Hey everyone. My name is Abby. I’m here with nursing.com and this lesson will discuss the normal values for cortisol. We’ll also talk about some disease processes or conditions that cause it to increase or decrease. Let’s get started. 

Cortisol is a steroid hormone that’s made by the adrenal glands. Adrenal glands are these little guys, these glands that are on top of our kidneys. Have you ever heard of the way to remember adrenal gland, hormones as sugar, salt, sex so, that you can remember, you know, like sugar, our glucocorticoids, salt for aldosterone, and sex for the androgens? Well, cortisol is the sugar. It raises our blood sugar and actually regulates our blood sugar, but it also is most active in the stress response. It can also help to fight infection. The lab value of course, is going to measure the level of it in the blood.

Some clinical indications for why we would draw this lab are to diagnose disorders of the adrenal gland. So, what are some disorders of the adrenal gland? Well, there’s Cushing syndrome where there’s an influx of hormones, there’s Addison’s disease, where there’s a lack of, and there could even be adrenal tumors that produce too much or too little of hormones. And then there’s also, when there’s an insufficiency, we wanna know how much cortisol is there. Are adrenal glands working properly? Are we seeing Cushing syndrome or Addison’s disease?

Normal therapeutic values are interesting, because the body releases a different amount of cortisol at different points throughout the day, the normal values actually vary based on the time that the lab is drawn. So, in the AM hours, particularly between about 6 and 10 AM, a normal cortisol value will be between 10 to 20 micrograms per deciliter. In the afternoon, the bodies or the adrenal glands in this case, uh, production of cortisol slows down a little bit to 3 to 10 micrograms per deciliter, and then things get real sluggish around the time that they should. 

When you’re falling asleep. About an hour after falling asleep, normal levels should be below five micrograms per deciliter. It can be collected in three different ways, either in a plasma separator tube for blood collection here, in the saliva, or in the urine. When lab values are high for cortisol, it either means that there’s been a trigger to the stress response, it could be an overactive pituitary gland, or a tumor that’s telling the adrenal glands to produce more of the cortisol. It could be a tumor of the adrenal gland itself or Cushing syndrome. This individual in this picture is having those classic symptoms of Cushing syndrome. There’s extra hair growth, the moon face that can form, and then even that little hump on the back, the Buffalo hump. So, when lab values are high, you might see someone with these characteristics. 

So, when lab values are decreased or when there’s a low level of cortisol, that might mean that the adrenal gland is either underactive or damaged like an Addison’s disease. This woman in this photo has Addison’s disease. See how she’s all tanned and she might be dehydrated, things like that. It also could mean that there’s an underactive pituitary gland or tumor. 

The linchpins for this lesson or that the cortisol lab measures the amount of cortisol, which is our stress hormone, um, or known as, and what cortisol really does is it helps to regulate our blood sugar and is drawn to evaluate our adrenal function. Normal values, If you remember, the body fluctuates in its production throughout the day of cortisol and so in the morning, it’s at its highest. Normal values, 10 to 20 in the afternoon, it’s at its kind of mid level 3 to 10, and an hour after falling asleep, we’re gonna have that big dip because we just don’t need more blood sugar. We’re going to bed. So, if the value is increased, that indicates Cushing syndrome or adrenal hypersecretion, or if it’s decreased, that indicates Addison’s disease or adrenal hyposecretion. 

Now you all did great on this lesson and that wraps it up for cortisol. We love you guys, now go out and be your best self today and as always, happy nursing.

References:

• https://medlineplus.gov/lab-tests/cortisol-test/#:~:text=A%20cortisol%20test%20is%20used,doesn’t%20make%20enough%20cortisol
• https://my.clevelandclinic.org/health/diagnostics/22417-cortisol-test
• https://ltd.aruplab.com/Tests/Pub/0070030
• https://www.adrenal.com/adrenal-tumors/symptoms
• https://www.uptodate.com/contents/measurement-of-cortisol-in-serum-and-saliva?search=normal%20cortisol%20level%20in%20the%20serum&sectionRank=1&usage_type=default&anchor=H2&source=machineLearning&selectedTitle=1~150&display_rank=1#H2