administered

Two variations of the dexamethasone suppression test are the low-dose test and the high-dose test. Both forms of the test can be done overnight or over the course of a three-day period. The standard test for both is the test that spans three days. During both forms of the test, your healthcare provider will give you a certain amount of dexamethasone and will later measure your levels of cortisol. A blood sample is also needed.

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Can I Take The Test At Home

There are commercially available at-home cortisol tests. These tests involve collecting a sample or blood, urine, or saliva and mailing it to a laboratory for analysis. Because cortisol levels change throughout the day, some tests require a sample to be collected in the morning, while others use samples taken at several different times during the day.

At-home cortisol tests may also be called at-home stress and sleep panels and measure other substances that can affect sleep and the bodys stress responses.

At-home tests can provide a snapshot of cortisol levels, but they are not able to replace physician-ordered tests. A doctors evaluation of your symptoms is very important when investigating potential problems with cortisol levels.