Cortisol test

A cortisol test measures the cortisol level in the saliva, urine or blood to check if cortisol is within the normal range in your body. Cortisol is an important hormone in the body, affecting most tissues and organs. It aids the following:

• Response to stress (it is also called the stress hormone)
• Regulate metabolism and blood sugar (how the body uses food to make energy)
• Control blood pressure
• Reduce inflammation

The adrenal gland (the two small glands on the kidneys) produces cortisol. A gland in the pituitary gland of the brain produces a hormone that controls the amount of cortisol produced by the adrenal gland. If your cortisol level becomes too low or too high, you may have a disorder of the adrenal gland, a tumour that produces cortisol or a problem with the pituitary gland.

Elevated cortisol levels may also occur from prolonged intake of large doses of some steroid medicines such as prednisone. Low cortisol levels occur if you suddenly stop the medicine. Without treatment, elevated and extremely low levels of cortisol can be serious.

Other names of cortisol include free cortisol, salivary cortisol, blood cortisol, urinary cortisol and plasma cortisol.

What is the test for?

A cortisol test helps the doctor determine if the adrenal glands are producing the right amount of the cortisol hormone. Cortisol measurement can help in diagnosing or monitoring certain health conditions.

Diagnostic testing aids in determining the cause of symptoms. It can help rule out or diagnose conditions responsible for abnormal cortisol levels, such as:

• Addison disease – a disorder where the adrenal gland produces insufficient hormones like cortisol
• Cushing’s syndrome – a condition resulting from high cortisol levels
• Cushing’s disease – a type of Cushing’s syndrome where an elevated level of the hormone called adrenocorticotropic hormone (ACTH) causes overproduction of cortisol

Monitoring tests are important to understand health changes over time. Cortisol testing monitors the effectiveness of treatment for people with unusually high or low cortisol levels.

Why is a cortisol test necessary?

You may need cortisol testing if you experience symptoms of a condition that affects your cortisol levels.

Symptoms of Cushing’s syndrome

• Easy bruising
• Weight gain
• Thin legs and arms
• Muscle weakness
• Wide purple streaks on the hips, under the arms, breasts and stomach
• Increased fat between the shoulder blades or around the base of the neck
• Round face

Symptoms of adrenal insufficiency (low cortisol) and Addison disease

• Weight loss
• Long-lasting fatigue
• Loss of appetite
• Abdominal (belly) pain
• Muscle weakness

What are the symptoms of elevated cortisol levels?

The symptoms of Cushing’s syndrome are;

• Red, round face
• Change in sex drive
• Balding or excessive hair growth
• High blood pressure (hypertension)
• Weight gain
• Stunted growth in children
• Wounds that heal properly
• Purple stretch marks on the abdomen
• Easy bruising on the legs and arms
• Increased risk of blood clots
• Mood swings
• Increased risk of fracture and weaker bones
• Diabetes

What are the symptoms of low cortisol levels?

The symptoms of Addison’s disease are:

• Dehydration
• Abnormal menstrual periods
• Abdominal pain
• Irritability
• Vomiting, nausea, or diarrhoea
• Muscle weakness, especially while combing hair and climbing stairs
• Low blood pressure (hypotension)
• Low blood glucose (hypoglycaemia)
• Cravings for salty food, unexplained weight loss or loss of appetite
• Darkening lips, palms and gums, patches of dark skin

When do I need this test?

Your healthcare provider may recommend getting a cortisol test if they think you have a condition that affects your cortisol levels. The doctor may order this test if you have a health problem that isn’t common for people in your age range, such as younger people with osteoporosis or hypertension.

Your doctor may also recommend the test if you have a severe health issue that affects cortisol levels or if they find an adrenal tumour during imaging tests for other health issues.

A recommendation for cortisol testing may also be based on your symptoms, particularly if you experience more than one symptom of high cortisol levels that worsens over time. These symptoms include:

• Fat accumulating around the base of your neck
• Unexplained weight gain, especially in children
• High blood sugar
• High blood pressure
• Lowered fertility and reduced interest in sex in people assigned male at birth or men
• Erectile dysfunction
• Slow growth in children
• A hump-like fat accumulation between the shoulders
• Irregular or no menstrual periods
• Unexplained body and facial hair growth

Your doctor may also recommend cortisol testing if you experience symptoms of low cortisol or suspect acute adrenal crises, an emergency resulting from insufficient cortisol.

The symptoms of low cortisol include:

• Abdominal pain
• Appetite loss
• Unexplained weight loss
• Muscle weakness
• Chronic fatigue

Conditions that cause low and high cortisol levels rarely occur, and other diseases usually cause most of these symptoms, so the doctor may recommend testing for other conditions before cortisol testing.

Cortisol testing can also serve as a monitoring test if you have had a previous high cortisol diagnosis and are taking medication to reduce your cortisol levels.

How much is a cortisol test?

The cost of cortisol testing depends on several factors, such as:

• Whether the test uses saliva, urine or blood
• The testing location
• Whether the test is done alone or with other tests
• Whether it is a repeated test
• Whether you have health insurance and if you do, the health insurance coverage details.

The total cost for a cortisol test may include fees for blood draws, laboratory analysis and office visits. Health insurance may cover some or all of these charges, but you may pay out-of-pocket for copayments or deductibles.

Consult your doctor and insurance provider for more information on the cost of your cortisol test. If you have no health insurance, contact your hospital administration or doctor about the estimated cost of your cortisol testing and if any programs are available to reduce the cost of your test.

If you have too low or high cortisol symptoms or your doctor has ordered cortisol testing, visit Blood London today for your cortisol test. You can call us on 020 71830244 for more information on cortisol testing or to book an appointment.