What you need to know about a cortisol test

Do you feel tired all the time, have aches and pains for no reason, or are you under a lot of stress? Maybe when you talked to your doctor about this, he or she told you about a blood or urine test. That's the cortisol test. Don't be afraid, despite the name, this is a very simple thing. Let's talk about it all clearly today.

Simply put, what is cortisol?

Cortisol is a very important hormone in our body. It is produced by two small glands located above our kidneys, the adrenal glands. It is also called the "stress hormone." This is because our bodies produce more of this hormone when we are stressed or afraid.

But that's not all cortisol does. It helps with many other things.

• Controlling the sugar levels in our body.
• Controlling blood pressure.
• Reducing inflammation in the body.
• Helping our memory.

So this cortisol test is to find out whether your body has the required amount of this hormone, or whether it has too little or too much of it.

Why is a doctor asking you to do this test?

If you have any symptoms in your body, your doctor may recommend this test to determine if they are due to changes in cortisol levels. This test is mainly performed if there is a suspicion of two medical conditions.

1. Addison's disease: This is a condition in which the body does not produce enough of the hormone cortisol. Symptoms may include constant fatigue, weight loss, and darkening of certain areas of the body (especially the elbows and knees).

2. Cushing's syndrome: This is a condition in which the body produces too much of the hormone cortisol. Symptoms may include a round, puffy face, weight gain (especially in the abdomen), thinning skin, and easy bruising.

In addition, certain types of tumors can also cause changes in cortisol levels. This test can also help confirm this if there is any doubt.

How is this cortisol level measured?

There are three main ways to measure cortisol levels. Sometimes your doctor may recommend one or more of these methods.

• From a blood sample
• From a urine sample
• From a saliva sample

Now let's see how each of these tests is performed.

Blood Test

This is something like a routine blood test that we all know and do regularly.

• You will be seated in a chair and an easy-to-find vein will be selected to draw blood, usually from the inside of your arm below the elbow.
• Then the area is cleaned thoroughly, a small needle is inserted, and a small amount of blood is collected in a tube. You may feel a slight stinging sensation when the needle is inserted.
• After the required amount of blood is taken, the needle is removed and a piece of cotton is placed and pressed down.
• Once the bleeding stops, a small plaster is applied to the area. The whole thing takes less than five minutes.

Saliva Test

This is a test that is usually done at home, because the exact time of day to collect the sample (either right after waking up in the morning or before going to bed at night) is important.

• The doctor will give you a special kit for this. You need to read the instructions carefully.
• It is generally advised not to eat, drink, brush your teeth, or smoke for 30 minutes before taking the sample.
• The cotton-like part (swab) in the kit should be placed inside the mouth without touching it with your hands.
• You should hold it in your mouth for a few minutes, until it is thoroughly moistened with saliva.
• Then you need to put it directly into the tube provided, without touching it again.
• Then the doctor will tell you how to take the sample to the lab.

Urine Test

This usually involves collecting the total amount of urine you excrete over a 24-hour period .

• The lab will give you a large container for this.
• On the day of the test, you should discard the first urine you urinate in the morning. That means don't collect it. But write down the exact time on a piece of paper. That is the starting time of the test.
• Then throughout the day, until the time you originally wrote down the next day, you have to collect it all into the container provided every time you urinate. Don't let a single drop go to waste.
• Don't let any toilet paper or feces get mixed in with this.
• When not in use, store this container in the refrigerator or in a cool place.
• Try to collect the last urine sample as close to the end of the 24-hour period as possible (e.g., if you started at 8 a.m. on Monday, collect it at 8 a.m. on Tuesday).
• You should clearly write your name, start time, and finish time on the container and take it to the lab as soon as possible.

How long does it take for the test results to come back?

It usually takes one to five days to get results, depending on the lab where you get the test.

What do these results say?

It's up to your doctor to interpret the results and decide what to do with them. This is because it depends on many factors, such as your symptoms and other test results. But for your information, let's look at the normal values.

These values ​​may vary slightly from lab to lab, so compare them to the "normal range" on your report.

Causes of elevated cortisol levels

• Taking high doses of certain medications (especially steroids - corticosteroids).
• A tumor in the pituitary gland causes excessive production of a hormone called `ACTH` (this `ACTH` hormone stimulates the adrenal glands to produce cortisol).
• Excessive production of cortisol due to a tumor in the adrenal gland.
• A tumor that occurs elsewhere in the body (e.g., in the lungs).

Causes of low cortisol levels

• Decreased production of ACTH due to decreased function of the pituitary gland or a tumor in it.
• Damage to the adrenal glands or decreased function.

Should I be worried if the result is abnormal?

Not at all. Just because a test result is outside the normal range doesn't mean you have a serious illness. Cortisol levels are very sensitive. Many other factors can affect the value.

For example:

• Stress: If you were under a lot of stress the day before the test, your score may change.
• Physical activity: Excessive exercise.
• Other medical conditions: Things like fever, infections.
• Temperature: Exposure to extreme cold or heat.
• Some medications.
• Sleep: If you work the night shift, your cortisol patterns may also change because your sleep patterns are different.

Perhaps, if the doctor needs more information, he or she may ask you to do some more tests.

• ACTH stimulation test: This tests how your adrenal glands respond to an injection of the synthetic hormone `ACTH`.
• Dexamethasone suppression test: A drug called dexamethasone is given, and then cortisol levels are measured.
• Imaging tests: An MRI or CT scan is done to check for any tumors in the glands.

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