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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 has the following functions:
Cortisol levels naturally rise and fall throughout the day. They’re 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. In some cases, your doctor may order both a cortisol urine test and another type of cortisol test to obtain more accurate results.
Your doctor may order a cortisol urine test if you’re showing symptoms of a medical condition that causes cortisol levels to rise or fall.
Cushing’s syndrome is a collection of symptoms associated with high cortisol levels. The most common symptoms include:
Women may have irregular periods and excess facial and chest hair. Children may show delayed physical or cognitive development.
The symptoms of low cortisol levels often emerge slowly. At first, they may only appear during times of extreme stress, but they’ll gradually increase in intensity over several months. Potential symptoms include:
When cortisol levels abruptly drop to life-threatening levels, an acute adrenal crisis may occur. The symptoms of an acute adrenal crisis include:
Call 911 if you’re having these symptoms. An acute adrenal crisis is a serious medical emergency that requires immediate treatment.
It’s important to tell your doctor about any prescription drugs or over-the-counter medicines you’re taking. Certain medications can interfere with the accuracy of the cortisol urine test. These include:
Your doctor may instruct you to stop taking medications that could affect the results. However, you should never stop taking your medications unless your doctor tells you to do so.
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. They’ll also explain how to collect the urine properly.
On the first day of the urine collection:
On the second day of the urine collection:
If your infant needs to have a cortisol urine test, you’ll collect their urine in a special bag. The collection procedure is as follows:
Collect urine samples over a 24-hour period. It will be necessary to check the bag often throughout the collection period.
Once the urine samples have been collected, they’ll be sent to a lab for analysis. The results will be sent to your doctor within a few days. Your doctor will discuss your results with you and explain what they mean.
A normal range for cortisol levels in urine is usually between 10 and 100 micrograms per 24 hours. However, normal ranges may vary slightly among different labs.
Abnormal results could be caused by a number of conditions.
High cortisol levels often indicate Cushing’s syndrome. This condition may be caused by:
Low cortisol levels may be caused by an insufficient production of cortisol in the adrenal glands. This is often a result of a condition called Addison’s disease. People with this disease are also at an increased risk of Addisonian crisis, or acute adrenal crisis, which occurs when cortisol levels drop dangerously low.
Further testing may be necessary to confirm a diagnosis any of these conditions.
Written by: Judith Epstein
Medically reviewed on: Jan 20, 2016: Steve Kim, MD
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