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Serum/Plasma Free Cortisol Concentration (24-Hour Urinary Total)

Published: August 9, 2026Updated: August 17, 2026

This test measures the total amount of cortisol excreted in your urine over a 24-hour period. Cortisol is a hormone produced by your adrenal glands that helps regulate stress responses and metabolism.

Quick summary

["This test helps assess how well your body produces and handles cortisol over time."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 17, 2026Editorial policy

Key facts at a glance

LOINC
11932-1
Short code
GA from HC.Hadlock84
Synonyms
GA from HC.Hadlock84
Category
chemistry
Sample
serum
Container
Red-top tube (SST)
Units
N/A
Ref low
22
Ref high
198
Critical range
— – 10000 N/A
Fasting
false
Population
adult
Sex
all
Age range
18–65 years
Method
us-estimated-from-hc-hadlock
CPT
82553
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 to diagnose conditions like Cushing’s syndrome (overactive cortisol production), adrenal insufficiency, or to monitor treatment for hormone-related disorders. It can also help identify whether cortisol levels are consistently elevated or low in your urine.

What to Expect Before the Test

No special preparation is needed for this test. You’ll provide a 24-hour urine sample collected in a sealed container, starting and ending at the same time each day. Make sure to drink plenty of fluids to help flush cortisol into your urine.

How the Test Works

Your urine sample is analyzed in a lab to measure the total cortisol content. The test accounts for cortisol that’s naturally broken down or bound in the body, providing a comprehensive picture of your cortisol excretion over a full day.

Possible Results and Their Meaning

Results are compared to standard ranges for healthy adults. High levels may suggest Cushing’s syndrome or other conditions affecting cortisol production, while low levels could indicate adrenal gland issues or other hormonal imbalances.

Reference range

Adult males: 22-198 U/L; Females: 22-198 U/LN/A

Specimen: serum

No special preparation required. Inform provider of any chest pain or symptoms.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

24-Hour Urinary Total Cortisol

Frequently asked questions

What causes abnormal cortisol levels in urine?
Abnormal cortisol levels in urine can result from conditions like Cushing’s syndrome (due to excess cortisol production), adrenal insufficiency (due to low cortisol), or prolonged stress. Other factors, such as certain medications, thyroid disorders, or kidney issues, may also influence results.
How long does it take to get my results?
Results are typically available within 1 to 2 weeks after your sample is submitted to the lab, depending on lab processing times and your healthcare provider’s workflow.
Can I take medications before this test?
Yes, you can take your usual medications, but inform your doctor or lab technician about any medications you’re taking, as some (like steroids) may affect cortisol levels. Avoid sudden changes to your medication routine without consulting your provider.
  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 17, 2026. · Read our editorial policy