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Latest Edit: Iva Lloyd, ND 2015-03-22 (EDT)

See Also Lab Tests

The cortisol test is used to help diagnose Cushing syndrome, primary or secondary adrenal insufficiency (such as Addison disease), or to detect conditions affecting the pituitary or adrenal glands. This test is ordered when a patient presents with symptoms of excess or deficient cortisol production.[1], [2]


  • This test measures the amount of cortisol in the blood, urine, or saliva.
  • Cortisol is a hormone produced by the adrenal glands that is involved in the metabolism of proteins, lipids, and carbohydrates.
  • It helps maintain blood pressure, affects blood glucose, and helps regulate the immune system.

Patient Preparation

  • A saliva test may require a patient to refrain from eating, drinking, or brushing teeth for a period of time.
  • Factors which can cause increased levels:
  • Pregnancy, physical and emotional stress, illness, hyperthyroidism, obesity
  • Insomnia or lack of proper sleep
  • Drugs: Oral contraceptives (birth control pills), hydrocortisone (the synthetic form or cortisol), and spironolactone
  • Factors which can cause decreased levels:

Clinical Implications

High levels indicate:

  • Cushing syndrome
  • ACTH-producing tumors
  • Overproduction by the adrenal glands (due to a tumor or excessive growth of adrenal tissues)
  • Symptoms of high cortisol include:

Low levels indicate:

  • Underactive pituitary gland
  • Pituitary gland tumor that inhibits ACTH production (secondary adrenal insufficiency)
  • Addison disease (underactive or damaged adrenal glands that limit cortisol production)
  • Symptoms of low cortisol include:

Associated Tests


  1. Pagana Kathleen D, Pagana Timothy J (2006) Mosby's Manual of Diagnostic and Laboratory Tests, Mosby.
  2. Weatherby Dicken, Ferguson Scott (2002) Blood Chemistry and CBC Analysis: Clinical Laboratory Testing from a Functional Perspective, Bear Mountain.