Contents
Urinalysis for cortisol is an important point in a comprehensive study of the state of health in pathologies localized in different parts of the body.
Cortisol is also called the stress hormone. In the medical classification, it falls into the category of steroid glucocorticoids. Produced adrenal cortex в normally functioning body. During a stressful situation, the hormone is released into the blood, which triggers a number of related mechanisms.
This is a significant increase in the number of heartbeats, pressure increase and increased concentration. It is not for nothing that people during unforeseen circumstances note that they begin to think faster in order to get out of dangerous conditions.
Approximately 90% of the substance in the blood is always associated with proteins. The rest of the components, which doctors call free cortisol, are not assigned to any specific biological elements. It is freely removed by the body naturally – during urination. It is his features that the laboratory assistant will study during the specified analysis.
Hormone Features
Despite the fact that the body produces a very small amount of cortisol, and even less of it is freely available for clinical study, it is often the result of such an analysis that has the final say. The results obtained help diagnose a number of diseases that are not directly related to the activity of the adrenal glands.
adrenocorticotropic hormone (abbreviated as ACTH), which generates the pituitary gland, regulates the excretion of accumulated cortisol from the human body. Against this background, it is clear why its volume directly reflects the amount of the hormone of the adrenal cortex itself. The relationship between these compounds is also used to make accurate diagnoses with rare pathologies.
The most important advantage that the presented hormone can boast of is constancy. Its amount almost never changes due to some external conditions, which makes testing really accurate. Changes here occur only due to the launch of some pathological process.
Thus, an increased content of the hormone often accompanies diabetes mellitus at the stage of decompensation or subcompensation. In addition, an abnormally high number will indicate potential ovarian damage or the development of cirrhosis of the liver.
Somewhat less often, such a deviation will indicate hypothyroidism, adrenal adenoma or the pituitary gland itself. But in the presence of obesity in the victim, increased cortisol is quite a common occurrence. The indicated reaction of the body is also considered within the normal range if a person has autoimmune disease or changes due to the defeat of the body by HIV infection.
False results can be obtained due to the influence of drugs that contain barbituric acid.
In pregnant women, an increased level of the hormone, on the contrary, is an indicator of a stable gestation. In a stressful situation, when there is an active production of the adrenal glands and the subsequent release of a shock hormonal dose, the physiological norm also increases significantly.
Something similar happens at the biological level with the person who consumes alcoholic beverages. But if, with a single intake of alcohol-containing liquids, this does not greatly affect the general state of health, then with regular libations, a double responsibility is assigned to the adrenal glands. Their resources wear out, which triggers irreversible processes that adversely affect the state of surrounding tissues and neighboring internal organs.
If cortisol was not enough, then this signals an insufficiency of the adrenal cortex or pituitary gland. Relative primary sources of this condition are also called a sharp weight loss and destabilization of the hormonal background.
Regardless of which direction the deviation was recorded, this is a sign of a violation of the normal functioning of the body. Cortisol is responsible for the control of glycemia and the process of protein breakdown. It also has an anti-inflammatory effect.
As soon as it is revealed in the urine that its level has even slightly fluctuated, this will be the reason for undergoing complex treatment and additional tests. и complex treatment. Otherwise, the victim is provided with problems with sugar level.
The scope of the norm
To get a detailed clinical picture, it will not be possible to use standard types of testing, which are based on a one-time result. The basis is taken indicators of daily urine, which will have to be collected throughout the day. The reason for this is the lack of a strictly fixed regime for its production.
With the patient feeling normal, the least of the hormone is found in the blood in the evening. The highest threshold is fixed in the morning hours.
A direct relationship between the boundaries of the hormone content and the age of the patient is also considered:
- in children under 16 years of age, the frames range from 83 to 580 nmol / l;
- in adults, the standard rises to 138-635 nmol / l.
The quantitative norm in the blood depends on the time of day, which can seriously affect the blurring of the overall clinical picture. In the morning hours from 7 to 9, the norm is 260-720 nmol / l. In the evening, from 16 to 18, the bar drops to 50-280 nmol / l.
Against this background, experts prefer to first conduct a study with a basis in the form of daily urine sampling, and not blood. But there the hormone can change the natural level due to pregnancy. There is no exact concentration value for this, but a 4-5 times excess becomes a generally accepted increase in the amount.
Proper preparation
To make the collection of biological fluid really correct, without the risk of distorting subsequent results, you will need to drain all the urine into a single container. The only exception is the first serving immediately after waking up in the morning.
To avoid problems after sleep, it is worth preparing a container of a suitable volume in the evening. A cleanly washed and disinfected three-liter glass vessel. If there is no such container at home, you can purchase a suitable vessel at the pharmacy.
It is possible to add strictly 1 gram of boric acid to the bottom of the container. She will play the role of a preservative.
In order not to bring down the natural acidity and the original composition, the collected waste biological fluid must be stored at a temperature of +4 to +8 degrees. If you place the vessel in a place that is too warm, then this will disrupt the natural balance of glucose, which will lead to a significant error in the future.
When the daily event is completed, the contents of the container must be mixed, and then pour about 100 ml into a separate container, be sure you need to measure and record the total volume of urine – this is important for calculating indicators. It is necessary to deliver the material as soon as possible.
It is strictly forbidden to independently refuse previously prescribed drugs from a treatment program approved by a narrow specialist. First, you should consult with the doctor who prescribed the medication. It is likely that it is more effective to simply wait for the end of the main course of treatment, and only then undergo profile testing.
Some chronic diseases can also become an obstacle to obtaining reliable information, so it is worth mentioning them at the first appointment with a doctor.
Before collecting material, you need to familiarize yourself with other preparatory techniques that affect the purity of the experiment:
- The night before, only a light dinner is allowed. It is impossible to transfer, as well as include fried foods, pickles, spicy dishes in the diet.
- Alcoholic drinks must not be consumed. You need to stop smoking at least a couple of days before the test.
- Consult a doctor if taking drugs.
Medical indications
Preparation for the examination should also include a primary diagnosis, or simply taking an anamnesis if the picture looks vague. Among the most common reasons that encourage doctors to send their wards to undergo such a study, there are:
- Itsenko-Cushing’s disease;
- Addison’s disease;
- muscle weakness;
- change in skin color with possible pigmentation;
- arterial hypertension;
- osteoporosis;
- early sexual development;
- early onset of secondary sexual characteristics in girls.
It does not do without a study of the case when it is necessary to exclude a possible oncological pathology of the central nervous system. Also check is made among kids if necessary. The result allows to exclude congenital malformations.
High and low rates
If during the diagnosis it suddenly turns out that there is an increased concentration of cortisol, then this will indicate a number of changes in the body. Some of them will be at the initial stage of development, which will facilitate further therapy. But if you ignore abnormally high limits, then this can lead to the launch of irreversible processes.
A high level of the hormone suggests that the victim has a neoplasm of a benign or malignant nature.
It is often localized in the pituitary gland, bronchi, ovaries, testicles, and the adrenal glands themselves. Occasionally, a different location of the tumor is possible. The same thing happens with hyperplasia of the adrenal cortex or hyperfunction of the thyroid gland. But at the top of the ranking almost always dominated by obesity of varying severity.
The reverse algorithm is supported by the body if a person has Addison’s disease of the congenital type. Oncological neoplasms in the brain can also adversely affect the amount of hormone produced.
Other warning signs may include low thyroid function or prolonged use of hormonal drugs to eliminate ailments in a given part. Even standard oral contraceptives offer identical results when taken long-term.
Doctors recommend refusing to take an analysis if the day before the person suffered a strong emotional shock, experienced heavy physical exertion, is in a state of psycho-emotional instability, or is exposed to stress on an ongoing basis. First you need to get rid of these factors that can seriously affect the reliability of the information received., distorting the analysis.
Also, doctors will never send a person to be tested immediately after they have had an operation. Separately, the doctor must clarify whether the victim has relatives with an identical problem in order to eliminate risks weighed down heredity.
Alcohol abuse, liver cirrhosis at any stage and hepatitis also change the examination data.
After the result is received on hand, the final diagnosis should be established by an endocrinologist with the support of a therapist. A disease detected in time will reduce the cost of therapy in the future, and will also guarantee the absence of significant complications.
The price of this type of examination varies depending on the need to conduct auxiliary tests, as well as on the pricing policy of each particular clinic.