What is Cortisol AM?
Cortisol is an essential hormone that is produced due to the stress or low levels of blood glucose by the adrenal glands. It is vital in the normal immune function, metabolism, regulation of blood pressure, and the response of the body to stress. It is also essential to control the inflammation. Cortisol levels fluctuate throughout the day and are typically at the highest level in the morning.
The cortisol AM test is the measurement of the levels of cortisol in the morning. If the cortisol levels are abnormal it is suggestive of various conditions including the disorders associated with the adrenal gland, Cushing’s syndrome, and Addison’s disease.
How is the Test Performed?
The cortisol AM test is conducted through the process of venipuncture and is usually taken in the morning from 6 AM to 8 AM as the levels of cortisol are at their peak.
Preparation
- Patients should avoid strenuous exercise and stress before the test.
- Always inform your doctor about the medication you are taking as he might advise you to stop taking certain medications that interfere with the cortisol levels.
Sample collection
- Blood is drawn from the vein and sent to the laboratory for analysis.
Laboratory Analysis
- The sample is analyzed in the laboratory using the technique of high-performance liquid chromatography-tandem mass spectrometry. (HPLC-MS/MS)
What are the symptoms that prompt this test?
The healthcare provider recommends this test if a person is exhibiting the symptoms of conditions associated with adrenal gland dysfunction;
Symptoms of High Levels of Cortisol
- Weight gain that is unexplainable
- Hypertension
- Weakness of the muscles
- Easy bruising
- Changes in mood
- Onset of anxiety or depression
- Urinating frequently
- Increased thirst
- Wound healing at a slower rate
- Accumulation of fat in the midsection
Symptoms of Low Levels of Cortisol
- Weakness
- Tiredness
- Unexplainable weight loss
- Hypotension
- Light-headedness
- Nausea, vomiting
- Pain in the abdomen
- Hyperpigmentation
- Craving for salt
- Pain in muscles and joints
- Depression
What are Normal Ranges for This Test?
The values for cortisol levels fluctuate throughout the day with the highest levels in the morning at the lowest in the evening. The generally accepted reference range is given below;
Adults (8 AM)– 5 to 23 mcg/dL
Children (8 AM) – 3 to 21 mcg/dL
Newborn – 1 to 24 mcg/dL
**The reference ranges vary according to the assay of the test used in the laboratory. **
What Happens if Test Results Show Abnormal Levels?
Abnormal levels of cortisol indicate that the person is affected by an underlying condition.
High Cortisol Levels
- Cushing’s disease- tumor in the pituitary
- Prolonged Stress
- Tumors in the adrenal gland
- Long-term use of the steroid hormones
Low Cortisol Levels
- Addison’s disease is an autoimmune disorder that destroys the adrenal gland
- Pituitary gland dysfunction
- Severe infections such as the infections affecting adrenal gland and tuberculosis
- Sudden discontinuation of corticosteroids that were being taken for a long time
Follow-up Tests
- Dexamethasone suppression test
- ACTH stimulation test
- 24-hour urine cortisol test
