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Cortisol (urine)

Urine_metabolic Unit: μg/24hr Urine test

Free cortisol excretion; reflects biologically active cortisol

Also known as: 24-Hour Urine Cortisol,Free Cortisol

Reference Ranges

Clinical Reference 3.0 – 50.0 μg/24hr
Optimal Range 10.0 – 35.0 μg/24hr

Gold standard for Cushing syndrome screening

Related Conditions

Cushing Syndrome High
Adrenal Insufficiency Low

Food & Lifestyle Recommendations

🏃 Exercise Avoid overtraining — excessive exercise raises cortisol; moderate exercise lowers it Overtraining syndrome elevates resting cortisol; moderate exercise reduces it
😴 Sleep Prioritize 7-9 hours of quality sleep — poor sleep significantly elevates cortisol Sleep restriction increases evening cortisol by 37% and overall cortisol exposure by 45%
🧘 Stress Practice daily stress management: meditation, deep breathing, yoga, or nature walks Chronic stress elevates cortisol; mindfulness reduces cortisol by 15-25% in RCTs

Evidence-Backed Supplements

When High

  • Magnesium Tier A May Decrease

    Moderate evidence; magnesium supplementation reduces cortisol levels. Studies show reduced salivary and urinary cortisol.

    Magnesium glycinate 200–300 mg elemental Mg/day Evening
    PMID 33419615 PMID 23440790 PMID 32956536
  • Ashwagandha Tier A May Decrease AYURVEDA

    Moderate evidence; ashwagandha is an adaptogen that reduces cortisol. Multiple RCTs show significant cortisol reduction.

    KSM-66 or Sensoril extract 300–600 mg/day Evening
    PMID 41475897 PMID 32316411 PMID 36017529

Questions to Ask Your Doctor

  • Could my elevated urine cortisol indicate Cushing syndrome, and what follow-up tests do I need? Elevated 24hr urine cortisol warrants dexamethasone suppression test and imaging.

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