Cortisol, Total Most Popular
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The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.
Also known as: Cortisol Total, Hydrocortisone, Total Cortisol
Cortisol, Total
The Cortisol, Total test contains 1 test with 1 biomarker .
Brief Description: The Cortisol Total test is a laboratory test that measures the total amount of cortisol in the blood. Cortisol is a hormone produced by the adrenal glands in response to stress and plays a crucial role in regulating various physiological processes in the body, including metabolism, immune response, and stress response.
Also Known As: Cortisol Total Test, Cortisol Test, Cortisol Blood Test
Testing Method: Immunoassay
Collection Method: Blood Draw 
Specimen: 1 ml Serum 
Test Preparation: No prepration required.
Medication Interactions: Test not recommended when patient is on prednisone/prednisolone therapy due to cross reactivity with the antibody used in this test
When is a Cortisol Total test ordered?
A Cortisol Total test may be ordered in the following situations:
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Evaluation of Adrenal Function: The test is commonly ordered to assess adrenal gland function, especially in patients with suspected adrenal insufficiency or adrenal disorders. It helps determine the overall cortisol production and its circadian rhythm.
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Diagnosis of Cushing's Syndrome: Cushing's syndrome is a condition characterized by excessive cortisol production. The Cortisol Total test can aid in the diagnosis of Cushing's syndrome by measuring the total cortisol level in the blood.
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Evaluation of Stress Response: In some cases, the Cortisol Total test may be ordered to evaluate the body's response to stress. It can help assess whether cortisol levels are within the expected range during stressful situations or if there is an abnormal response.
What does a Cortisol Total blood test check for?
Cortisol is a hormone that plays a function in protein, lipid, and carbohydrate metabolism. It has an effect on blood glucose levels, blood pressure, and immune system regulation. Only a small fraction of cortisol in the blood is "free" and biologically active; the majority is attached to a protein. Cortisol is a hormone that is produced into the urine and found in the saliva. This test determines how much cortisol is present in the blood, urine, or saliva.
Cortisol levels in the blood usually rise and fall in a pattern known as "diurnal variation." It reaches its highest point early in the morning, then gradually decreases over the day, reaching its lowest point around midnight. When a person works irregular shifts and sleeps at different times of the day, this rhythm might fluctuate, and it can be disrupted when a disease or condition inhibits or stimulates cortisol production.
The adrenal glands, two triangle organs that sit on top of the kidneys, generate and emit cortisol. The hypothalamus in the brain and the pituitary gland, a small organ below the brain, control the hormone's production. The hypothalamus produces corticotropin-releasing hormone when blood cortisol levels drop, which tells the pituitary gland to create ACTH. The adrenal glands are stimulated by ACTH to generate and release cortisol. The brain, pituitary, and adrenal glands must all be operating properly in order to produce enough levels of cortisol.
Cushing syndrome is a collection of signs and symptoms associated with an unusually high cortisol level. Cortisol production may be increased as a result of:
- Large doses of glucocorticosteroid hormones are given to treat a range of ailments, including autoimmune illness and certain cancers.
- Tumors that produce ACTH in the pituitary gland and/or other regions of the body.
- Cortisol production by the adrenal glands is increased as a result of a tumor or abnormal expansion of adrenal tissues.
Rarely, CRH-producing malignancies in various regions of the body.
Cortisol production may be reduced as a result of:
- Secondary adrenal insufficiency is caused by an underactive pituitary gland or a pituitary gland tumor that prevents ACTH production.
- Primary adrenal insufficiency, often known as Addison disease, is characterized by underactive or injured adrenal glands that limit cortisol production.
After quitting glucocorticosteroid hormone medication, especially if it was abruptly stopped after a long time of use.
Lab tests often ordered with a Cortisol Total test:
When a Cortisol Total test is ordered, it's often part of an evaluation for conditions such as Cushing's syndrome (where cortisol levels are high) or Addison's disease (where cortisol levels are low). Several other tests are commonly ordered alongside it to provide a more comprehensive assessment:
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ACTH (Adrenocorticotropic Hormone) Test:
- Purpose: ACTH is a hormone produced by the pituitary gland that stimulates the adrenal glands to produce cortisol.
- Why Is It Ordered: To help determine whether abnormal cortisol levels are due to a problem with the adrenal glands or with the pituitary gland. Elevated ACTH can indicate primary adrenal insufficiency (Addison’s disease), while low levels might be seen in secondary adrenal insufficiency due to pituitary dysfunction.
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- Purpose: Checks how taking a steroid (dexamethasone) affects cortisol production.
- Why Is It Ordered: To help diagnose Cushing's syndrome and differentiate between different types of Cushing's syndrome and other conditions causing elevated cortisol.
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- Purpose: To measure levels of renin and aldosterone, hormones that help regulate blood pressure and fluid balance.
- Why Is It Ordered: These tests can be useful in evaluating adrenal function and differentiating between various adrenal and renal disorders.
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- Purpose: To measure electrolyte levels.
- Why Is It Ordered: Cortisol can affect fluid and electrolyte balance; abnormalities might indicate an adrenal problem.
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- Purpose: To measure blood sugar levels.
- Why Is It Ordered: Cortisol influences glucose metabolism, and abnormalities in cortisol levels can lead to changes in blood sugar levels.
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- Purpose: To provide a general overview of health.
- Why Is It Ordered: Chronic stress and cortisol imbalances can affect the immune system and blood cell production.
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Thyroid Function Tests (such as TSH, Free T3, Free T4):
- Purpose: To assess thyroid function.
- Why Is It Ordered: Thyroid and adrenal glands can affect each other's function, and symptoms of thyroid disorders can sometimes mimic those of adrenal disorders.
These tests, when ordered alongside a Cortisol Total test, provide a comprehensive view of an individual’s adrenal function and help in diagnosing disorders related to cortisol production. They are essential for understanding the extent of the disorder, monitoring organ involvement, and guiding treatment. The specific combination of tests will depend on the individual’s symptoms, clinical history, and the results of the initial cortisol test.
Conditions where a Cortisol Test is recommended:
A Cortisol Total test may be required in the following conditions or diseases:
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Adrenal Insufficiency: Cortisol Total test helps diagnose adrenal insufficiency, a condition characterized by insufficient cortisol production. It aids in assessing adrenal gland function and guiding appropriate treatment.
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Cushing's Syndrome: Cortisol Total test is useful in diagnosing Cushing's syndrome, a disorder caused by excessive cortisol production. It helps identify the underlying cause of increased cortisol levels.
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Stress-related Disorders: In certain cases, the Cortisol Total test may be ordered to evaluate the body's response to stress in conditions such as chronic stress, post-traumatic stress disorder (PTSD), or adrenal hyperactivity.
How does my healthcare provider use a Cortisol Total test?
Health care providers use the results of a Cortisol Total test to:
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Diagnose and Monitor Adrenal Disorders: Abnormal cortisol levels can indicate adrenal gland dysfunction, allowing health care providers to diagnose and monitor conditions such as adrenal insufficiency or Cushing's syndrome.
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Guide Treatment Decisions: The Cortisol Total test helps health care providers determine appropriate treatment strategies for adrenal disorders. It aids in adjusting medication dosages or implementing hormonal replacement therapy to restore cortisol balance.
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Assess Stress Response: In stress-related disorders, the Cortisol Total test helps evaluate the body's response to stressors and can assist in determining treatment plans or interventions to manage the stress response effectively.
It's essential to interpret the Cortisol Total test results in conjunction with the patient's clinical history, symptoms, and other relevant tests to make an accurate diagnosis and develop an appropriate management plan.
What do my Cortisol Total test results mean?
Cortisol levels are typically lowest before bedtime and highest shortly after awakening, though this pattern can be disrupted if a person works rotating shifts and sleeps at various times on separate days.
Excess cortisol and Cushing syndrome are indicated by an increased or normal cortisol level shortly after awakening, as well as a level that does not diminish by bedtime. If the excess cortisol is not suppressed after an overnight dexamethasone suppression test, the 24-hour urine cortisol is elevated, or the late-night salivary cortisol level is elevated, the excess cortisol is likely due to abnormal increased ACTH production by the pituitary or a tumor outside of the pituitary, or abnormal production by the adrenal glands. Additional tests will aid in determining the root of the problem.
If the person examined responds to an ACTH stimulation test and has insufficient cortisol, the problem is most likely due to insufficient ACTH production by the pituitary. If the person does not respond to the ACTH stimulation test, the problem is most likely to be with the adrenal glands. Secondary adrenal insufficiency occurs when the adrenal glands are underactive as a result of pituitary dysfunction and/or insufficient ACTH synthesis. Adrenal injury causes decreased cortisol production, which is referred to as primary adrenal insufficiency or Addison disease.
Once an irregularity has been found and linked to the pituitary gland, adrenal glands, or another source, the health practitioner may utilize additional testing, such as a CT scan, to determine the extent of any gland damage.
Most Common Quesitons About the Cortisol test:
Understanding the Cortisol Total Test and Its Purpose
What is the Cortisol Total test?
The Cortisol Total test measures the level of cortisol, a steroid hormone, in your blood. Cortisol is produced by the adrenal glands and is vital in regulating the body's response to stress, metabolism, and immune response.
Why is the Cortisol Total test performed?
The Cortisol Total test is typically performed to evaluate the function of the adrenal and pituitary glands. It helps diagnose conditions related to cortisol level imbalances, such as Cushing's syndrome and Addison's disease.
Who should get the Cortisol Total test?
This test may be recommended for individuals exhibiting symptoms of a cortisol imbalance, such as unexplained weight loss or gain, muscle weakness, fatigue, high blood pressure, and changes in mood.
Interpreting Test Results and Abnormal Findings
What do results of the Cortisol Total test mean?
Normal cortisol levels vary throughout the day but are generally highest in the morning and lowest around midnight. Abnormally high or low levels may indicate health issues like Cushing's syndrome or Addison's disease, respectively.
What could cause elevated levels of cortisol?
Elevated cortisol levels could be due to various reasons, including Cushing's syndrome, stress, depression, physical trauma, or conditions like obesity or high blood pressure.
What could cause low levels of cortisol?
Low cortisol levels could be caused by Addison's disease, hypopituitarism, or adrenal insufficiency. Some medications, like steroids, can also lower cortisol levels.
Understanding the Implications and Health Impact
What role does cortisol play in the body?
Cortisol has various functions in the body. It plays a crucial role in the body's response to stress, helps maintain blood sugar levels, reduces inflammation, assists with memory formulation, and is involved in the metabolism of proteins, fats, and carbohydrates.
What health conditions can be associated with abnormal cortisol levels?
High cortisol levels can be associated with Cushing's syndrome, while low levels can indicate Addison's disease. Chronic stress, depression, and some other medical conditions can also affect cortisol levels.
Risk Factors, Prevention, and Treatment
How can I influence my cortisol levels?
While cortisol levels are mainly controlled by your body's internal processes, certain lifestyle changes can influence them. These include managing stress, maintaining a regular sleep schedule, eating a balanced diet, and getting regular exercise.
Can medication help regulate abnormal cortisol levels?
Yes, medications can be used to regulate cortisol levels. In cases of Cushing's syndrome, drugs can be prescribed to reduce the production of cortisol. For Addison's disease, hormone replacement therapy may be needed to maintain normal cortisol levels.
What happens if abnormal cortisol levels are left untreated?
If left untreated, abnormal cortisol levels can lead to various health problems. High cortisol levels can cause Cushing's syndrome, leading to weight gain, high blood pressure, and type 2 diabetes. On the other hand, low cortisol levels can cause Addison's disease, which can result in severe fatigue, loss of appetite, weight loss, and low blood pressure.
How does the Cortisol Total test relate to other hormone tests?
The Cortisol Total test is often performed alongside other hormone tests, like ACTH, to provide a comprehensive view of an individual's hormonal balance and help identify possible disorders.
Are there any future potential treatments for cortisol-related disorders?
Research into cortisol-related disorders is ongoing. There are ongoing studies into new medications for conditions like Cushing's syndrome and Addison's disease, and new diagnostic techniques are also being explored.
How often should I get a Cortisol Total test?
The frequency of the Cortisol Total test depends on your individual circumstances. Your healthcare provider will recommend how often you should get tested based on your medical history, symptoms, and risk factors.
Can pregnancy influence the results of a Cortisol Total test?
Yes, pregnancy can influence cortisol levels. Cortisol levels naturally rise during pregnancy, so it's essential to consider this when interpreting the results of a Cortisol Total test.
We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.