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Cortisol Test

General Instructions

When taking a cortisol test, the patient is asked to avoid physical activity for the day preceding the blood test and may be asked to rest or lie down for the half hour directly before blood is given. Like strenuous activity, medications can also have a large effect on test results. One should speak with a doctor about all of the medications and supplements that one is taking before giving blood for the test. Cortisol levels change throughout the day, with the highest levels seen in the morning. Individuals need to make sure that they are being tested during the recommended timeframe.  Normally, there aren't fasting requirements for a cortisol blood test.

Why It Is Used

A cortisol blood test is used to measure the level of cortisol, a hormone which is present in the blood.  The cortisol hormone is produced by the adrenal glands, but the level of cortisol in the blood is also affected by the pituitary glands.  A cortisol test is primarily used to detect any problems with the adrenal or pituitary glands.  Cortisol serves many different purposes in the body - it helps with the metabolizing of sugars and fats and also plays a role in stress management.  Cortisol levels may be altered by emotional stress and arduous physical activity, and also by infection in or injury to the body.    

How It Works

The level of cortisol in one’s bloodstream fluctuates greatly throughout the day.  Cortisol is released into the blood by the adrenal glands.  The production is highest in the early morning, and one will find the highest levels of cortisol in the blood at around 7:00AM.  Throughout the day cortisol levels drop, and they are the lowest in the evening time.  The pituitary gland plays a role in how much cortisol is released into the blood.  The pituitary gland produces a hormone called adrenocorticotropic hormone (ACTH).  When the pituitary gland releases the ACTH hormone into the bloodstream it causes the adrenal glans to produce more cortisol.  If blood cortisol levels results are either too low or too high, they indicate a problem with adrenal and pituitary gland functioning.

Results

Due to the fluctuations in cortisol throughout the day, a doctor may order a lab test to be done at different times of the day, depending on the concern.  For example, if a doctor is concerned that one’s cortisol levels are too high, he or she may order the blood test to be done in the evening when levels are supposed to be low.  If one’s cortisol levels are high - even in the evening, it might indicate that either the adrenal or pituitary glands are over functioning.  If the doctor is concerned that an individual’s cortisol levels are too low, he or she may order the blood test to be taken in the early morning when cortisol levels are supposed to be at their peak.  If cortisol levels are low even in the early morning it is likely that the adrenal and pituitary glands are not working properly. 

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