Cortisol hormone test: Meaning, types, cost, normal range, timing and home guide

Cortisol, also known as the stress hormone, is made by the adrenal glands, which sit on top of the kidneys. It plays a key role in how the body responds to stress, regulates blood sugar, controls blood pressure, maintains energy, and supports metabolism. When cortisol levels are not balanced, the body struggles to cope with stress, leading to health problems.

To monitor cortisol balance, doctors often recommend a cortisol test. This test checks if the body is making too much or too little of the hormone. Abnormal levels can indicate medical conditions such as Cushing’s syndrome (high cortisol) or Addison’s disease (low cortisol). It can also help doctors understand the cause of unexplained fatigue, weight changes, blood pressure issues, or fertility problems.

What is a cortisol test and why it is done

A cortisol test is a medical investigation that measures the level of cortisol in the body. Since cortisol levels naturally rise in the morning and fall at night, the timing of the test is very important. Doctors use it to check if the adrenal glands and pituitary gland are working properly.

Why doctors recommend a cortisol test

Your doctor may ask for this test if you experience:

• Extreme fatigue or weakness

• Sudden weight gain or weight loss

• High blood pressure that does not improve with medicines

• Irregular periods or fertility problems

• Anxiety, constant stress, or depression

• Symptoms linked to Cushing’s syndrome (excess cortisol) or Addison’s disease (low cortisol)

Cortisol tests can be done through blood, saliva, or urine samples. Sometimes, doctors may ask for multiple tests at different times of the day to see how cortisol levels change.

Types of cortisol tests

There are different methods to check cortisol levels:

1. Cortisol blood test

   • The most common type of test.

   • A sample is taken from a vein in your arm, usually in the morning when cortisol is highest.

2. Serum cortisol test

   • Measures the exact concentration of cortisol in the blood serum.

3. Morning cortisol test

   • Done between 6 am and 8 am when levels are naturally at their peak.

4. ACTH stimulation test

   • Measures how well the adrenal glands respond to adrenocorticotropic hormone (ACTH).

   • Used to diagnose adrenal insufficiency or pituitary problems.

5. Saliva cortisol test

   • Collected at night to check if cortisol drops to its lowest level.

   • Useful for detecting hidden adrenal disorders.

6. 24-hour urine cortisol test

   • Measures total cortisol production in a full day.

   • Helps identify conditions like Cushing’s syndrome.

Normal range of cortisol levels

Cortisol levels vary depending on the time of day:

• Morning (6–8 am): 5 to 23 mcg/dL

• Afternoon (around 4 pm): 3 to 13 mcg/dL

• Night (midnight): Less than 5 mcg/dL

These values can differ slightly depending on the lab. Always review results with your doctor, who will consider your symptoms and health history.

Conditions detected by cortisol test

A cortisol test can help diagnose:

1. Cushing’s syndrome – Caused by high cortisol. Symptoms include weight gain, a round face, high blood sugar, and high blood pressure.

2. Addison’s disease – Caused by low cortisol. Symptoms include fatigue, weight loss, dark skin patches, and low blood pressure.

3. Adrenal or pituitary problems – Both glands control cortisol balance.

4. Stress-related disorders – Chronic stress can disrupt cortisol production.

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Price of cortisol test in India

The cost depends on the type of test and the diagnostic lab. On average:

• Serum cortisol test: ₹500 – ₹900

• Morning cortisol test: ₹600 – ₹1,000

• ACTH stimulation test: ₹1,500 – ₹3,000

• 24-hour urine test: ₹800 – ₹1,200

• Saliva cortisol test: ₹700 – ₹1,200

(Prices may vary across cities and labs.)

How to prepare for the test

• Medication adjustment – You may need to stop certain medicines (like steroids) before the test. Always consult your doctor first.

• Avoid stress – Stress can increase cortisol levels and affect the results.

• Fasting not always required – For most tests, you do not need to fast, but follow your doctor’s instructions.

The test itself is quick and painless, usually taking just a few minutes for blood collection.

At-home cortisol tests

Some labs and companies offer home test kits for saliva or urine samples. These can be useful for night-time cortisol checks. However, blood tests still need to be done in a lab under professional supervision.

Cortisol is an important hormone that helps the body manage stress, blood pressure, metabolism, and energy. Too much or too little cortisol can indicate serious health problems. A cortisol test—done through blood, saliva, or urine—helps doctors identify conditions like Cushing’s syndrome, Addison’s disease, or adrenal gland issues.

With timely diagnosis, lifestyle changes, and medical treatment, cortisol levels can be managed effectively. If you are facing unexplained fatigue, mood changes, or blood pressure problems, talk to your doctor about whether a cortisol test might help.