Cortisone: Cortisol Ratio Test Cost & Procedure

Cortisone, a downstream metabolite of cortisol, provides additional diagnostic variables for various adrenal disorders, including defects in 11-β-hydroxysteroid dehydrogenase (11-β-HSD), the enzyme that converts cortisol to cortisone.

Cortisol is a steroid hormone synthesized from cholesterol by a multi-enzymatic cascade in the adrenal glands. Cortisol plays an important role in glucose metabolism, maintaining vascular tone, regulating immune responses, and the body's response to stress.

Cortisone: cortisol ratio test

Measurement of the urinary cortisol/cortisone ratio is clinically used in Cushing's syndrome, frank mineralocorticoid excess, and also provides information on 11β-hydroxysteroid dehydrogenase (11β-HSD) type 2 activity.

Elevated cortisol: cortisone ratios may be seen in chronic renal failure, excessive intake of glycyrrhetinic acid or derivatives, or liver or bile acid abnormalities.

Cushing syndrome

Cushing syndrome occurs when your body produces a large amount of the hormone cortisol. This can result from taking oral corticosteroid medicine. Or your body might stimulate too sizably cortisol.

The most expected indications of Cushing syndrome are:

• A fatty hump between your shoulders
• A rounded face
• Pink or purple stretch scars on your skin

Sample Required

Accessories: Urine Tube, 10 mL (T068)

Dispenser/Tube: Plastic, Urine Tube(T068)

Sample Volume: 5 mL

Collection Procedure

• Collect urine for 24 hours.
• Add 10 g of boric acid as a preservative at the start of the collection.

Interpretation

Most patients with Cushing's syndrome have increased 24-hour urinary excretion of cortisol and/or cortisone. Further studies, such as inhibitory or stimulatory tests, measurement of serum levels of corticotropin (adrenocorticotropic hormone), and imaging studies, are usually required to confirm the diagnosis and identify the etiology.

Normal range values ​​may occur in patients with mild Cushing's syndrome or regular hormone formation. is. Patients with Cushing's syndrome due to synthetic glucocorticoid use should have both cortisol and cortisone suppressed.

Suppressed cortisol and cortisone levels are also seen in primary adrenal insufficiency and hypopituitarism. However, random urine samples are not suitable for the assessment of cortical hypofunction. Moreover, even in many normal individuals, he has very low 24-hour urinary cortisol excretion, which overlaps significantly with levels observed in pathologic hypocritical disorders. Therefore, 24-hour urinary cortisol measurements cannot be used to diagnose hypocritical dysfunction without other tests.

11beta HSD deficiency may have a cortisone-to-cortisol ratio of less than 1, whereas ratios of 2:1 to 3:1 are observed in normal patients.