What Causes High Cortisol Levels in Urine

Abnormalities in Urine

Our bodies use several mechanisms for excretion of waste material and metabolic by-products. Urine, sweat, and exhalation (Carbon Dioxide) are some of these mechanisms.

Before discussing what causes high cortisol levels in urine, we are going to discuss urine, its composition and one of its major abnormalities – Cortisol. Our urinary system is made up of a pair of kidneys, renal pelvis, a pair of ureters, urinary bladder, urethra and a pair of adrenal glands.

Kidneys are the major organs which produce urine. Blood from the circulation gets filtered through the mesh-like structures present in kidneys and travel through right and left ureters where they finally get collected in the bladder. This balloon-like container stores urine, until it fills up to a certain extent and is ready to get excreted through urination.

An average healthy adult will excrete 1-1.8L of urine per day, but this may vary according to the age, gender and other circumstances like consumption of water.

As far as the normal appearance of Urine is considered, it’s a clear, transparent or straw-colored liquid which is composed of water, urea, and uric acid. However, certain health conditions in our body like Diabetes Mellitus, Kidney diseases and jaundice can give rise to certain changes in urine affecting its color and composition.

For example, a urine analysis carried out in a patient with Diabetes Mellitus will have sugar (glycosuria); urine sample of a patient with a kidney disease like Nephrotic syndrome will have protein (proteinuria); urine sample of a patient with jaundice will have bile pigments in (tea-colored urine). Individuals suffering from certain health conditions will pass high levels of Cortisol with urine.

What Causes High Cortisol Levels in Urine

What is Cortisol?

Cortisol and Stress are two terms which go hand in hand with each other. Cortisol is a hormone which is produced in Adrenal glands and it is released by the stimulation of ACTH hormone. Produced by the pituitary gland in the brain, Cortisol is responsible for regulating stressful situations in the body. It also plays a major role in metabolizing carbohydrates, fats, and proteins, regulating physical and emotional stress, inflammatory responses, and reactions following injury and strenuous activities.

In healthy individuals, Cortisol levels usually rise up in the morning with a peak concentration noted, around 7 a.m. This level becomes significantly low during the late evening and during the initial most phase of sleep. However, sleeping during the daytime might result in slight alterations of this pattern but the general nature will remain the same.

Any deviations from this standard pattern will have to be investigated since there is a possibility of a health condition most likely in the pituitary or adrenal gland.

What Causes High Cortisol Levels in Urine?

Cortisol levels in urine are usually checked in individuals who experience signs and symptoms associated with various health issues related to endocrine system – pituitary gland or adrenal gland.

This is done by collecting a 24-hour urine sample and analyzing it to quantify the concentration of Cortisol present.

Adult – <100mcg

Teen – 5-55 mcg

Child – 2- 27 mcg

These values are just a guide and ranges may vary from one laboratory to another, depending on the measurements used. However, what is important is, to see the word ‘NORMAL’ in your lab report. If there is anything unusual, you will require medical advice.

High values of Cortisol may be seen in conditions such as,

  • Long term intake of Corticosteroids like Dexamethasone, Prednisolone, and Estrogens or Amphetamines.
  • Benign tumors of the pituitary gland and adrenal gland.
  • Malignant conditions in the pituitary gland or adrenal gland or rare lung cancers
  • Cushing’s disease or Cushing’s syndrome
  • primary or secondary adrenal insufficiency (Addison disease)

Other pathological conditions which might result in an increased cortisol level in urine include

  • Physical or emotional stress
  • Pregnancy
  • Hypoglycemia (low blood sugar levels)
  • Strenuous exercises
  • Collecting urine for less than 24 hours.

Now that you have gained some sort of knowledge about the possibilities where the composition of urine can become abnormal in relation to certain diseases, you can be on the watch out for any abnormalities in your urine. In fact, if there is any change in the nature of urine, associated with other signs and symptoms such as lower abdominal pain, fever with chills and rigors (urinary tract infections) yellowish discoloration of mucous membranes (jaundice), it is advisable to seek early medical advice.

Image Courtesy:

“Illu urinary system” By Illu_urinary_system.jpg: Arcadianderivative work: Thstehle – Illu_urinary_system.jpg, (Public Domain) via Commons Wikimedia

About the Author: Embogama

Embogama is a passionate freelance writer for several years. Her areas of interest include general medicine, clinical medicine, health and fitness, Ayurveda medicine, psychology, counseling and piano music