Quick Facts
- Sample: 24-hour urine collection
- Fasting: Not required
- Turn-around: 7-12 business days. May take longer based on weather, holiday or lab delays.
Benefits
- Comprehensive adrenal assessment using advanced LC-MS/MS technology for maximum accuracy.
- Convenient at-home collection eliminates need for doctor visits or lab appointments.
- Complete hormone profile captures daily fluctuations other tests miss.
- Early detection of Cushing's syndrome with 95% sensitivity and 98% specificity.
- Confidential results delivered securely online.
- Cost-effective screening for unexplained symptoms like fatigue and weight changes.
Who Is This Test For?
- Individuals experiencing unexplained weight gain, especially around midsection and upper back.
- People with persistent fatigue, high blood pressure, or mood changes.
- Those with purple stretch marks, easy bruising, or slow-healing wounds.
- Patients monitoring known adrenal disorders or treatment effectiveness.
- Anyone with a family history of Cushing's syndrome or Addison's disease.
- Health-conscious individuals seeking comprehensive hormone screening.
How It Works - Just 3 Steps
- Order online and receive your collection kit with detailed instructions.
- Collect all urine over 24 hours in the provided container, keeping refrigerated.
- Ship your sample using the prepaid label and access results online.
FAQ
What does this test measure? Free cortisol, cortisone, and creatinine levels in your urine over 24 hours to assess adrenal function.
How accurate is this test? The LC-MS/MS method provides 95% sensitivity and 98% specificity for detecting Cushing's syndrome (Analytical and Bioanalytical Chemistry 2022).
Do I need to stop medications? Some medications like steroids or estrogen may affect results. Consult your healthcare provider about timing.
What if my results are abnormal? Follow up with your healthcare provider for additional testing and proper interpretation of results.
Can I exercise during collection? Avoid vigorous exercise the day before and during collection as it may affect cortisol levels.
How do I store the sample? Keep the collection container refrigerated throughout the 24-hour period and ship promptly.
More Details
What is the purpose of this test?
This test evaluates your adrenal glands by measuring free cortisol and cortisone production over 24 hours. It helps diagnose conditions like Cushing's syndrome (excess cortisol) and Addison's disease (insufficient cortisol). The creatinine measurement ensures sample accuracy and proper collection (MedlinePlus 2023).
Who would benefit from this test?
Anyone experiencing symptoms of hormone imbalance should consider this test. Common indicators include central weight gain, purple stretch marks, easy bruising, muscle weakness, or mood changes. It's especially valuable for those with high blood pressure, diabetes, or bone loss that might be hormone-related (Mayo Clinic 2024).
When should I order this test?
Order when experiencing unexplained symptoms lasting several weeks, especially weight changes or persistent fatigue. It's also recommended for monitoring known adrenal conditions or when other hormone tests suggest imbalances. Timing isn't cycle-dependent, making it convenient for both men and women.
How do I interpret the results?
Free cortisol: 4–50 mcg/24hrs
- What it means: Normal adrenal function
- Typical action: Continue routine monitoring
Free cortisol: Above 50 mcg/24hrs
- What it means: Possible Cushing's syndrome
- Typical action: Endocrinologist consultation recommended
Free cortisol: Below 4 mcg/24hrs
- What it means: Possible adrenal insufficiency
- Typical action: Further testing with ACTH stimulation
Cortisone: 23–195 mcg/24hrs
- What it means: Normal enzyme function
- Typical action: No immediate action needed
Cushing's syndrome affects approximately 10-15 people per million annually in the U.S. (NIH 2023).
Disclaimer: Reference ranges may vary by laboratory. Listed ranges are general guidelines and may differ from those used by the performing lab. Always consult your healthcare provider for interpretation
Pre-test preparation
Maintain your normal routine but avoid strenuous exercise 24 hours before collection. Some medications may need temporary discontinuation—consult your healthcare provider. Avoid excessive licorice intake, which can affect cortisone metabolism. Start collection upon waking and continue for exactly 24 hours.
How often should I get tested?
- Initial screening with symptoms: Once, then follow-up if abnormal
- Monitoring known adrenal disorders: Every 3–6 months
- Treatment effectiveness tracking: As directed by healthcare provider
- Preventive health screening: Annually if risk factors present
Why early detection matters
Early identification of adrenal disorders prevents serious complications including cardiovascular disease, diabetes, bone loss, and psychiatric symptoms. Untreated Cushing's syndrome can lead to life-threatening complications, while early intervention significantly improves outcomes and quality of life (Mayo Clinic 2024).
Related tests you may consider
Adrenocorticotropic Hormone (ACTH) Blood Testmeasures levels of ACTH in the blood to diagnose conditions related to abnormal cortisol levels.
Creatine Kinase Isoenzymes (CK Isoenzymes) Blood Test without Total CK is useful in locating damage to muscles in your body, including heart, brain, and skeletal muscle.
Cortisol Blood Test, Random Serum detects excess or deficient cortisol production.
Comprehensive Metabolic Panel (CMP-14) with eGFR Blood Test evaluates nutrient levels, liver, and kidney function.
