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Doctor insights on: Why Would Urine Cortisol Be High And Blood Cortisol Be Normal

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If my blood and 24 hr urine cortisol levels are normal is it still possible for me to have Cushing's? I have almost all the symptoms.

If my blood and 24 hr urine cortisol levels are normal is it still possible for me to have Cushing's? I have almost all the symptoms.

One more idea: You may be a candidate for a low-dose dexamethasone test. Remember that the large majority of folks for whom Cushing's is a serious consideration turn out not to have it. In the meantime, I hope you're finding time and opportunity to pursue physical fitness activities. Best wishes. ...Read more

Urine (Definition)

Urine is the product of the kidneys, which is produced to eliminate the waste products of metabolism, manage body fluid balance, &maintain acid-base balance. The blood is first filtered by the kidneys, and the composition of the resulting fluid is then altered depending on the body's needs. It is composed of mostly water, and breakdown products from blood cells impart ...Read more


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Testing for cushings, 24 hour urine cortisol 150, yet blood cortisol after dexamethasone only 1.5? any reason to be concerned?

Testing for cushings, 24 hour urine cortisol 150, yet blood cortisol after dexamethasone only 1.5? any reason to be concerned?

Here are some ...: At this time of individual care, you should refer this Q to the ordering / treating Doc who knows more about your medical detail so the findings could be correlated with clinical picture. Sporadic info online may cause more confusion and unnecessary anxiety. So, be patient to talk with your doctor; that is most reasonable and best for you, especially in non-urgent events as such. Best wishes... ...Read more

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What are possible reasons for normal cortisol levels in the blood but high levels in the urine?

What are possible reasons for normal cortisol levels in the blood but high levels in the urine?

Need More tests: A single blood sample may not accurately reflect cortisol levels as peak values may have occurred at a different point during the daily cycle, producing a normal blood sample when cortisol levels are actually elevated. The elevation would be detected, however, by 24-hour urine cortisol levels. High urine cortisol can be caused by cushing's, lung cancer, adrenal tumors. ...Read more

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Have cushings like symptoms and 24 hr urine cortisol test results were 100 mcg (lab range 4-50). Is this really high? Hoping it would explain things.

Have cushings like symptoms and 24 hr urine cortisol test results were 100 mcg (lab range 4-50).  Is this really high? Hoping it would explain things.

Need a confirmatory: test. The diagnosis of Cushings needs to positive screening tests, because sometimes you can get a false positive. The other screening tests include a Dexamethasone suppression test or midnight salivary cortisol. If the confirmatory test is elevated, then it is highly likely that you have cushings. ...Read more

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My 24H urine cortisol test result shows free cortisol level as 5.44 ug/dl. Is this a normal level?

My 24H urine cortisol test result shows free cortisol level as 5.44 ug/dl. Is this a normal level?

Not enough info: For a 24 hour urine free cortisol test, you want to know the total cortisol on 24 hours. It will be in mcg/24 hours. You are telling me the concentration without the volume of urine. It is the total cortisol that we need to know in 24 hrs. Also there are differences among lab assays and you generally need to follow the local labs referemce range. Typically if total is greater than 130 then high. ...Read more