Name of the Procedure:

Cortisol; free, also known as Free Cortisol Test or Unbound Cortisol Test.

Summary

A free cortisol test measures the unbound cortisol levels in your urine or saliva. Cortisol is a hormone produced by the adrenal glands, which helps regulate metabolism, immune response, and stress. This procedure evaluates the unbound, bioactive cortisol rather than the total cortisol.

Purpose

The free cortisol test is used to diagnose and monitor conditions related to abnormal cortisol levels, such as Cushing's syndrome and Addison's disease. The goal is to identify unbalanced cortisol production, providing critical information for appropriate treatment plans.

Indications

• Symptoms of Cushing's syndrome (e.g., weight gain, hypertension, muscle weakness)
• Symptoms of Addison's disease (e.g., fatigue, weight loss, low blood pressure)
• Monitoring cortisol levels in patients undergoing steroid therapy
• Evaluating adrenal gland function in patients with chronic fatigue syndrome or other stress-related conditions

Preparation

• Follow specific instructions regarding fasting if required by the healthcare provider.
• Avoid certain medications that may affect cortisol levels, as advised by the physician.
• Collect urine or saliva samples at specific times of the day, usually in the morning and late at night, to account for natural fluctuations in cortisol levels.

Procedure Description

1. Urine Test:

   • A 24-hour urine collection is required. The patient collects all urine produced in a 24-hour period in a provided container.
   • The container is returned to the lab for analysis.

2. Saliva Test:

   • The patient collects saliva samples at specified times using a provided kit. This involves spitting into a small tube.
   • Samples are typically collected in the morning and late at night and then sent to the laboratory for testing.

Duration

• Urine collection spans a full 24-hour period.
• Saliva sample collection takes a few minutes per sample.

Setting

The initial setup and instructions can be provided in a healthcare setting or at home. Samples are analyzed in a laboratory.

Personnel

• The test may be instructed by a doctor or nurse.
• Laboratory technicians analyze the samples.

Risks and Complications

The procedures are generally safe with minimal risks. Possible issues include:

• Contamination of samples leading to inaccurate results.
• Misinterpretation of timing during sample collection.

Benefits

• Non-invasive and simple to perform.
• Provides crucial data on cortisol levels to help diagnose and monitor adrenal gland disorders.
• Helps tailor appropriate treatment plans for affected conditions.

Recovery

No recovery time is needed. Patients can resume normal activities immediately after collecting the samples.

Alternatives

• Blood cortisol test, which measures total cortisol levels but may not provide specific information about unbound cortisol.
• Dexamethasone suppression test, which assesses adrenal gland function by measuring cortisol levels after taking a synthetic steroid.

Patient Experience

• Sample collection is straightforward and can be done at home.
• Minimal discomfort is associated with the procedure.
• Patients should ensure accurate timing and storage of samples for reliable results.