A cortisol level is a blood test that measures the amount of cortisol, a steroid hormone produced by the adrenal cortex.
Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.
Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.
In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.
The health care provider may ask you to stop taking drugs that can affect the test. Drugs that can increase cortisol measurements include:
Drugs that can decrease cortisol measurements include:
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
The test is done to check for increased or decreased cortisol production. Cortisol is a steroid hormone released from the adrenal gland in response to ACTH, a hormone from the pituitary gland in the brain.
Cortisol affects many different body systems. It plays a role in:
Different diseases, such as Cushing's disease and Addison's disease, can lead to either too much or too little production of cortisol. Cortisol levels are often measured to help diagnose these conditions and to evaluate how well the pituitary and adrenal glands are working.
Stewart PM. The adrenal cortex. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, PA: Saunders Elsevier; 2008: chap 14.
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