A urine test for cortisol why is it done and how to take it correctly

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The study of urine for cortisol is widely used in the treatment of various hormonal abnormalities. Indications of this analysis allow to determine the presence of systemic diseases of varying severity. One of the most severe conditions for adrenal gland failure are Addison’s disease and Itsenko-Cushing’s syndrome.

Cortisol in urine is determined using a special technique. The accuracy of the test result, as a rule, depends on the patient himself, therefore, a urine test for cortisol content should be taken strictly following the rules.

The result of a study such as urinary cortisol can be influenced by various physiological conditions, such as severe physical overload, obesity, or puberty in adolescents. The rate in women during the period of bearing a child is slightly different.

You should know which doctor to contact if the results of this study deviate from the norm, since the patient’s health depends on this.

What is cortisol

Cortisol is a hormone of the adrenal cortex. He is responsible for the stable functioning of the whole organism under stress and various physiological conditions. It refers to steroid hormones that regulate carbohydrate metabolism.

The energy balance of the body directly depends on the production of this hormone. The concentration of free cortisol is measured in both urine and blood. Blood cortisol levels can vary throughout the day. So, its level in the blood is higher in the morning than in the evening.

And free cortisol in urine does not depend on the time of day and has a constant value. Thus, it is the determination of the level of this hormone in the urine that has a special diagnostic value, for example, in Itsenko’s disease.

Indications for urinalysis for cortisol

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There are conditions in which the doctor may suspect that the patient’s adrenal glands are not working correctly. In some of them, hormones are produced by this organ in excess, while in others – with a deficiency. Consider for what diseases a daily test for cortisol in the urine is prescribed.

To exclude or confirm Cushing’s syndrome or disease, an analysis of free cortisol in daily urine is prescribed. This pathology, in which cortisol will be increased, is one of the most serious. In addition, doctors prescribe this study to exclude other pathologies. Indications for this can be the following states:

  • weakness of muscle tone,
  • high blood pressure
  • premature puberty,
  • the presence of primary male sexual characteristics in female representatives,
  • excessive pigmentation or discoloration of the skin,
  • hyperplasia of the adrenal cortex,
  • oncological diseases,
  • osteoporosis,
  • congenital abnormalities in the development of various organs.

Preparation for collection of analyzes

In order for the result of urine analysis for cortisol to be as accurate as possible, you need to prepare for it. It is important on the eve of the study not to eat spicy foods, spicy and salty, and brightly colored vegetables and fruits such as beets, carrots, etc. are not recommended, alcohol is also prohibited.

A few days before giving urine for examination, you must stop taking certain medications, such as corticosteroids, diuretics and contraceptives.

In addition, on the eve of the procedure, heavy physical exertion should be excluded, participation in sports activities and emotional overloads are also prohibited, for example, exams, etc. Preparation for this procedure is important, and the accuracy of the indications depends on it, therefore it must be approached responsibly.

How to properly pass a urine test for cortisol, the patient should be told by the doctor or nurse who gives the referral for the study. On the day of the analysis, you need to wash yourself thoroughly and only after that collect the material for analysis.

Factors affecting test results

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In order for the test for cortisol to be accurate enough, it is necessary to know what factors can influence its result. Increased rates can be found in women during pregnancy, during stress, trauma and in the postoperative period.

Treatment with corticosteroids also provokes an overestimated result. In addition, taking diuretic drugs will also increase the study result. Do not smoke while collecting -hour urine, this can also distort the results.

An underestimated result can be observed with renal failure and when taking drugs that include ethacrynic acid and thiazides. In addition, the patient must know how to correctly take an analysis for the content of free cortisol in the urine, since a violation of the procedure affects the result of the study.

All urine collected during the day is left for analysis, with the exception of the morning portion. The correctness of the preliminary preparation and procedure for collecting the analysis affects the accuracy of the study, which, in turn, affects the reliability of the diagnosis made by the doctor.

Collecting material for analysis

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Collecting daily urine for cortisol differs from collecting a general urine test. The result of the analysis largely depends on the patient himself, that is, on the preliminary preparation and correct collection of material. To test urine for cortisol, it is required to collect all daily urine.

To do this, you need to prepare a suitable container with a volume of 3 liters with a tight-fitting lid, which will store the urine collected during the day, and a preservative – boric acid, you can buy it at a pharmacy or get it for free at a polyclinic laboratory.

Boric acid will maintain the necessary acidity of urine. The collection container should be stored in a cool, dark place, such as a refrigerator.

So, how to properly collect daily urine for cortisol? On the day of collection of the biomaterial, it is advisable not to take any medications. The drinking regime is normal, but it should be noted that alcohol and smoking should be excluded on this day.

Early in the morning it is necessary to carry out the toilet of the external genital organs. The first morning urine sample is not suitable for analysis. It drains into the toilet. Further, all daily urine is collected for analysis for cortisol. Each subsequent portion of the biological fluid is drained into a prepared three-liter jar.

It is necessary to collect all the daily urine, regardless of the time of day, that is, all the urine produced during the day and in the evening is collected, and if there is a need to go to the toilet at night, then this portion is also included. The last portion is harvested the next morning.

Next, the total volume of all collected urine is measured, and this figure is recorded on the direction. Then all the liquid is thoroughly mixed and approximately 100 milliliters is poured into a sterile container to collect the biomaterial. This amount of urine will be sufficient for analysis and should be taken to the laboratory as soon as possible.

The rate of cortisol in urine

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The study for cortisol in the analysis of daily urine is carried out using a special technique. The indicated volume of collected urine is required to calculate the daily amount of cortisol.

The result of the study largely depends on the patient himself, more precisely, on how correctly the preliminary preparation and collection of the biomaterial itself was carried out. The rate of cortisol in women and men does not differ by sex, but varies with age.

In children, cortisol in daily urine ranges from 6 to 75 nmol/L (nanomolar per liter) per day.

In adolescents, this indicator varies from 15 to 154 nmol/l.

Free cortisol in daily urine in adults normally ranges from 55 to 249 nmol/L.

Thus, the older the person, the higher the rates.

Interpretation of results

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What does the research result say? In some pathological processes, cortisol in the urine is increased. These are states such as:

  • oncological diseases of the adrenal glands, uterus, ovaries, bronchi, pituitary gland, tumors of other organs,
  • Itsenko-Cushing’s disease,
  • hyperthyroidism
  • diabetes,
  • obesity.

It should be noted that Cushing’s disease is most often triggered by a pituitary adenoma of the brain. It is the pituitary gland that controls the function of the adrenal cortex, which synthesizes cortisol. The reasons for the increase in the hormone in the blood are carefully investigated, and, depending on this, treatment is prescribed.

In addition, there are physiological conditions in which an increase in hydrocortisone levels is considered normal. These include:

  • overweight,
  • puberty in adolescents,
  • pregnancy in women.

When the amount of the hormone decreases, it can provoke muscle weakness, hypotension, weight loss, apathy, and abdominal pain. A decrease in this indicator is possible with prolonged use of corticosteroid drugs, as well as in women with various violations of the menstrual cycle.

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Cortisol in urine is lowered in the following pathologies:

  • Addison’s disease
  • hypothyroidism,
  • tumor processes of a different nature in the brain,
  • chronic hepatitis,
  • renal failure
  • cirrhosis of the liver and other pathological changes in organs.

The condition of the adrenal glands affects the production of cortisol. The prognosis of the disease depends on a timely and correct diagnosis.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.