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Cortisol, 24-Hour Urinary Free (Total)

Published: August 9, 2026Updated: August 16, 2026

This test measures the total amount of cortisol, a natural steroid hormone, excreted in your urine over a 24-hour period. Cortisol helps regulate metabolism, immune response, and stress reactions.

Quick summary

["Assesses long-term cortisol levels to diagnose conditions like Cushing’s syndrome or adrenal insufficiency."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 16, 2026Editorial policy

Key facts at a glance

LOINC
32312-1
Short code
Cortis 2h p chal SerPl-sCnc
Synonyms
Cortis 2h p chal SerPl-sCnc
Category
hormone
Sample
serum
Container
Red-top tube (SST)
Units
N/A
Fasting
false
Population
adult
Sex
all
Age range
18–65 years
Specimen volume
5 mL
Stability
Room temperature: 4h, Refrigerated: 24h, Frozen: 7d
Hemolysis max
500
Lipemia max
1000
Icterus max
500
TAT
4–24 hours
Order
routine

Why This Test Matters

Cortisol is released by your adrenal glands in response to stress, but chronic high or low levels can signal underlying health issues. Measuring urinary cortisol helps doctors evaluate whether your body produces too much or too little cortisol over time.

What to Expect Before the Test

You’ll collect all urine for a full 24-hour period, typically starting after midnight of one day and ending midnight the next. A healthcare provider will give you instructions to ensure accurate collection.

How the Test Works

Your urine sample is analyzed to determine the total cortisol content, which reflects your body’s natural cortisol production over the day. This method helps avoid fluctuations that can occur with single blood or saliva tests.

Common Conditions Monitored

This test is often used to diagnose conditions like Cushing’s syndrome (too much cortisol) or adrenal insufficiency (too little cortisol), as well as to monitor treatment responses in patients on long-term steroid medications.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

24-Hour Urine Cortisol

Frequently asked questions

Why do doctors order this test?
Doctors may recommend this test if you have symptoms like unexplained weight changes, fatigue, high blood pressure, or signs of excess cortisol (e.g., bruising easily, thinning skin). It helps distinguish between conditions like Cushing’s syndrome or adrenal disorders.
What does a high or low result mean?
A high urinary cortisol result may suggest Cushing’s syndrome or prolonged stress. A low result could indicate adrenal insufficiency or other hormonal imbalances. Your doctor will interpret results in the context of your symptoms and medical history.
Can I take medications before this test?
Some medications, like certain steroids or blood pressure drugs, may affect cortisol levels. Always follow your doctor’s instructions—some may ask you to temporarily adjust or avoid certain medications before testing.
  1. 1
    MedlinePlus — Laboratory TestsSource
  2. 2
    Lab Tests OnlineSource
  3. 3
    Mayo Clinic — Tests & ProceduresSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 16, 2026. · Read our editorial policy