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Cortisol is an antidepressant hormone secreted in the adrenal cortex. Cortisol levels in the body are highest in the morning and lowest at night. Cortisol test to evaluate the state of decreased or increased cortisol, thereby helping to guide the diagnosis of Cushing's disease, Addison's disease or some diseases related to the adrenal cortex.1. What is Cortisol?
Cortisol or glucocorticoid is a steroid hormone produced in the adrenal cortex, which has anti-stress properties. When the body is under stress, it will stimulate the hypothalamus to increase the secretion of adrenocorticotropic hormone, which then stimulates the pituitary gland to increase ACTH which stimulates the adrenal cortex to secrete cortisol. An increase in cortisol in turn stimulates the pituitary gland to reduce ACTH production.Functions of cortisol in the body:
Helps consume glucose to create active energy for the body, Stimulates increased metabolism of substances in the body, especially energy reserves such as fat, protein... Fights stress thanks to its ability to initiate responses to stressors. Involved in immune function, anti-inflammatory responses. Increases gastric secretion. Cortisol levels in the body help assess the function of the adrenal cortex. Cortisol production depends on a diurnal rhythm. Normally, blood cortisol levels peak between 6 and 8 hours and are lowest at night. Therefore, when conducting a cortisol test, the ideal time to sample is in the morning.
The cortisol test can be performed with a 24-hour blood or urine specimen depending on the doctor's prescription and the patient's medical condition.
2. What does the cortisol test mean?
With the blood cortisol test, the change in cortisol levels helps to evaluate the differential diagnosis:
Primary adrenal insufficiency with secondary adrenal insufficiency. Evaluation of some problems related to the pituitary gland. Cushing's syndrome. With the urinary cortisol test index:
Helps orient the diagnosis and monitor the effectiveness of treatment of some diseases such as hyperadrenocorticism, Addison's disease... Supports abnormal diagnosis of 11 beta hydroxysteroid dehydrogenase. Diagnosis of hyperaldosteronism. The meaning of the cortisol test index:
Normal value of cortisol: The blood cortisol test is normal: From 7 to 10 hours: 171 536 nmol/l equivalent to 6.2 - 11.9 μg/dl. From 16 to 20h: 64 - 327 nmo/l equivalent to 2.3 - 11.9 μg/dl. Concentration of urinary cortisol: 27.6 - 276 mmol/day equivalent to 10 - 100 μg/day. High blood cortisol test is common in the following cases: Cushing's syndrome. People who are obese, or work too hard. The person is in shock or shows signs of stress. Patients with adenocarcinoma of the adrenal gland, hyperpituitary gland or hyperthyroidism. Elevated cortisol signals an infection, the risk of eclampsia, or the presence of a tumor that is producing ACTH in the wrong place. In addition, in pregnant women, burns or acute pancreatitis, cortisol is also increased. Blood cortisol test index decreases when: Addison's disease or liver disease. Have adrenal insufficiency, hypothyroidism, or postnatal pituitary necrosis. Patients with hypoglycemia also lead to a decrease in blood cortisol. Elevated urinary cortisol levels: Pregnant women or amenorrhea. Stress. Patients with hyperthyroidism, with pituitary tumor. Cushing's syndrome increases both urinary and blood cortisol. People with lung cancer. Decreased urinary cortisol levels: The patient presents with glomerular dysfunction. Addison's disease, hypothyroidism, hypopituitarism. In addition, the change in cortisol levels in the body is also related to non-pathological factors such as:
Stress, overwork, or sleep. Due to the use of Dexamethasone, oral contraceptives, Amphetamine, Levodopa, Androgen... People with polycystic ovary syndrome, alcoholism, acute cortisol disorder... Samples have not been collected and stored properly. .
3. Notes when taking samples for cortisol test
Some factors can affect test results:
Psychological factors such as fear, stress, stress. Pregnancy can cause increased cortisol levels in the urine. Eat, drink and exercise vigorously before the test. The patient has low blood sugar. Using birth control pills or taking medication for medical conditions. Within 1 week before the test have a radiograph. Samples. In order not to have much error in the cortisol test leading to incorrect diagnosis, it should be noted:
Cortisol levels in the body change continuously during the day, the best time to do the test is in the morning. If the patient is indicated for blood sampling:
Fast for 10 to 12 hours before blood collection. Do not exercise vigorously for 1 day before the test. Some other medications that can affect the results of the cortisol test should be stopped 24 hours before the test, such as: anti-epileptic drugs, progesterone and estrogen-type contraceptives, androgens or glucocorticoids. For patients with suspected Cushing's syndrome, blood should be drawn twice: at 7 - 10 am and at 4 pm - 8 pm. If the patient is assigned to collect urine specimens:
Collect 24-hour urine samples according to the instructions of medical staff, store in a container with boric acid as required. In general, cortisol is an important hormone of the body. To find out the level of cortisol in the body can do blood or urine tests. Increased cortisol or decreased cortisol are both related to diseases in the body. Cortisol tests can be inaccurate if not performed correctly, leading to inaccurate diagnoses. Therefore, perform a cortisol test at reputable medical facilities so as not to affect the medical diagnosis leading to wrong treatment directions.
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