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Urine sample
Urine sample
Female urinary tract
Female urinary tract
Male urinary tract
Male urinary tract

Cortisol - urine
Definition:

A test that measures the amount of cortisol in the urine.
Alternative Names:
24 hour urinary free cortisol, 24 hour 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 upon arising in the morning.
  • Collect all subsequent urine (in a special container) for the next 24-hours. Keep it in the refrigerator or a cool place during the collection period.
  • On day 2, urinate into the container in the morning upon arising.
  • 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.
Infant:
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 your infant. For males, the entire penis can be placed in the bag and the adhesive attached to the skin. For females, the bag is placed over the labia. Place a diaper over the infant (bag and all). The infant should be checked frequently and the bag changed after the infant has urinated into the bag. For active infants, this procedure may take a couple of attempts--lively infants can displace the bag, causing an inability to obtain the specimen. 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. 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.

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: Additional conditions under which the test may be performed:
  • exogenous Cushing's syndrome
Special considerations:
Interfering factors:
  • severe emotional or physical stress
  • Medications, including glucocorticoids, lithium, diuretics, ketoconazole, estrogens and tricyclic antidepressants
Review Date: 2/17/2002
Reviewed By: Mary D. Ruppe, M.D., Division of Endocrinology and Metabolism, Johns Hopkins Hospital, Baltimore, MD. Review provided by VeriMed Healthcare Network
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