Cortisol with 24-Hour Urinary Free Cortisol and Metanephrines (Triple Test)
This test measures cortisol levels in your blood and two urinary metabolites (free cortisol and metanephrines) to help assess your body’s cortisol production and adrenal function over time.
["This panel helps diagnose conditions like Cushing’s syndrome or adrenal insufficiency by evaluating cortisol and its breakdown products."]
Key facts at a glance
- LOINC
- 40316-2
- Short code
- Cortis 2h p Triple Bolus SerPl-sCnc
- Synonyms
- Cortis 2h p Triple Bolus SerPl-sCnc
- Category
- hormone
- Sample
- serum
- Container
- Red-top tube (SST)
- Units
- N/A
- Ref low
- 0.8
- Ref high
- 1.2
- Critical range
- — – 5 N/A
- Fasting
- false
- Population
- adult
- Sex
- all
- Age range
- 18–65 years
- CPT
- 85610
- SNOMED
- 396252006
- 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 Is Done
Your doctor may order this test if they suspect hormonal imbalances, such as overproduction of cortisol (Cushing’s syndrome) or underproduction (adrenal insufficiency). It’s also used to monitor conditions like pheochromocytoma (a tumor affecting hormone production).
What to Expect Before the Test
For the blood test, you’ll likely have a simple vein stick. For the 24-hour urine collection, you’ll collect urine for a full day, typically starting after a morning void. Follow your doctor’s instructions carefully to ensure accurate results.
Blood Test: Cortisol Levels
Cortisol is a stress hormone produced by your adrenal glands. Elevated blood cortisol may indicate overproduction (e.g., from tumors or excess steroid use), while low levels may suggest adrenal gland dysfunction.
Urine Test: Free Cortisol and Metanephrines
Free cortisol in urine reflects cortisol production over 24 hours, while metanephrines (byproducts of adrenaline and noradrenaline) help detect tumors affecting these hormones. These tests together provide a more complete picture than blood alone.
Reference range
INR: 0.8-1.2 (warfarin: 2.0-3.0)N/A
Inform your healthcare provider if you are taking blood thinners. No special preparation required.
Clinical interpretation
How abnormal results are interpreted and what conditions they suggest.
Clinical Significance
Short name
Cortisol Panel (Triple Bolus)
Frequently asked questions
Elevated cortisol and metanephrines may point to Cushing’s syndrome or pheochromocytoma, while abnormal blood cortisol could indicate adrenal insufficiency or other hormonal disorders. This panel helps guide treatment decisions.
Your results will be compared to reference ranges for your age and health status. If results are out of range, further testing or evaluation may be needed to determine the cause.
The blood test is typically done in the morning, while the urine test spans a full 24-hour period. Follow your doctor’s exact instructions for timing and sample collection.
Sources
- 1
- 2Lab Tests OnlineSource
- 3
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.
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