Cortisone (Compound E),24 Hours Urine Test Cost & Procedure

Cortisone is a pregene steroid hormone. It is a naturally occurring corticosteroid metabolite. It is also used as a prodrug for pharmaceuticals. Cortisone is not synthesized in the adrenal gland.

Primarily, by the action of the enzyme 11-β-dehydrogenase isoenzyme 2, Cortisone is converted to an inactive metabolite. And by the movement of the enzyme 11β-hydroxysteroid dehydrogenase type 1, Cortisone is converted to an active steroid, especially in the liver.

The term "cortisone" is often used to refer to either corticosteroids or hydrocortisone and is another name for cortisol.

Cortisone can be administered as a prodrug, which means that it can be made effective after its administration by the body.

Values of Cortisone

Priority Sample-10 ml urine

Minimum Volume-2.1 mL urine

Urine Collection Procedure

Urine is collected (10 g) and can also be used as a  preservative. The urine is refrigerated during collection if it is not in use. The 24-hour urine volume is measured.

The things used in the test are

• A Transport container
• A Plastic urine container
• Temperature Maintained(Transport)
• A cold pack

Clinical Significance

24-hour urinary cortisone- This test is helpful in the diagnosis of overt mineralocorticoid excess(AME)Syndrome when it is used in conjunction with the measurement of 24-hour urinary cortisol.

Cortisone is metabolized in the kidney by 11-β-hydroxysteroid dehydrogenase type 2 (11-β-HSD2), an inactive metabolite.

In AMD patients, the deficiency of 11-β-HSD2 impairs the inactivation of cortisol to cortisone. As a result, accumulated cortisol activates mineralocorticoid receptors, leading to clinical symptoms resembling primary aldosteronism. AME patients usually present with hypotension, hypertension, hypokalemia, and metabolic alkalosis. Similarly, ingesting certain compounds that inhibit 11-beta-HSD2 activity, such as glycyrrhetinic acid (found in licorice), carbenoxolone, and phthalates, may decrease the conversion of cortisol to cortisone. Therefore, a high cortisol-to-cortisone ratio measured in 24-hour urine can help identify disorders caused by impaired activity of 11-beta-HSD2.

Cortisone test interpretation

• Normal adult urinary cortisol levels are 3.5 to 45 mg per 24 hours.
• There can be many abnormal conditions. High values ​​cause Cushing's syndrome, which includes a round face, thinning of legs, and weight gain.
• Low levels cause less production of cortisol in the adrenal glands, resulting in Addison's disease, which includes weakness of muscles, weight loss, and abdominal pain