Cortisol (4:00 PM)
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Cortisol plays a major role in Regulating metabolism, Managing immune response, Controlling blood pressure, Assisting in glucose regulation
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🕒 Cortisol (4:00 PM) — Serum
Test Name | Cortisol (Afternoon) – 4:00 PM Sample |
|---|---|
Sample Type | Serum (from blood sample) |
Fasting Required | ❌ Not required (but avoid caffeine, stress, heavy meals) |
Timing | Drawn specifically at 4:00 PM to assess diurnal variation |
Normal Range (4 PM) | 3–10 µg/dL (varies by lab and method) |
Department | Endocrinology / Internal Medicine |
Turnaround Time | 1–2 working days |
🧬 What is Cortisol?
- Cortisol is the primary stress hormone produced by the adrenal glands.
- It plays a vital role in:
- Regulating metabolism
- Managing immune response
- Controlling blood pressure
- Assisting in glucose regulation
🌗 Why Test Cortisol at 4:00 PM?
Cortisol follows a diurnal rhythm:
- Peak in early morning (6–8 AM)
- Lowest around midnight
- Moderate levels by 4:00 PM
Testing at 4:00 PM helps:
- Compare with morning levels to assess normal circadian rhythm
- Screen for Cushing’s syndrome (loss of daily rhythm or consistently high levels)
- Evaluate Addison’s disease (low cortisol across the day)
⚕️ When is this test recommended?
Indication | Reason |
|---|---|
Suspected Cushing’s syndrome | Check if cortisol is abnormally high in the afternoon |
Suspected Addison’s disease | Check for abnormally low cortisol levels |
Fatigue, weight loss, weakness | Adrenal insufficiency screening |
Hirsutism, menstrual irregularity | In women with suspected adrenal dysfunction |
Persistent hypertension or glucose intolerance | As part of metabolic evaluation |
🧪 Associated Tests
Test | Purpose |
|---|---|
8 AM Cortisol | Compare AM vs PM to assess cortisol rhythm |
ACTH (Adrenocorticotropic Hormone) | Differentiate adrenal vs pituitary issue |
ACTH Stimulation Test | Confirm adrenal insufficiency |
Dexamethasone Suppression Test | Detect Cushing’s syndrome |
Aldosterone & Renin | Adrenal gland profile |
Electrolytes | Assess sodium, potassium, linked to cortisol |
24-Hour Urinary Free Cortisol | Long-term assessment of cortisol levels |
📉 Low 4 PM Cortisol May Indicate
- Adrenal insufficiency (Addison’s disease)
- Hypopituitarism
- Chronic stress with adrenal fatigue
- Abrupt corticosteroid withdrawal
📈 High 4 PM Cortisol May Indicate
- Cushing’s syndrome
- Adrenal adenoma or hyperplasia
- Ectopic ACTH production (e.g., from tumors)
- Severe stress, depression, alcoholism
📝 Summary
Aspect | Details |
|---|---|
Test | Cortisol (4:00 PM) |
Use | Detect adrenal dysfunction, monitor diurnal pattern |
High Value | Suggests Cushing’s syndrome, stress, tumors |
Low Value | Suggests Addison’s disease, adrenal fatigue |
Paired Tests | 8 AM Cortisol, ACTH, Dexamethasone Suppression Test |
Clinical Value | Useful in evaluating chronic fatigue, endocrine disorders, unexplained hypertension or glucose issues |
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