Cortisol, 24-hour urinary free cortisol (total)
This test measures the total amount of cortisol, a natural steroid hormone, excreted in your urine over a 24-hour period. It helps assess adrenal gland function and hormone balance.
["This test helps diagnose conditions related to cortisol production or metabolism."]
Key facts at a glance
- LOINC
- 87429-7
- Short code
- Cortisol AM + PM Pnl SerPl
- Synonyms
- Cortisol AM + PM Pnl SerPl
- Category
- hormone
- Sample
- serum
- Container
- Red-top tube (SST)
- Units
- N/A
- Ref low
- 6.2
- Ref high
- 19.4
- Critical range
- 3 N/A – 50 N/A
- Fasting
- false
- Population
- adult
- Sex
- all
- Age range
- 18–65 years
- CPT
- 82533
- SNOMED
- 34350002
- 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 Is This Test Done?
Your healthcare provider may order a 24-hour urine cortisol test if you have symptoms like unexplained weight changes, fatigue, mood swings, or signs of hormonal imbalances. It can also be used to evaluate conditions such as Cushing’s syndrome (too much cortisol) or adrenal insufficiency (too little cortisol).
What to Expect Before the Test
You’ll collect all urine produced in a 24-hour period in a special container. Start and end timing at the same time each day (e.g., midnight to midnight). Drink plenty of fluids to ensure full collection. Avoid certain medications that may affect cortisol levels, as directed by your provider.
During the Test
You’ll return the collected urine sample to the lab. The lab will analyze it to measure the total cortisol excreted over the full day. No special preparation is needed beyond following the collection instructions.
After the Test
Results will be reviewed by your healthcare provider to determine if cortisol levels are within expected ranges. They may compare your results to your symptoms and other tests to diagnose conditions like hormonal disorders.
Reference range
Morning: 6.2-19.4 μg/dLN/A
Typically collected in the morning (8-10 AM). Inform your provider if taking steroid medications.
Clinical interpretation
How abnormal results are interpreted and what conditions they suggest.
Elevated 24-hour urine cortisol levels may suggest Cushing’s syndrome, a condition caused by prolonged exposure to high cortisol levels, often due to tumors or excess hormone production. Low levels may indicate adrenal insufficiency, where the adrenal glands fail to produce enough cortisol. This test helps confirm or rule out these conditions and guide treatment decisions.
Short name
24-Hour Urine Cortisol
Frequently asked questions
How is this test different from a blood cortisol test?
What conditions might this test help diagnose?
Can I take medications before this test?
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