Alternative Names
  • Cortisol
  • Free Cortisol; Dexamethasone Suppression Test
  • DST
  • ACTH Stimulation Test
  • Compound F
  • Hydrocortisone
  • Corticosteroids
  • Cortrosyn Stimulation Test

Test Code: 3008

Tests Included Cortisol
Use Used to help diagnose Cushing sydnrome, Addison diseas, or adrenal insufficiency. Cortisol is the major glucocorticoid produced and secreted by the adrenal cortex. It affects (a) the metabolism of protein, fat, and carbohydrates, (b) the maintenance of muscle and myocardial integrity, and (c) the suppression of inflammatory and allergic activities adrenal insufficiency or Addison disease, conditions associated with deficient cortisol Cushing syndrome, a condition associated with excess cortisol.
Clinical Utility Abnormal changes in cortisol levels occur due to hypothalamic, pituitary, or adrenal malfunction. If undiagnosed and untreated, these disorders can lead to severe metabolic imbalance which may be life-threatening. The measurement of serum or plasma cortisol - utilizing morning and evening levels and/or stress tests such as ACTH stimulation or dexamethasone suppression - aids in the diagnosis of adrenal related disease. Excess cortisol levels are found in Cushing's syndrome (adrenal cortical hyperfunction) while decreased levels are found in Addison's Disease (adrenal cortical insufficiency).
Intended Patient Population 18+ and Older Adult Males & Females; Time of Collection 8:00 - 10:00 AM
Patient Preparation Morning collection required
Sample Whole Blood, Serum, Plasma
Tube Red, Green, Tiger
Volume 4mL Whole Blood (1mL Serum/Plasma)
Min Sample Volume 0.1 mLs
Reference Ranges M & F ≥ 18 yrs old; 4.6-20.6 ug/dL 8:00-10:00 AM Collection Time
Analytical Measurement Range 1.0-35.0 ug/mL
Units ug/dL
Test Methodology LC/MS/MS
Test Turnaround Time 7 Days
Limitations Serum cortisol levels may appear depressed in patients that are pregnant or undergoing hormone therapy (e.g.
oral/vaginal contraceptives).3,4,5,6 If the result does not match the clinical picture, perform a urinary (free)
cortisol to confirm.

Elevated cortisol levels may occur in patients receiving prednisolone or prednisone (which is converted to
prednisolone in vivo) due to cross-reactivity to prednisolone.
Shipping Requirements Refrigerated
Specimen Stability 10 Days RT
6 Days RF
Reject Criteria 0
Laboratory Developed Test (LDT) Yes
CMS Guidance None
  1. Bondy PK. The adrenal cortex. In Metabolic control and disease, eighth edition, 1980; 1427-1499. Edited by Bondy, PK, Rosenberg LE, Philadelphia, PA: WB Saunders Co.
  2. Fujimoto WY. Disorders of glucocorticoid homeostasis. In Blue book of endocrinology, X edition, 1985; 43-59. Edited by Metz R, Larson E, Philadelphia, PA: WB Saunders Co.
  3. Klose M, Lange M, Rasmussen AK, Skakkebaek NE, Hilsted L, Haug E, Andersen M, Feldt-Rasmussen U. (2007)Factors influencing the adrenocorticotropin test: Role of contemporary cortisol assays, body composition, and oral contraceptive agents. J Clin Endocrinol Metab. 92(4):1326-1333.
  4. Qureshi AC, Bahri A, Breen LA., Barnes SC., Powrie JK. , Thomas SM. and Carroll PV. (2007) The influence of the route of oestrogen administration on serum levels of cortisol-binding globulin and total cortisol Clinical Endocrinology 66, 632-635
  5. Wiegratz I, Jung-Hoffmann C, Kuhl H. Effect of two oral contraceptives containing ethinylestradiol and gestodene or norgestimate upon androgen parameters and serum binding proteins. Contraception. 1995 Jun;51(6):341-6.
  6. Carr BR, Parker CR Jr, Madden JD, MacDonald PC, Porter JC (1981) Maternal plasma adrenocorticotropin and relationships throughout human pregnancy Am J Obstet Gynecol. 15;139(4):416-22.

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