24 Hour Urine Cortisol

You should get a 24-hour urine cortisol test if you have signs of Cushing’s syndrome, such as unexplained weight gain around the face and abdomen, purple stretch marks, easy bruising, muscle weakness, high blood pressure, or high blood sugar. It is also recommended for an adrenal mass, early osteoporosis, and monitoring Cushing’s treatment.

To prepare for a 24-hour urine cortisol test, discard your first morning urine and note the time. Then collect all urine for the next 24 hours, including the next morning’s first sample, and keep it refrigerated. Avoid excess fluid intake, alcohol, strenuous exercise, and licorice. Inform your doctor about steroids (including creams and inhalers) and hormonal medicines.

No, fasting is not required for a 24-hour urine cortisol test. You can eat and drink normally during the collection period, but avoid excessive fluid intake, alcohol, and licorice, as they can affect results. Collect every urine sample over the full 24 hours, and keep the container refrigerated.