Cortisol, Urinary Free (HPLC)
Label Mnemonic: UFCHPLC
Epic code: LAB382
Downtime form: A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery
Commercial Mail-out Laboratory
5231 RCP
356-8593
Specimen(s):
Specimen Instructions:
Refrigerate during 24 hr collection in plastic container. Record start and end of 24 hour collection on requisition for submission to lab.

Random urine is also accepted in a yellow top round bottom tube (no additive).
Collection Medium:
or
Urine - 24 hour/timed plastic urine container Yellow top round bottom tube (no additive)
Minimum:
Preferred Minimum: 4 mL aliquot from well mixed 24 hr sample or 4 mL random sample.
Absolute Minimum: 1 mL aliquot from well mixed 24 hr sample or 1 mL random sample.
Rejection Criteria:
Room temperature specimens. Acidified specimens or specimens with preservatives.
Delivery Instructions:
Submit specimen to laboratory as soon as possible after collection period is completed. Refrigerated sample is viable for one week.
Turn Around Time:
1-4 days upon receipt at reference laboratory
Reference Range:
Cortisol, Urine Free - per 24 hr
  Female
    3-8 years:  < 18 μg/24 hr
    9-12 years: < 37 μg/24 hr
   13-17 years: < 56 μg/24 hr
   18 years and older: < 45 μg/24 hr
  Male
    3-8 years:  < 18 μg/24 hr
    9-12 years: < 37 μg/24 hr
   13-17 years: < 56 μg/24 hr
   18 years and older: < 60 μg/24 hr

Cortisol/Cortisone, Ratio*
  Female
    0-17 years: To be determined
    18 years and older: 0.15-0.50
  Male
    0-17 years: To be determined
    18 years and older: 0.15-0.50

Cortisone, Urine Free - per volume
  Female
    Value used to calculate Cortisol/Cortisone ratio

Cortisol, Urine Free - ratio to crt
  Female
    Prepubertal: Less than 25 μg/g crt
    18 years and older: Less than 24 μg/g crt
    Pregnancy: Less than 59 μg/g crt
  Male
    Prepubertal: Less than 25 μg/g crt
    18 years and older: Less than 32 μg/g crt

*The ratio of the concentrations of cortisol to cortisone will not be
 evaluated if the cortisol concentration is less than 5 
μg/L.
Interpretive Data:
The optimal specimen for this testing is a 24-hour urine collection. Mass per day calculations are not reported for the following specimen types: a random collection, a collection with duration of less than 20 hours, a collection with duration of greater than 28 hours, or a collection with total volume less than 400 mL or greater than 5000 mL. Ratios to creatinine may be useful for these evaluations.

Baseline urinary free cortisol excretion less than 5 ug/d may be consistent with adrenal insufficiency.
Comments:
Reference intervals are based on literature from Taylor R.L. et al., Validation of a High-Throughput Liquid Chromatography-Tandem Mass Spectrometry Method for Urine Cortisol and Cortisone. Clinical Chemistry 2002; 48:1511-19.
Methodology:
Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry
CPT Code:
Cortisol 82530
LC-MS/MS 83789