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 you'll learn
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Insights that connect the dots. A clinician reads your whole picture, not one result in isolation, connecting family history, past results, and lifestyle into clear next steps.
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Your personalized action plan. Nutrition, supplements, and training in one clinician-reviewed protocol, updated as your results change.
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Track your trends. Upload results from any lab and see each biomarker trend over time, so you know what is working.
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Never miss a recheck. Mito tells you what is worth retesting and when, then reminds you so nothing slips.
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.
Mito Membership
$9 /mo
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Without membership
$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. It is never a profit on the test itself. Mito makes its money on the $9 membership, not on marking up your tests. Membership is $9 per month, and any applicable lab order or draw fee is itemized before you pay.
Where do I get tested?
Choose an available partner lab at checkout. If your cart contains multiple blood tests, Mito helps consolidate the eligible tests at one lab when possible. At-home kits and scans follow the collection or appointment process shown on their product page.
Is this eligible for HSA/FSA?
Yes. Eligible tests can be paid for with an HSA or FSA card at checkout.
When will I get my results?
Your results appear in your Mito dashboard after the laboratory completes processing. A clinician then reviews them before your analysis and personalized action plan are finalized. Timing varies by test, and specialty assays and at-home kits may take longer.
Do I need a physician's order?
No. Mito provides the laboratory order when one is required, so you do not need to arrange a separate physician visit before purchasing.
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