Cortisol, 24-Hour Urinary Free (Total)
This test measures the total amount of cortisol, a natural steroid hormone, excreted in your urine over a 24-hour period. Cortisol helps regulate stress responses, metabolism, and immune function.
["A 24-hour urine cortisol test helps assess how your body handles stress and hormone production."]
Key facts at a glance
- LOINC
- 58750-1
- Short code
- MR Hrt W Stress
- Synonyms
- MR Hrt W Stress
- Category
- chemistry
- Sample
- serum
- Container
- Red-top tube (SST)
- Units
- N/A
- Fasting
- false
- Population
- adult
- Sex
- all
- Age range
- 18–65 years
- Method
- mr
- 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 an issue with your adrenal glands, such as Cushing’s syndrome (overproduction of cortisol) or Addison’s disease (underproduction of cortisol). It can also help diagnose conditions related to stress responses or hormone imbalances.
What to Expect Before the Test
You’ll collect all urine for 24 hours, starting from one point in the morning and ending the next morning. Store the urine in a refrigerator or freezer to keep it fresh. Bring all samples to the lab on the same day.
What Happens During the Test
No special preparation is needed beyond collecting urine over 24 hours. The lab will analyze the total cortisol content in your urine sample.
Possible Results and Next Steps
Results may be compared to reference ranges provided by your lab. High levels could indicate Cushing’s syndrome or excessive stress, while low levels may suggest adrenal insufficiency or other hormonal disorders. Your doctor will discuss findings with you.
Clinical interpretation
How abnormal results are interpreted and what conditions they suggest.
Cortisol is a critical hormone that influences stress reactions, immune function, and metabolism. Abnormal levels can signal underlying health issues, such as adrenal gland disorders, pituitary problems, or chronic stress. This test helps doctors diagnose and monitor conditions affecting cortisol production or metabolism.
Short name
24-Hour Urine Cortisol
Frequently asked questions
What does a high cortisol level mean?
Low cortisol levels in urine could indicate adrenal insufficiency (e.g., Addison’s disease), where the adrenal glands do not produce enough cortisol, or other hormonal imbalances.
How often is this test repeated?
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