Test Code: 3008CPT:
|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|
|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.
|Specimen Stability||10 Days RT
6 Days RF
|Laboratory Developed Test (LDT)||Yes|
|References||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
cortisol relationships throughout human pregnancy Am J Obstet Gynecol. 15;139(4):416-22.