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Cortisol (p.m.)

Adrenal cortex disorders Hypothalamic, Pituitary disorders

CSample: Serum

Schedule: Daily

Units: nmol/L Factor nmol/L ÷ 27.6 = ug/dL

Range: Approx. 50% of a.m. value.

Remarks: Cortisol is the most abundant circulating steroid and the major glucocorticoid secreted by the adrenal cortex. Physiologically effective in anti inflammatory activity and blood pressure maintenance, cortisol is also involved in gluconeogenesis, calcium absorption and the secretion of gastric acid and pepsin. As an indicator of adrenocortical function, measurement of blood cortisol levels is useful in the differential diagnosis of Addisons and Cushings disease, hypopituitarism, and adrenal hyperplasia and carcinoma.

A variety of stimulation and suppression tests, as ACTH Cosyntropin (Synacthen) Stimulation, ACTH Reserve, or Dexamethasone suppression test , can supply supportive information on adrenocorticol function. Anomalous cortisol concentrations have been shown to exist in patients with acute infections, severe pain, diabetes mellitus or heart failure, and in women either pregnant or on estrogen therapy. In addition, certain virilizing syndromes and iatrogenic conditions raise other naturally occurring steroid levels to high (no nphysiologic) concentrations that may interfere with assaying cortisol directly, unless a highly specific antiserum is used. Ôï ì