Cortisol Studies: Blood, Saliva, Urine
Hydrocortisone, compound F.
To assist in diagnosing adrenocortical insufficiency such as found in Cushing syndrome and Addison disease.
Single cortisol level There are no food, fluid, activity, or medication restrictions unless by medical direction. Cortisol peak specimens should be collected between 0600 and 0800 hr; trough specimens should be collected between 2300 and 2400 hr.
|Specimen type/Study||General Instructions|
|24 hr urine free-cortisol||Urine is collected over a timed (24 hr) interval and stored in a clean plastic container with 10g boric acid as a preservative|
Cortisol and adrenocorticotropin hormone (ACTH) studies are often ordered together. In order not to duplicate large amounts of information please refer to the study titled “Adrenocorticotropin Hormone (and Challenge Tests)” for additional detailed information regarding ACTH and cortisol challenge testing.Normal Findings
Method: Electrochemiluminescent immunoassay.
|Time||Conventional Units||SI Units (Conventional Units × 27.6)|
|Birth–1 wk||2–11 mcg/dL||55–304 nmol/L|
|1 wk–adult/older adult||5–25 mcg/dL||138–690 nmol/L|
|1 wk–adult/older adult||3–16 mcg/dL||83–442 nmol/L|
|Long-term use of corticosteroids in patients, especially older adults, may be reflected by elevated cortisol levels (Cushing syndrome). Abrupt cessation of corticosteroids may be reflected in decreased cortisol levels since the body’s normal production of cortisol has been suppressed. Adrenal insufficiency may occur in this case and could be life threatening. Cessation of corticosteroid therapy must always be tapered. After the first week of life, cortisol levels approach adult levels.|
|Salivary Cortisol||Conventional Units||SI Units (Conventional Units × 27.6)|
|0700–0900||100–750 ng/dL||2760–20,700 nmol/L|
|1500–1700||Less than 401 ng/dL||Less than 11,068 nmol/L|
|2300–midnight||Less than 100 ng/dL||Less than 2760 nmol/L|
|24 hr Urine Free Cortisol||Conventional Units||SI Units (Conventional Units × 27.6)|
|3–8 yr||1.4–20 mcg/24 hr||38.6–552 nmol/L|
|9–12 yr||2.6–37 mcg/24 hr||71.8–1021 nmol/L|
|13–17 yr||4–56 mcg/24 hr||110.4–1545.6 nmol/L|
|18 yr–adult||3.5–45 mcg/24 hr||96.6–1242 nmol/L|
Critical Findings and Potential Interventions
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