Hormone Profile: Adrenocorticotropic Hormone (ACTH) and Cortisol (24-hour urine)
This test measures your body’s natural production of ACTH and cortisol, hormones that help regulate stress and adrenal function. It helps diagnose conditions like Cushing’s syndrome or adrenal insufficiency.
["This test helps identify whether your adrenal glands are overproducing or underproducing key stress hormones."]
Key facts at a glance
- LOINC
- 50601-4
- Short code
- HPA-4 Bld
- Synonyms
- HPA-4 Bld
- Category
- chemistry
- Sample
- whole-blood
- Container
- Lavender-top (EDTA)
- Units
- N/A
- Fasting
- false
- Population
- adult
- Sex
- all
- Age range
- 18–65 years
- Specimen volume
- 3 mL
- Stability
- Room temperature: 4h, Refrigerated: 24h
- Hemolysis max
- 0
- Lipemia max
- 0
- Icterus max
- 0
- TAT
- 4–24 hours
- Order
- routine
Why This Test Is Done
Your doctor may recommend this test if you have symptoms like unexplained weight changes, fatigue, high blood pressure, or unusual hair growth. It’s also used to check for conditions like Cushing’s disease (caused by a pituitary tumor) or adrenal tumors.
How the Test Works
ACTH is measured in blood, while cortisol is measured in a 24-hour urine sample. The urine test captures cortisol levels over a full day to get a more accurate picture of your body’s natural cortisol rhythm.
What to Expect Before the Test
For the ACTH blood test, you may need to fast for a few hours before your blood is drawn. For the urine test, collect all urine for 24 hours, starting and ending with a sample at the same time each day. Drink plenty of water to help flush urine.
What to Expect During the Test
The ACTH blood draw is quick and done in a lab setting. The urine collection requires careful timing and may involve a 24-hour period at home. Follow your doctor’s instructions precisely to ensure accurate results.
Clinical interpretation
How abnormal results are interpreted and what conditions they suggest.
High ACTH levels combined with low cortisol may suggest Cushing’s disease (pituitary tumor) or ectopic ACTH syndrome. Low ACTH with low cortisol could indicate adrenal insufficiency (Addison’s disease). High cortisol in urine may indicate Cushing’s syndrome, while low cortisol may indicate adrenal failure. These findings guide treatment decisions like medication adjustments or surgery.
Short name
ACTH/Cortisol Profile
Frequently asked questions
What Does My Test Result Mean?
Can I Eat or Drink Before the Test?
How Long Will I Wait for Results?
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