Cortisol

Cortisol is a stress-response hormone made by the adrenal cortex. It follows a daily rhythm (highest in the morning, lowest around midnight) and is measured in blood, late-night saliva, or 24-hour urine to evaluate cortisol excess or deficiency. (MedlinePlus)

Last reviewedJune 16, 2026

Serum

sample type

~5 mL

blood needed

~7 days

results in app

Morning, 7 to 9am

best timing

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Why test Reference ranges What you'll learn What affects it How testing works Sources FAQ

In short

Cortisol is a steroid hormone made by your adrenal glands. It is often called the main stress hormone because it rises when your body needs to respond to pressure, but it does much more than that.

It helps control blood sugar, blood pressure, metabolism, and the sleep and wake rhythm. Levels follow a daily pattern, highest in the early morning and lowest around midnight.

Metabolic & Diabetes

Reviewed against DGKL reference practice.

Why test this?

Cortisol helps you see whether your stress response and adrenal glands are working normally. Persistently high levels can point to Cushing's syndrome, chronic stress, or certain medications, and may go along with weight gain, high blood pressure, and poor sleep.

Low cortisol can signal adrenal insufficiency (Addison's disease) or a pituitary problem, and may cause fatigue, low blood pressure, and weight loss. Because cortisol changes through the day, the timing of the draw matters a lot.

What is a normal result?

Aniva reads your result against research-backed ranges, not just the lab's wide normal. The reference shown below is specific to this biomarker.

Adult reference values as used by Aniva. Ranges are guidance and can vary by laboratory and method.

Group	Normal range
Adults	171 to 536 nmol/L

Sources: ACB Cortisol Catalogue

Your Aniva report reads your result against these values together with your age, sex and the rest of your panel.

Ranges are guidance and vary by lab and assay, aligned with DGKL practice. Always read your result against your own lab's reference interval.

What insights will this test give you?

Whether your morning cortisol sits in the expected range
Early signals of over or under active adrenal function
Context for symptoms like fatigue, stress, or sleep trouble
A baseline to track over time alongside lifestyle changes

What can affect this result?

What can skew the result

Time of day has a large effect, so morning draws are standard. Stress, acute illness, pregnancy, and oestrogen containing pills raise levels by increasing binding protein. Steroid medication, including inhaled or topical forms, can suppress results. Shift work and poor sleep can shift the daily pattern.

Best interpreted with

Often read alongside ACTH, and with TSH and glucose when fatigue or metabolic symptoms are being worked up.

How is this tested?

Sample

Serum

Blood needed

~5 mL

Method

Immunoassay

Best timing

Morning, 7 to 9am

Sources. The evidence behind this

Endocrine Society: Adrenal hormones, LOINC 2143-6 Cortisol, Mayo Clinic Laboratories: Cortisol, Serum, NIH MeSH: Hydrocortisone (cortisol)

Common questions

What do my cortisol results mean in simple terms? They reflect how your adrenal glands respond to daily demands and stress. Your doctor considers timing, symptoms, and other tests to interpret them.

Do I need to fast for a cortisol test? No. Timing matters more; early morning or late-night sampling may be recommended.

What can affect my cortisol levels? Steroid medicines, birth control or estrogen, illness, stress, poor sleep, shift work, intense exercise, and pregnancy can change results.

How often should I test cortisol? Test when symptoms are present, after medication changes, or to monitor an abnormal result, as advised by your clinician.

How long do results take? Results are usually ready in about 7 days.

What should I discuss with my clinician? Share your symptoms, all medicines and supplements, sleep schedule, and ask if confirmatory tests like saliva, urine, or an ACTH stimulation test are needed.

Which Aniva panels include this marker?

Core

Your annual full-body baseline with more than 100 biomarkers, included in your Aniva membership.