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Laboratory Tests to Assess Cortisol Concentration

Laboratory Tests to Assess Cortisol Concentration


Two of the most serious adrenal disorders are Addison’s disease and Cushing’s syndrome. To diagnose these, levels of cortisol must be assessed and this is usually done by blood and urine test. However, there are health professionals that use salivary cortisol to detect Cushing’s syndrome and assess other stress-related diseases but these are not that widespread. 


The urine and blood tests are the 2 most frequent tests to assess cortisol production. Once an abnormal concentration has been detected, additional diagnostic tests are done to help confirm the deficiency or excess and to help determine the cause.

This neurotransmitter is affected by Calm PRT and AdreCor

ACTH Stimulation

ACTH stimulation test is usually done if the initial urine and/or blood cortisol test show insufficient production of cortisol. The test measures one’s level of cortisol before and after the injection of synthetic ACTH. Increased cortisol concentration indicates that the adrenal glands are functioning normally. A longer version of this test usually takes 1 to 3 days and is done to help distinguish between pituitary and adrenal insufficiency.


Dexamethasone Suppression

Dexamethasone suppression test is usually done if the initial urine and/or blood cortisol test show excessive cortisol production. This test helps determine whether the cause is due to excess ACTH production by the pituitary gland. The test is done by measuring the urine and blood cortisol level of a patient after giving him or her an oral dexamathasone, a synthetic glucocorticoid. Dexamethasone inhibits the production of ACTH and should therefore decrease the production of cortisol.  There may be variations in the dosing schedules but it is commonly given every 6 hours for 2 to 4 days before the collection of urine or blood. There is a separate 24 hour urine sample is obtained prior and throughout the testing period. Cortisol levels are then measured and evaluated.  

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