Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
COLLEGE OF HEALTH SCIENCES – HAIL Medical laboratory Dept.- Second term THIRD YEAR – Hormones& Endocrinology lab 8,9 Cortisol level A cortisol level is a blood test that measures the amount of cortisol, a steroid hormone produced by the adrenal cortex. How the Test is Performed Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood. Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding. In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding. How to Prepare for the Test The health care provider may ask you to stop taking drugs that can affect the test. Drugs that can increase cortisol measurements include: Estrogen Human-made (synthetic) glucocorticoids, such as prednisone and prednisolone Drugs that can decrease cortisol measurements include: Androgens Phenytoin How the Test Will Feel Prepared By Dr. Abdelrahman Elresheid1 When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing. Why the Test is Performed The test is done to check for increased or decreased cortisol production. Cortisol is a steroid hormone released from the adrenal gland in response to ACTH, a hormone from the pituitary gland in the brain. Cortisol affects many different body systems. It plays a role in: Bone Circulatory system Immune system Metabolism of fats, carbohydrates, and protein Nervous system Stress responses Different diseases, such as Cushing's disease and Addison's disease, can lead to either too much or too little production of cortisol. Cortisol levels are often measured to help diagnose these conditions and to evaluate how well the pituitary and adrenal glands are working. Normal Results Normal values for a blood sample taken at 8 in the morning are 6 - 23 micrograms per deciliter (mcg/dL). Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results. What Abnormal Results Mean Higher than normal levels may indicate: Adrenal tumor Cushing's syndrome Ectopic ACTH-producing tumors Lower than normal levels may indicate: Addison's disease Hypopituitarism Other conditions under which the test may be performed: Prepared By Dr. Abdelrahman Elresheid2 Acute adrenal crisis Ectopic Cushing's syndrome Pituitary Cushing's (Cushing's disease) Risks Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others. Other risks associated with having blood drawn are slight but may include: Excessive bleeding Fainting or feeling light-headed Hematoma (blood accumulating under the skin) Infection (a slight risk any time the skin is broken) Considerations Normally, cortisol levels rise and fall during the day, repeating on a 24-hour cycle (diurnal variation). Highest levels are at about 6 - 8 a.m. and lowest levels are at about midnight. Physical and emotional stress can increase cortisol levels, because during the normal stress response, the pituitary gland increases its release of ACTH. Higher than normal cortisol levels are expected in women who take estrogen or birth control pills. Alternative Names Serum cortisol Prepared By Dr. Abdelrahman Elresheid3 lab 5 Cortisol - urine A cortisol urine test measures the amount of the steroid hormone cortisol in the urine. How the Test is Performed A 24-hour urine sample is needed. The health care provider will instruct you, if necessary, to stop taking drugs that may affect the test. On day 1, urinate into the toilet when you get up in the morning. Afterwards, collect all urine in a special container for the next 24 hours. Keep the container in a cool place during the test period. On day 2, urinate into the container when you get up in the morning. Cap the container. Label the container with your name, the date, the time of completion, and return it as instructed. Keep it in the refrigerator or a cool place until you return it to the laboratory. FOR INFANTS Thoroughly wash the area around the urethra. Open a urine collection bag (a plastic bag with adhesive paper on one end), and place it on the infant. For boys, the entire penis can be placed in the bag and the adhesive attached to the skin. For girls, the bag is placed over the labia. Diaper as usual over the secured bag. This procedure may take a couple of attempts -- lively infants can displace the bag. Check the infant frequently and change the bag after the infant has urinated into the bag. Drain the urine into the container for transport to the laboratory. Deliver the urine to the laboratory or your health care provider as soon as possible. How to Prepare for the Test No special preparation is necessary for this test. If you are taking the collection from an infant, you may need a couple of extra collection bags. How the Test Will Feel The test involves only normal urination, and there is no discomfort. Prepared By Dr. Abdelrahman Elresheid4 Why the Test is Performed Cortisol is a steroid hormone released from the adrenal gland in response to ACTH, a hormone from the anterior pituitary gland in the brain. Cortisol levels rise and fall during the day. Highest levels occur at about 6 a.m. to 8 a.m. and lowest levels at about midnight. Cortisol affects many different body systems. It plays a role in: Bone Circulatory system Immune system Metabolism of fats, carbohydrates, and protein Nervous system Stress responses The test is done to determine if you have increased or decreased cortisol production. Different diseases, such as Cushing's disease and Addison's disease, can lead to either too much or too little production of cortisol. Urine cortisol levels can help to diagnose these conditions. Normal Results Normal range: 10 - 100 micrograms per 24 hours (mcg/24h) Normal value ranges may vary slightly among different laboratories. Normal results may sometimes be present in someone with mild Cushing syndrome. Talk to your doctor about the meaning of your specific test results. What Abnormal Results Mean Increased levels of urine cortisol may indicate: Cushing syndrome -- pituitary-independent Cushing's disease -- pituitary-dependent Pseudo-Cushing's Severe depression Tumor that releases ACTH Decreased levels of urine cortisol may indicate: Addison's disease Hypopituitarism Congenital adrenal hyperplasia The test may also be done in cases of exogenous Cushing syndrome. Prepared By Dr. Abdelrahman Elresheid5 Considerations Factors that interfere with this test are: Medications, including glucocorticoids, lithium, diuretics, ketoconazole, estrogens and tricyclic antidepressants Severe emotional or physical stress Note: Due to these interfering factors, the urine cortisol is often tested on three or more separate occasions to get a more accurate picture of average cortisol production. Alternative Names 24-hour urinary free cortisol (UFC) Prepared By Dr. Abdelrahman Elresheid6