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Cortisol Level
The body's cortisol level in the bloodstream displays what is known
as a diurnal variation - that is, normal concentrations of cortisol
level vary throughout a 24-hour period, with levels in normal
individuals being highest in the early morning at around 6-8 am.
Lowest levels occur lowest around midnight. A normal cortisol
level in the bloodstream range from 6-23 mcg/dl (micrograms per
deciliter).
What does a blood cortisol test result mean?
An adult has a slightly higher cortisol level than a child does. In
normal people, cortisol levels are very low at bedtime, and at their
highest just after waking. In Cushing syndrome, this pattern is
typically lost, so bedtime cortisol is often used when your doctor
suspects this diagnosis.
A urine cortisol level requires collecting all urine for a 24-hour
period, and provides information about total cortisol production by
your adrenal gland. High blood and urine levels of cortisol indicate
Cushing syndrome, and low blood and urine levels suggest
Addison disease.
Pregnancy, as well as physical and emotional stress, increases
cortisol levels. Stress can slightly increase your cortisol level, and
levels go up significantly when you are sick. Cortisol levels may
also increase as a result of hyperthyroidism or obesity. A number
of drugs can also increase levels, particularly oral contraceptives
(birth control pills), hydrocortisone (the synthetic form of cortisol),
and spironolactone.
Hypothyroidism may decrease your cortisol level. Drugs that may
decrease levels include some steroid hormones.
For the blood cortisol test, you should maintain a normal salt diet
(2 to 3 grams per day) beforehand, and fast and limit physical
activity for 10 to 12 hours prior to the test.
Salivary cortisol testing is being used more frequently to help
diagnose Cushing syndrome and stress-related disorders but still
requires specialized expertise to perform and is not yet widely
available.
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