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Cortisol blood test

Serum cortisol

The cortisol blood test measures the level of cortisol in the blood. Cortisol is a steroid (glucocorticoid or corticosteroid) hormone produced by the adrenal gland.

Cortisol can also be measured using a urine or saliva test.

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How the Test is Performed

A blood sample is needed.

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:

How the Test will Feel

When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or slight bruising. This soon goes away.

Why the Test is Performed

The test is done to check for increased or decreased cortisol production. Cortisol is a glucocorticoid (steroid) hormone released from the adrenal gland in response to adrenocorticotropic hormone (ACTH). ACTH is a hormone released from the pituitary gland in the brain.

Cortisol affects many different body systems. It plays a role in:

Different diseases, such as Cushing syndrome and Addison disease, can lead to either too much or too little production of cortisol. Measuring blood cortisol level can help diagnose these conditions. It is also measured to evaluate how well the pituitary and adrenal glands are working.

The test is often done before and 1 hour after injection of a medicine called ACTH (cosyntropin). This part of the test is called an ACTH stimulation test. It is an important test that helps check the function of the pituitary and adrenal glands.

Other conditions for which the test may be ordered include:

Normal Results

Normal values for a blood sample taken at 8 in the morning are 5 to 25 mcg/dL or 140 to 690 nmol/L.

Normal values depend on the time of day and the clinical context. Normal ranges may vary slightly among different laboratories. Some labs use different measurements or may test different specimens. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

A higher than normal level may indicate:

A lower than normal level may indicate:

Risks

There is little risk involved with having your blood taken. Veins and arteries vary in size from one person to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight, but may include:

Related Information

Cushing syndrome
Addison disease
Hypopituitarism
Acute adrenal crisis
Ectopic Cushing syndrome
Cushing disease

References

Chernecky CC, Berger BJ. Cortisol - plasma or serum. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:388-389.

Stewart PM, Newell-Price JDC. The adrenal cortex. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016:chap 15.

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Review Date: 5/6/2019  

Reviewed By: Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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