Cortisol (Morning & Evening Sample) Test: Booking, Price, and Results

The cortisol (morning & evening sample) test measures the level of cortisol, a hormone produced by the adrenal glands, at two specific points in the day. Cortisol naturally rises and falls throughout the day, so two blood draws are needed to capture this pattern. Doctors prescribe this test when they suspect a problem with the adrenal or pituitary glands. It is also known as the serum cortisol AM/PM test or the cortisol diurnal variation test.

This test is ordered when a doctor suspects that the adrenal or pituitary glands are not producing the right amount of cortisol. It can also be used to monitor ongoing treatment for certain hormone conditions.

Common Symptoms That May Require This Test

• Unexplained fatigue or persistent weakness
• Unexplained weight gain or weight loss
• Low blood pressure (also known as hypotension)
• Changes in skin colour or unusual skin darkening
• Mood swings or persistent low mood
• Difficulty sleeping or disrupted sleep patterns
• Difficulty concentrating or general mental fogginess

Conditions This Test Can Help Detect

• Cushing's syndrome, a condition caused by abnormally high cortisol levels over a prolonged period
• Addison's disease, in which the adrenal glands are damaged and produce too little cortisol
• Secondary adrenal insufficiency, where the pituitary gland fails to signal the adrenal glands adequately
• Pituitary gland tumours that affect cortisol production
• Stress-related hormone imbalances and sleep disorders

Preparing for this test is straightforward, but the timing of your blood draws is the single most important factor.

Do You Need to Fast?

No, fasting is not required for the cortisol (morning & evening sample) test. Timing, not food intake, is what matters most. You must give your morning sample between 7:00 a.m. and 9:00 a.m., and your evening sample between 3:00 p.m. and 5:00 p.m. Arriving outside these windows may affect the accuracy of your results.

Practical Tips Before Your Test

• Avoid strenuous physical exercise the day before your test.
• Get 7 to 9 hours of sleep the night before to support a normal cortisol rhythm.
• Avoid alcohol in the 24 hours leading up to your test, as it can suppress cortisol production.
• Stop taking biotin (vitamin B7) supplements at least 72 hours before collection, as biotin can interfere with the test method.
• Inform your doctor of all medications you are taking, including oral contraceptives, oestrogen therapy, corticosteroids, and antidepressants.
• Try to minimise stress immediately before each blood draw, as acute stress can temporarily raise cortisol levels.

Step-by-Step Procedure

1. Arrive at the collection centre (or arrange home collection) between 7:00 a.m. and 9:00 a.m. for your first draw.
2. A phlebotomist will clean a vein site, usually on your inner arm, and collect a small serum blood sample into a yellow gel tube.
3. Return for your second blood draw between 3:00 p.m. and 5:00 p.m. on the same day.
4. The same collection process is repeated for the evening sample.
5. Both samples are stored at 2 to 8°C and sent to the laboratory for analysis using the EIA (enzyme immunoassay) method.
6. Your report is typically ready within one day of the final sample being received.

Your results will show two cortisol readings, one from the morning and one from the evening. A doctor will compare both values to assess the natural rhythm of your cortisol production.

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.

A normal result shows a clearly higher morning reading that drops significantly by evening, confirming that the adrenal glands and circadian rhythm are working as expected. High levels may point to Cushing's syndrome, adrenal tumours, or chronic stress. Low levels may suggest Addison's disease, secondary adrenal insufficiency, or hypopituitarism (reduced pituitary gland function).

Results During Special Conditions

Certain situations can affect how your results should be read. Pregnancy raises total cortisol concentrations by two to three times the usual level because of increased oestrogen and changes in cortisol-binding proteins. Standard reference ranges do not apply to pregnant women. Oral contraceptives and oestrogen therapy also elevate cortisol concentrations, so results need to be interpreted with this in mind. Long-term night shift work can shift the body's circadian rhythm, making standard morning and evening reference ranges less reliable.

The cortisol (morning & evening sample) test is available at Lupin Diagnostics starting at ₹1,000, with home collection offered across cities in India.

Prices are indicative and may vary by location. Please confirm the current price at the time of booking.

Home Collection

Cortisol test home collection is available across cities through Lupin Diagnostics. A certified phlebotomist will visit your home to collect both the morning and evening samples at the required times. All samples are processed in NABL-accredited laboratories, and your digital report is accessible via email or WhatsApp once ready.