Cortisol, Total
CPT Code(s):
82533
Turnaround Time:
4 hours
Specimen Requirements
Preferred Specimen:
Serum
Minimum Volume:
1.0 mL
Transport Container:
Serum Separator Tube (SST) or Red Top Tube
Transport Temperature:
Room Temperature
Collection Instructions:
Allow blood to clot completely prior to centrifugation. Separate serum from cells within 45 minutes of collection.
Rejection Criteria:
Plasma specimen; gross hemolysis; lipemia; improper labeling
Stability Criteria
Room Temperature:
24 hours
Refrigerated:
4 days
Frozen:
30 days
Clinical Significance
Cortisol holds specific clinical significance and diagnostic use in the field of endocrinology and stress response evaluation. This test measures the level of cortisol, a hormone produced by the adrenal glands, in a patient's blood, saliva, or urine.
The clinical significance and diagnostic use of Cortisol include:
1. Assessment of Adrenal Function: Cortisol is primarily used to assess adrenal gland function. Cortisol plays a crucial role in the body's response to stress, regulating metabolism, immune function, blood pressure, and inflammation. Abnormal cortisol levels can indicate adrenal dysfunction, such as adrenal insufficiency (low cortisol levels) or Cushing's syndrome (excess cortisol levels). The test helps healthcare providers evaluate adrenal function and guide appropriate interventions.
2. Diagnosis of Adrenal Disorders: Cortisol aids in the diagnosis of adrenal disorders. Low cortisol levels may suggest primary adrenal insufficiency (Addison's disease) or secondary adrenal insufficiency due to hypothalamic-pituitary dysfunction. Elevated cortisol levels may indicate Cushing's syndrome, which can result from various causes, including adrenal tumors, pituitary tumors, or long-term use of corticosteroid medications. The test helps differentiate between these conditions and guide further diagnostic investigations.
3. Evaluation of Stress Response: Cortisol is often referred to as the "stress hormone" as its levels increase in response to physical or psychological stress. Cortisol can be used to evaluate the body's stress response and assess whether cortisol levels are within the normal range during times of stress or trauma. It provides valuable information in conditions associated with dysregulated stress responses, such as post-traumatic stress disorder (PTSD) or chronic stress.
4. Monitoring of Corticosteroid Therapy: Cortisol is used to monitor patients receiving corticosteroid therapy, such as for autoimmune conditions, allergies, or organ transplant. Regular monitoring of cortisol levels helps ensure appropriate dosing and adherence to treatment regimens. It also aids in assessing the body's own cortisol production, which may be suppressed due to exogenous corticosteroid use.
5. Investigation of Cushings Syndrome: Cortisol is an essential component in the investigation of Cushing's syndrome, a condition characterized by excessive cortisol production. It helps confirm the presence of hypercortisolism and guides further diagnostic tests, such as dexamethasone suppression tests or imaging studies, to identify the underlying cause of the syndrome.
6. Evaluation of HPA Axis Dysfunction: Cortisol helps evaluate the function of the hypothalamic-pituitary-adrenal (HPA) axis, which regulates cortisol production. Abnormal cortisol levels can indicate dysfunction at various levels of the HPA axis, including hypothalamic or pituitary disorders. The test aids in diagnosing conditions such as adrenal insufficiency, Cushing's syndrome, or HPA axis dysregulation associated with certain psychiatric or endocrine disorders.
In summary, Cortisol has specific clinical significance in the assessment of adrenal function, diagnosis of adrenal disorders, evaluation of stress response, monitoring of corticosteroid therapy, investigation of Cushing's syndrome, and evaluation of HPA axis dysfunction. By measuring cortisol levels, this test provides valuable information for clinical decision-making, enabling healthcare providers to diagnose and manage various adrenal-related conditions, assess stress responses, guide treatment interventions, and promote endocrine health and well-being.