Free Cortisol and Cortisone, 24-Hour Urine with Creatinine
A 24-hour window on total cortisol output, the core test when Cushing's syndrome is on the table.
Consider this test if:
- Central weight gain, a rounded face, purple stretch marks, easy bruising, or thinning skin
- New or hard-to-control high blood pressure or blood sugar alongside muscle weakness
- Working up suspected Cushing's syndrome and wanting a full-day measure rather than a single draw
- Evaluating possible mineralocorticoid excess or heavy licorice intake, where the cortisol-to-cortisone ratio matters
- Tracking cortisol output over time after treatment or while adjusting steroid-affecting medication
- HSA/FSA eligible
- Results delivered to your dashboard · Reviewed by a real clinician
- Drawn at a CLIA/CAP-accredited lab near you ·
Pre-test considerations
This is a full 24-hour urine collection: discard the first morning void, then collect every drop for the next 24 hours, including the next morning's first void, and keep the container refrigerated throughout. An incomplete collection is the most common reason for an inaccurate result, which is why creatinine is measured to check completeness. Glucocorticoid medications, including oral, inhaled, and topical steroids, and physical or emotional stress and illness can raise cortisol output, so note any steroid use and timing for accurate interpretation.
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What this test is for
Free cortisol in a 24-hour urine collection measures how much active cortisol your adrenal glands released across a full day, which smooths out the large hour-to-hour swings that make a single blood draw hard to interpret. Persistently elevated urinary free cortisol is one of the main findings in Cushing's syndrome, and the test is commonly ordered when there is unexplained central weight gain, easy bruising, purple stretch marks, muscle weakness, high blood pressure, or high blood sugar. Creatinine is measured alongside to confirm the collection was complete, since an undercollected sample understates true output.
This version adds cortisone, the inactive partner that cortisol is converted to and from by the 11-beta-HSD enzymes. The cortisol-to-cortisone relationship adds information the cortisol-only 24-hour test does not, which is useful when apparent mineralocorticoid excess or heavy licorice intake is suspected; if your only question is total cortisol output, the Cortisol, Free, 24-Hour Urine test covers that.
Biomarkers tested
Includes 4 biomarkers
- Specimen
- Urine
- Measures
- Volume
- Specimen
- Urine
- Measures
- Ratio
- Specimen
- Urine
- Measures
- Ratio
- Specimen
- Urine
- Measures
- Ratio
What to expect
- 1 Book instantly
Click, book, done. Choose a convenient lab location near you. Transparent, up-front pricing.
- 2 Quick lab visit
Testing to fit your busy schedule, usually 15 minutes or less. Walk-in and appointments available.
- 3 Fast, dashboard-delivered results
Your results post straight to your dashboard as soon as the lab completes them.
- 4 Expert guidance
Included with Mito membership. A clinician reviews your results and your personalized action plan follows, with clear next steps.
Everything your health needs,
in one membership
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Every test at our cost
Members pay our cost on every test, with lab fees passed straight through. The full receipt is itemized, never padded.
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Continuous tracking, all in one place
Upload past labs and watch your trends over time. Every marker and visit lives in one longitudinal record, so all your care stays together.
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Year-round clinician support
Text anytime and get clinician-reviewed answers. When you want to go deeper, 1:1 consultations are available at affordable rates.
All for $9/month
Order any test or consult without joining. For $9/month, members unlock member prices, trend tracking, and year-round clinician guidance.
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$9 /mo
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$0
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Frequently asked questions
View all FAQsHow does pricing work?
Every test shows the member price next to the standard non-member price, so you can see what membership saves you. The member price is our cost — covering the lab and what it takes to run the service — never a profit on the test itself; Mito makes its money on the $9 membership, not on marking up your tests. Membership is $9/mo, and you still pay the lab’s order fee. Prices are itemized before you pay, with no hidden fees.
Where do I get tested?
Choose a partner lab (Quest, Labcorp, or BioReference) at checkout. If your cart spans multiple tests, we consolidate the whole order onto a single lab so you only make one visit.
Is this eligible for HSA/FSA?
Yes. This test is HSA/FSA eligible, and you can pay with your HSA/FSA card at checkout.
When will I get my results?
Your results post to your dashboard once your lab completes them, then a clinician reviews them and your full analysis and personalized action plan (with clear next steps) follow. Turnaround varies by test: specialty assays and at-home kits take longer, and each test shows its expected turnaround before you buy.
Do I need a doctor’s order?
No. Mito provides the lab order for you, so you can book and get tested without a separate doctor visit.
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