Question 1

Purpose Test

Accepted Answer

Diagnosing Cushing’s syndrome (hypercortisolism) through elevated morning levels, often followed by confirmatory tests such as the dexamethasone suppression test. Assisting in the diagnosis of primary (Addison’s disease) or secondary adrenal insufficiency, where morning levels are low and unable to reach normal peaks. Evaluating the function of the hypothalamic-pituitary-adrenal (HPA) axis in general. Monitoring patients receiving long-term corticosteroid therapy (e.g., prednisone) to assess adrenal suppression.

Question 2

Recommended groups

Accepted Answer

Patients showing signs of cortisol excess (Cushing’s syndrome): central weight gain, moon face, buffalo hump, high blood pressure, new-onset diabetes. Patients showing signs of cortisol deficiency (adrenal insufficiency): persistent severe fatigue, low blood pressure, weight loss, hyperpigmentation. Patients with tumors of the pituitary or adrenal glands. Patients receiving long-term corticosteroid therapy.

Question 3

Symptoms indicative

Accepted Answer

Rapid weight gain with fat concentration in the abdomen and face (moon face) and neck (buffalo hump). General weakness and severe fatigue that does not improve with rest. Unexplained high blood pressure. Long purple stripes on the abdomen (stretch marks). Low blood pressure, dizziness, and strong craving for salt.

Question 4

Frequently Asked Questions (FAQs)

Accepted Answer

Serum (blood): measures total cortisol (free + bound) at a specific moment (morning). It is the most common initial test. Saliva: measures free cortisol, and can be easily collected at home at different times to assess daily rhythm. 24-hour urine: measures free cortisol excretion over a full day, giving an idea of total daily production, and is useful for diagnosing Cushing’s syndrome. Severe physical or psychological stress before the test (increases it). Poor sleep the night before. Certain medications (e.g., oral contraceptives that increase cortisol-binding protein CBG, which may raise total cortisol). Pregnancy (increases it). Therefore, it is important to inform your doctor about these factors.

Question 5

Normal Levels

Accepted Answer

Morning (7-9 AM): 5 - 25 micrograms per deciliter (µg/dL) or 138 - 690 nanomoles per liter (nmol/L). Evening (around 4 PM): the level is approximately less than half of the morning level. Midnight: it is at its lowest level. Abnormally high in the morning: indicates possible cortisol excess (Cushing’s syndrome). Abnormally low in the morning: indicates possible adrenal insufficiency.

Cortisol (A.M.) Serum Test