Patient Education - Endocrine Encyclopedia
Endocrine Surgery Encyclopedia
 Definition:
A cortisol urine test measures the amount of cortisol in the urine.
Alternative Names: 24-hour urinary free cortisol (UFC)
How the test is
performed:
A 24-hour urine sample is needed. The health care provider will instruct you, if necessary,
to discontinue drugs that may interfere with the test.
On day 1, urinate into the toilet when you get up in the morning. Afterwards, collect
all urine in a special container for the next 24 hours. Keep the container in a cool place
during the test period.
On day 2, urinate into the container when you get up in the morning.
Cap the container. Label the container with your name, the date, the time of completion,
and return it as instructed. Keep it in the refrigerator or a cool place until returned to
the laboratory.
FOR INFANTS
Thoroughly wash the area around the urethra. Open a urine collection bag (a plastic bag
with an adhesive paper on one end), and place it on the infant. For boys, the entire penis
can be placed in the bag and the adhesive attached to the skin. For girls, the bag is placed
over the labia. Diaper as usual over the secured bag.
This procedure may take a couple of attempts -- lively infants can displace the bag. The
infant should be checked frequently and the bag changed after the infant has urinated into
the bag. The urine is drained into the container for transport to the laboratory.
Deliver it to the laboratory or your health care provider as soon as possible upon completion.
How to prepare for the test:
No special preparation is necessary for this test, but if the collection is being taken from
an infant, a couple of extra collection bags may be necessary.
How the test will feel:
The test involves only normal urination, and there is no discomfort.
Why the test is performed:
The test is used to evaluate for increased or decreased cortisol production.
Cortisol is a steroid hormone released from the adrenal gland in response to ACTH, a hormone
from the anterior pituitary gland in the brain. Cortisol levels rise and fall during the
day. Highest levels occur at about 6 to 8 a.m. and lowest levels at about midnight.
Cortisol affects many different body systems. It plays a role in lipid, carbohydrate,
and protein metabolism. Cortisol also plays a role in the bone, circulatory, nervous, and
immune systems. Cortisol is critical for normal stress responses.
Different diseases, such as Cushing's disease and Addison's disease, can lead to either
over- or under-production of cortisol. Urinary free cortisol measurements can help to diagnose
these conditions.
Urinary free cortisol is a measurement of the cortisol in the urine that is not attached
to other substances. Free cortisol represents the active form of the hormone. The urine measurement
directly reflects the blood level of cortisol.
Normal Values:
The normal range is 10 to 100 mcg/24 h. Normal value ranges may vary slightly among different
laboratories.
Note: mcg/24 h = micrograms per 24 hours
What abnormal results mean:
Increased levels of urine cortisol may indicate:
- ACTH-secreting tumor
- Cushing's syndrome -- pituitary-independent
- Cushing's disease -- pituitary-dependent
- Pseudo-Cushing's
Decreased levels of urine cortisol may indicate:
- Addison's disease
- Hypopituitarism
- Congenital adrenal hyperplasia
Additional conditions under which the test may be performed include exogenous Cushing's syndrome.
What the risks are:
Special considerations:
Factors that interfere with this test are:
- Severe emotional or physical stress
- Medications, including glucocorticoids, lithium, diuretics, ketoconazole, estrogens
and tricyclic antidepressants
Note: Due to these interfering factors, the urine cortisol is often tested on three or more
separate occasions to get a truer picture of average cortisol production.
Review Date: 3/8/2006
Reviewed By: Robert Hurd, M.D., Department of Biology, College of Arts and Sciences, Xavier
University, Cincinnati, OH. Review provided by VeriMed Healthcare Network.
 A.D.A.M.,
Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission
(www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M.
follows rigorous standards of quality and accountability. A.D.A.M. is among the first to
achieve this important distinction for online health information and services. Learn more
about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also
a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net
Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for
the diagnosis or treatment of any medical condition. A licensed medical professional should
be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for
all medical emergencies. Links to other sites are provided for information only -- they do
not constitute endorsements of those other sites. © 1997- 2007 A.D.A.M., Inc. Any duplication
or distribution of the information contained herein is strictly prohibited.
|
