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.
Common Symptoms Of Elevated Stress And Sleep Deprivation:
- Cant get to sleep or stay asleep
- Frequent or early waking
- Feeling âtired but wiredâ
If you are having issues related to sleep or stress, taking an at-home cortisol test may be helpful for you to understand what may be causing your symptoms.
Cortisol regulates how much sugar and fat gets stored in your body and how much is released to use for fuel. Thatâs why a cortisol imbalance can lead to changes in weight, energy, and other symptoms.
Cortisol is also your bodyâs main stress hormone. When your body is stressed, your adrenal glands release a burst of cortisol, sending blood flow into your muscles and increasing your blood sugarâ âgiving you a boost of energy. Stressors can be psychological or physiological , and various activities of day-to-day living all cause physiological stress that results in spikes of cortisol.
But lots of stress for a prolonged amount of time can lead to chronically elevated cortisol levels. This may increase your risk of health issues including:
- Increased weight
- Difficulty remembering
Cortisol testing can be useful because it can help you see if your cortisol levels are very high -potentially causing symptoms-so you can discuss possible next steps with your healthcare provider.
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Will Lowering Cortisol Help Lose Weight
Answer From Katherine Zeratsky, R.D., L.D. There is no solid evidence that cortisol blockers lead to weight loss. When you’re under stress, your body boosts production of the hormone cortisol. Chronic stress and persistently high cortisol levels may be associated with increased appetite and weight gain.
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High Cortisol Testing And Diagnoses
Your doctor can order a number of tests to determine if you have abnormally high cortisol levels. Both blood and urine testing help reveal a problem, but a 24-hour urine test is used more often than a cortisol blood test to diagnose Cushings disease or syndrome.
The cortisol values listed below, which can be obtained from a blood test, serve as a reference range for whats considered normal. Cortisol levels above this normal range are considered high and can be risky or problematic.
But keep in mind that values differ depending on time of day, age and the type of cortisol test preformed. Saliva tests are now also recommended and appear to be as reliable as a blood sample. Additionally, an overnight dexamethasone suppression test may also be recommended, and it involves taking a dose of a corticosteroid medicine called dexamethasone to determine how blood cortisol is affected.
Because of this, your doctor will always need to evaluate your results in light of your specific symptoms and medical history.
- Normal cortisol ranges for adults and children in the morning are between five to 23 micrograms per deciliter or 138 to 635 nanomoles per liter
- Normal cortisol ranges for adults and children in the afternoon are between three to 16 mcg/dL or 83 to 441 nmol/L
- Normal cortisol for a newborn baby is between two to 11 mcg/dL or 55 to 304 nmol/L
Final Thoughts on Cortisol Levels
What Does Cortisol Do To My Body

Almost all tissues in your body have glucocorticoid receptors. Because of this, cortisol can affect nearly every organ system in your body, including:
- Integumentary system .
More specifically, cortisol affects your body in the following ways:
Optimum cortisol levels are necessary for life and for maintaining several bodily functions. If you have consistently high or low cortisol levels, it can have negative impacts on your overall health.
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Can I Measure Cortisol At Home
People can buy at-home cortisol tests online. These require a blood, urine, or saliva sample that a person collects at home, then sends to the companys labs.
The company returns the test results to the person after a few days or weeks.
However, no studies have investigated the accuracy of at-home cortisol tests. A person should contact a healthcare professional once they have received their results.
Getting Tested By Your Doctor
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Where Can I Find A Cortisol Test Near Me
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.
Requirements:
People ordering this test on a Doctors recommendation should be aware of any medications they are taking which may affect Cortisol levels.
It is recommended that someone taking Biotin stop consumption at least 72 hours prior to the collection of a sample.
Categories:
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Why Do I Need Cortisol
Cortisol is released in stressful situations and when we feel under threat, along with adrenaline. Stress hormones make your body release energy, make you awake and alert, and suppress digestion and the immune system. These factors mean you are optimally equipped for a stressful fight-or-flight situation.
Cortisol has other functions in the body:
It regulates blood sugar and blood pressure
It is involved in fat, protein and carbohydrate metabolism
It inhibits inflammation including that caused by other hormones such as adrenaline during a stressful situation
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Cortisol Tests For Adrenal Fatigue
A cortisol test is a very important step when you have Adrenal Fatigue Syndrome . AFS occurs when ongoing stress causes overwork and eventually damage to the adrenal glands. Cortisol testing can help identify both of these stages of AFS.
When youre in the early stages of AFS, it means that youre constantly stressed. When youre under stress, the NeuroEndoMetabolic stress response activates. This causes changes throughout the body that make you alert and ready to face the cause of the stress. These changes also help protect you from damage. The NEM brings about these changes by prompting the adrenal glands to produce more cortisol. So, if you have a cortisol test while youre in these stages, your levels may be higher than normal, perhaps even abnormally high depending on your body and your stress tolerance.
The NEM stress response is only designed to be active for short periods. When youre stressed long-term, as too many people seem to be in the modern world, the adrenal glands start to fatigue. They struggle to produce the cortisol levels that your body is demanding, and levels may drop. If you have your cortisol levels tested at this stage, you may have abnormally high levels of the hormone or low levels. It all depends on how far the adrenal dysfunction has gone.
What Do The Results Mean
A cortisol test alone can’t diagnose the cause of abnormal cortisol levels. If your cortisol level isn’t normal, you will usually have more tests to find out what is causing the problem.
High levels of cortisol may be a sign that you have Cushing’s syndrome. It may be caused by:
- Taking high doses of certain steroid medicines for a long time to treat conditions, such as asthma, rheumatoid arthritis, and lupus
- Tumors in your pituitary gland or other parts of your body that make too much of the hormone that tells your adrenal glands to make cortisol
- Tumors in your adrenal glands that make extra cortisol
Low levels of cortisol may mean you have Addison disease or secondary adrenal insufficiency:
- Common causes of Addison’s disease include damage to the adrenal glands from conditions, such as:
- Certain infections, such as tuberculosis and HIV/AIDS
The most common cause of low cortisol levels is suddenly stopping steroid medicines after using them for a long time.
If your cortisol results aren’t normal, it doesn’t always mean you have a medical condition that needs treatment. Cortisol levels can be affected by:
- Certain medicines, such as birth control pills
To learn what your test results mean, talk with your health care provider.
Learn more about laboratory tests, reference ranges, and understanding results.
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How Cortisol Testing Works
The cortisol hormone can be measured using blood, saliva, or urine samples.
Your cortisol levels change the entire day, so your doctor will likely set a specific time to conduct the test.
For example, the cortisol in your blood is at its peak early in the day. In the afternoon, it reaches its lowest value. The blood samples for a cortisol blood test are often collected in the morning.5
Some tests also collect a sample in the afternoon. They check if cortisol levels are dropping as they normally should.
The cortisol in your saliva and the active or free cortisol in your plasma are balanced in the evening. Your doctor will require you to collect the specimen for a cortisol saliva test at night.6
A cortisol urine test requires that you collect all your urine within a 24-hour period. The lab will provide sterile containers for obtaining your urine sample. Theyll also instruct you on how to collect your urine specimen.
What Happens When Cortisol Is High

Over the last 20 years, studies have increasingly revealed that moderate to high cortisol levels may lead to an array of health issues, such as :
- Chronic disease. Long-term increased cortisol may increase your risk for high blood pressure, heart disease, type 2 diabetes, osteoporosis, and other chronic diseases.
- Weight gain. Cortisol may increase appetite and signal the body to shift metabolism to store fat.
- Lack of energy/difficulty sleeping. It can interfere with sleep hormones which may impact sleep quality and length.
- Difficulty concentrating. Also referred to as brain fog, some people report trouble focusing and lack of mental clarity.
- Impaired immune system. Increased cortisol can hamper the immune system, making it more difficult to fight infections.
- Cushings syndrome. In rare cases, very high cortisol levels can lead to Cushings syndrome, a rare but serious disease.
Elevated cortisol levels can be caused from many underlying issues such as overactivity or cancer of the pituitary or adrenal glands, chronic stress, and medication side effects .
Further, existing chronic disease may lead to higher cortisol levels, causing a chicken or the egg type of scenario .
Therefore, its best to work with a qualified health professional to establish the root cause of your health issues. Along with this, you may want to introduce some effective lifestyle habits that may help you better manage your cortisol levels. Here are some recommendations:
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Best Urine Sample Cortisol Test: Everlywell Sleep & Stress Test
- Sample type: This test requires a urine sample.
- Results time: People receive their results in 25 days.
- Pro: It tests for three hormones over different periods of the day. Everlywell also accepts flexible savings account and health savings account payments.
- Con: It is expensive.
This Everlywell product uses a urine sample to test the levels of three hormones, cortisol, cortisone, and melatonin, over four points during the day. It also tests for another marker, creatinine, which is a waste product of the muscles.
There are three steps to this test. First, a person registers the testing kit on Everlywells website, follows the instructions to take the urine sample, places it in the prepaid package, and sends it off to Everlywells certified labs.
People will receive their results digitally via the Everlywell website. Everlywell claims this can be within 25 days. Healthcare professionals can also offer insights into a persons results via Everlywells secure platform.
In addition to providing a personalized report of each marker, Everlywell sends detailed information explaining the results.
The company claims that the labs where Everlywell tests samples are CLIA certified. Everlywell also says it ensures that independent, board certified doctors within the persons state review and approve all results.
This test is best for people who want into their hormone fluctuations and prefer urine sample tests.
The Everlywell Sleep & Stress Test costs $199.
Best Cortisol Test For Am And Pm Testing: Rx Hometest Cortisol Am
- Sample type: This test requires two saliva samples.
- Results time: People receive their results in 5 business days.
- Pro: A person takes two samples throughout the day to allow for fluctuations.
- Con: People must remember to take the sample within the appropriate time window.
This Rx HomeTest Cortisol AM/PM Test requires a person to take two saliva samples: one 3060 minutes after waking in the morning, before eating breakfast or brushing teeth, and the other before bed.
The company states that collecting two samples can help provide insight into a persons 24-hour cortisol cycle.
Once a person collects the sample, they can ship it to the Rx HomeTest CLIA lab for free. The company claims it sends test results within 5 business days and that they are easy to understand.
This test may be best suited to people who to understand their 24-hour cortisol cycle, but do not want to take an invasive sample.
The RxHomeTest Cortisol AM/PM Test is available across the United States, except in the following states:
usually take a persons blood sample and analyze their cortisol levels. They may also provide a saliva test kit for analyzing a persons cortisol levels.
With home cortisol tests, a person takes a sample of their blood, urine, or saliva. There are currently no studies investigating the accuracy of these results.
However, home cortisol tests may be faster and more convenient than undergoing testing in a clinic or hospital setting.
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The Role Of The Cortisol Hormone
The job description of the cortisol hormone is vast and varied. Its responsible for helping to control blood sugar levels and motivating you to move, for example. And, although cortisol is seen as the bad stress hormone, this isnt the complete story.
If we didnt have cortisol we wouldnt be able to survive, says Dr Andrea on Wellness Women Radio, How Stress Makes Us Fat. Cortisol is what gets you up in the morning, what flips your body into fight mode when it thinks youre in danger and is key for metabolic processes.
However, as cortisol is pretty much your bodys built-in internal alarm system, it should rise and fall as needed. But, tech, tetchy people at work and endless rushing can mean the alarm button is triggered far too often.
What Do High Cortisol Levels Mean
High cortisol levels could be a sign of many different conditions. First of all, high cortisol levels upon waking up, or even normal cortisol levels which do not decrease towards the end of the day, could suggest Cushing syndrome. It is important to rule out any contributing factors to these high cortisol levels, such as stress or taking high doses of glucocorticoid medications .
For this, an overnight dexamethasone suppression test is carried out as dexamethasone suppresses ACTH production from the pituitary gland which in turn decreases cortisol production. If you are experiencing stress or you are taking glucocorticoid medication, your cortisol levels should decrease after the dexamethasone suppression test .
With Cushing syndrome, your cortisol levels will remain unchanged, you might have an abnormal production of ACTH from the pituitary gland due to an overactive pituitary gland or an adrenal gland tumour, or in more severe cases a tumour of the pituitary gland. Your doctor might ask you to take your cortisol home test late at night, as it is the best way to determine if you have Cushing syndrome .
Bear in mind that if you are pregnant or if you are having oestrogen therapy, your cortisol levels will be generally higher .
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