Cortisol (Midnight) Test: Booking, Price, and Results
About Cortisol (Midnight) Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | Late-night cortisol test, midnight serum cortisol, MSC |
| Sample Type | Serum (venous blood) |
| Fasting Required | No fasting required; bring a detailed clinical history to your appointment |
| Report Time | 1 Day |
| Recommended For | Adults of all genders, commonly ordered for those aged 30 to 50 with suspected adrenal disorders |
| Price | Starting at ₹600 |
What Is a Cortisol (Midnight) Test?
The cortisol (midnight) test measures the level of cortisol, a hormone produced by your adrenal glands, in your blood at midnight or late at night. In healthy individuals, cortisol naturally drops to its lowest point around midnight. This test checks whether that normal daily pattern is preserved. It is also called the late-night cortisol test or midnight serum cortisol (MSC). A serum blood sample is collected for this test.
What Does a Cortisol (Midnight) Test Measure?
The test measures cortisol in your blood at a specific time of night. Cortisol is a hormone that helps your body manage stress, regulate blood sugar, support metabolism, and maintain blood pressure. Here is what the test evaluates:
| Parameter | What It Tells Your Doctor |
|---|---|
| Midnight serum cortisol level | Whether cortisol has dropped to its expected low at night |
| Circadian (daily) rhythm | Whether the normal pattern of cortisol, high in the morning, low at midnight, is intact |
| Loss of diurnal variation | Whether the cortisol level remains abnormally high at night, suggesting a possible disorder |
Why Is a Cortisol (Midnight) Test Done?
Your doctor may order a cortisol (midnight) test when your symptoms suggest the body is producing too much or too little cortisol.
Common Symptoms That May Require This Test
Several physical changes can prompt a doctor to request this test. These include:
- Unexplained weight gain, particularly in the face (sometimes called "moon face") or at the back of the neck
- Fatty deposits between the shoulders, often described as a "buffalo hump"
- Purple or pink stretch marks on the abdomen, breasts, or hips
- Skin that bruises easily or wounds that are slow to heal
- Persistent and worsening fatigue or muscle weakness
- Patches of darkened skin (hyperpigmentation)
- Abdominal pain, nausea, or vomiting
Conditions This Test Can Help Detect
A cortisol test can provide information that helps a doctor investigate several conditions, including:
- Cushing syndrome, a condition where the body produces too much cortisol over a prolonged period
- Addison disease (primary adrenal insufficiency), where the adrenal glands are unable to produce enough cortisol
- Secondary adrenal insufficiency, where the pituitary gland fails to signal the adrenal glands to make cortisol
- Tumours of the pituitary or adrenal glands that disrupt normal hormone production
- Certain tumours elsewhere in the body, such as small cell lung cancer, that trigger excess cortisol production
Cortisol (Midnight) Test for Chronic Disease Monitoring
The cortisol (midnight) test is also used to track conditions that are already diagnosed. Patients with Cushing syndrome or Addison disease may have periodic cortisol tests to assess how well treatment is working. Regular monitoring helps a doctor adjust treatment based on current hormone levels.
How to Prepare and What to Expect
Preparing correctly for this test helps ensure accurate results. Below is what you need to know before your appointment.
Do You Need to Fast?
No fasting is required for the cortisol (midnight) test. You can eat and drink normally before the blood draw. However, you must bring a detailed clinical history to your appointment, as this is required for the test.
Practical Tips Before Your Test
A few simple steps before your test can help improve the reliability of your results:
- Bring a detailed clinical history including your symptoms, previous test results, and family history, as this is required for the test
- Inform your doctor about all current medications, especially corticosteroids, oestrogen-containing medicines, or antiseizure drugs
- Rest before the test, as stress and vigorous exercise can raise cortisol levels
- Avoid excessive alcohol in the days before the test
Step-by-Step Procedure
The blood sample for this test is collected from a vein. Here is what typically happens:
- You will be seated comfortably. A trained phlebotomist will look for an accessible vein, usually in the inner part of your arm near the elbow.
- The area is cleaned and disinfected.
- A small needle is inserted into the vein. You may feel a brief pinch. A small amount of blood (around 3 ml) is collected into a yellow gel tube (SST gel tube).
- Once enough blood is collected, the needle is removed. A cotton ball or gauze is pressed over the site to stop any bleeding, and a small bandage is applied.
- The sample is labelled and stored at refrigerated temperature (2 to 8°C) before being sent to the laboratory for testing using an EIA (enzyme immunoassay) method.
- The entire procedure takes just a few minutes.
Factors That Can Affect Accuracy
Several factors can influence the test result. Be aware of the following:
- Acute stress, including hospitalisation or recent surgery
- Depression, anxiety, or alcohol use disorder
- Medications such as corticosteroids, anticonvulsants, and oestrogen-containing drugs
- Irregular sleep patterns, such as those experienced by night-shift workers
- Obesity or poorly controlled diabetes, which may mimic high cortisol patterns
Understanding Your Cortisol (Midnight) Test Results
Your doctor will review your results alongside your symptoms and medical history. The table below shows general reference ranges for cortisol at different times of day.
| Parameter | Normal Range |
|---|---|
| Morning cortisol (6 to 8 a.m.) | 10 to 20 mcg/dL |
| Afternoon cortisol (around 4 p.m.) | 3 to 10 mcg/dL |
| Sleeping midnight serum cortisol (normal) | Less than 50 nmol/L (less than 1.8 mcg/dL) |
| Late-night salivary cortisol (11 p.m. to midnight, normal) | Less than 145 ng/dL |
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain situations can affect how results are interpreted.
Pregnancy and oestrogen use can raise total cortisol levels, as oestrogen increases the protein that carries cortisol in the blood. Doctors take this into account when reviewing results during pregnancy.
Pseudo-Cushing states, seen in people with obesity, depression, heavy alcohol use, or poorly controlled diabetes, can cause temporarily raised midnight cortisol without true Cushing syndrome. Additional tests may be needed to confirm a diagnosis.
How to Maintain Healthy Levels
These general wellness habits support healthy cortisol balance:
- Manage stress through regular sleep, moderate exercise, and relaxation practices such as deep breathing or meditation
- Follow a balanced diet and maintain a healthy weight
- Limit alcohol intake and seek support for conditions such as depression or anxiety if they affect your daily life
Lupin Diagnostics Cortisol (Midnight) Test Price and Home Collection
The cortisol (midnight) test is available at Lupin Diagnostics starting at ₹600, with home sample collection available across cities.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 600 |
| CHENNAI | 600 |
| HYDERABAD | 600 |
| KOLKATA | 600 |
| NAVI MUMBAI | 600 |
| PUNE | 600 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
Home Collection
Lupin Diagnostics offers home sample collection for the cortisol test across multiple cities in India. All samples are processed in NABL-accredited laboratories by experienced staff. Digital reports are delivered directly to you via email or WhatsApp once ready.
How to Book
Select the cortisol (midnight) test on the Lupin Diagnostics website.
- Choose your city and preferred time slot.
- Opt for home sample collection by a certified phlebotomist, or visit your nearest Lupin Diagnostics centre.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
Cortisol follows a daily rhythm in healthy individuals, with levels peaking in the early morning and dropping to their lowest point around midnight. Testing at this specific time helps doctors check whether this rhythm is preserved. A raised cortisol level at midnight is one of the key markers of conditions like Cushing syndrome.
The blood draw involves a small needle insertion, which may feel like a brief pinch. The procedure typically takes just a few minutes, and most people find it straightforward. Any minor soreness at the site usually resolves quickly.
A blood-based cortisol (midnight) test requires sample collection at midnight, which may mean a late-night visit to a collection centre or, in some cases, an inpatient setting. Your doctor will advise you on the most appropriate setting based on your clinical situation.
Yes. Corticosteroids, oestrogen-containing medicines, antiseizure drugs, and certain other medications can raise or lower cortisol levels, or interfere with the normal daily rhythm. Always inform your doctor about every medication and supplement you are taking before the test.
The midnight serum cortisol test is considered a reliable screening tool for Cushing syndrome. Research suggests that a sleeping midnight serum cortisol above 50 nmol/L has high sensitivity for detecting the condition. A single midnight cortisol value above 7.5 mcg/dL has been shown to correctly identify most patients with Cushing syndrome with high specificity.
Stress, including the stress of being in a medical setting, can raise cortisol levels and affect results. Your doctor will consider this when interpreting your report. Resting before the test and avoiding strenuous exercise beforehand can help reduce this effect.
At Lupin Diagnostics, reports for the cortisol (midnight) test are delivered within 1 day of sample collection. You will receive your report digitally via email or WhatsApp.
Cortisol (Midnight) Test: Booking, Price, and Results
