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HelpTest Code CORTU Cortisol, Free, 24 Hour, Urine
Necessary Information
24-Hour volume (in milliliters) is required.
Specimen Required
Supplies: Urine Tubes, 10-mL (T068)
Submission Container/Tube: Plastic urine tube
Specimen Volume: 5 mL
Collection Instructions:
1. Collect urine for 24 hours.
2. Add 10 g of boric acid as preservative at start of collection.
Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Specimen Type
UrineSpecimen Minimum Volume
3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Refrigerated (preferred) | 14 days |
| Frozen | 28 days | |
| Ambient | 7 days |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Clinical Information
Cortisol is a steroid hormone synthesized from cholesterol by a multienzyme cascade in the adrenal glands. It is the main glucocorticoid in humans and acts as a gene transcription factor influencing a multitude of cellular responses in virtually all tissues. Cortisol plays a critical role in glucose metabolism, maintenance of vascular tone, immune response regulation, and in the body's response to stress. Its production is under hypothalamic-pituitary feedback control.
Only a small percentage of circulating cortisol is biologically active (free), with the majority of cortisol inactive (protein bound). As plasma cortisol values increase, free cortisol (ie, unconjugated cortisol or hydrocortisone) increases and is filtered through the glomerulus. Urinary free cortisol (UFC) in the urine correlates well with the concentration of plasma free cortisol. UFC represents excretion of the circulating, biologically active, free cortisol that is responsible for the signs and symptoms of hypercortisolism.
Urinary free cortisol is a sensitive test for the various types of adrenocortical dysfunction, particularly hypercortisolism (Cushing syndrome). A measurement of 24-hour UFC excretion, by liquid chromatography tandem mass spectrometry (LC-MS/MS), is the preferred screening test for Cushing syndrome. LC-MS/MS methodology eliminates analytical interferences including carbamazepine (Tegretol) and synthetic corticosteroids, which can affect immunoassay-based cortisol results.
Reference Values
0-2 years: Not established
3-8 years: 1.4-20 mcg/24 h
9-12 years: 2.6-37 mcg/24 h
13-17 years: 4.0-56 mcg/24 h
≥18 years: 3.5-45 mcg/24 h
Use the factor below to convert from mcg/24 hr to nmol/24 hr:
Conversion factor
Cortisol: mcg/24 h x 2.76=nmol/24 hr (molecular weight=362.5)
For International System of Units (SI) conversion for Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html.
Day(s) Performed
Monday through Friday
Report Available
2 to 6 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
82530
Forms
If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.