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Cortisol Urine Test

Last updated July 24, 2019

Approved by: Maulik P. Purohit MD MPH

The Cortisol Urine Test is a test, to assess the levels of cortisol in the body. It is used to test for diseases of cortisol insufficiency or cortisol excess. It is also used to assess pituitary gland and adrenal gland health.


What are the other Names for this Test? (Equivalent Terms)

  • Free Cortisol Urine Test
  • Hydrocortisone Urine Test 

What is Cortisol Urine Test? (Background Information)

  • Cortisol is a glucocorticoid stress hormone important for its anti-inflammatory effects. It also releases stored nutrients for immediate use
  • Cortisol is secreted by the adrenal glands, which are two pyramid-shaped organs, each sitting atop one kidney. Cortisol secretion occurs upon stimulation by the adrenocorticotropic hormone (ACTH), from the pituitary gland
  • Glucocorticoids, such as cortisol, are released when the body is in a state of physical or mental exertion. One effect of cortisol is to increase the energy availability. It does this by stimulating the liver to produce glucose. It also does so by stimulating adipose (fat) cells to release fatty acids into blood, for immediate use
  • Another effect of cortisol is to suppress inflammation, which it does by inhibiting the effects of white blood cells and other components of the immune system
  • Certain disease states result from either excessive or deficient cortisol production. These can be caused by genetic factors, or due to cancer. Examples of such diseases include Cushing’s disease and Addison’s disease
  • The Cortisol Urine Test is a test, to assess the levels of cortisol in the body. It is used to test for diseases of cortisol insufficiency or cortisol excess. It is also used to assess pituitary gland and adrenal gland health

What are the Clinical Indications for performing the Cortisol Urine Test?

Following are the clinical indications for performing a Cortisol Urine Test:

  • Rapid weight change
  • Fat deposition on the shoulders (“buffalo hump”) or face (“moon face”)
  • Excessive urination
  • Lesions in the mouth
  • Fragile skin
  • Purple streaks on the abdomen 

How is the Specimen Collected for Cortisol Urine Test?

Following is the specimen collection process for Cortisol Urine Test:

Sample required: Urine

Process: Either a random or 24-hour urine test, for a urine sample.

Preparation required: No special preparation is needed prior to the test. 

What is the Significance of the Cortisol Urine Test Result?

The significance of the Cortisol Urine Test is explained:

  • Increased cortisol levels may indicate:
    • Adrenal adenoma
    • Cushing’s syndrome
    • Ectopic ACTH production
    • Hyperglycemia
    • Stress
  • Decreased cortisol levels may indicate:
    • Addison’s disease
    • Adrenogenital syndrome
    • Hypopituitarism

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario. 

Additional and Relevant Useful Information:

  • Cortisol’s anti-inflammatory effects make it useful for surface application through creams and gels. It may be administered onto a poison ivy rash, or other areas of irritation. In such cases, it helps decrease swelling; but, it also slows healing and increases susceptibility to infection. However, cortisol should never be applied to open wounds
  • Certain factors may interfere with the results of the Cortisol Urine Test. These include:
    • Excessive stress, prior to performing the test 

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider, the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

References and Information Sources used for the Article:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 25, 2014
Last updated: July 24, 2019