Know your Cortisol. Know your health.
Add Cortisol to your panel, alongside 100+ other biomarkers in a single blood draw.
Normal range: 6.2 – 19.4 µg/dL (higher is better)
Cortisol is your body's primary stress hormone. Your adrenal glands release it on a daily rhythm (highest in the morning, lowest at night), and levels spike in response to physical or emotional stress. Cortisol regulates blood sugar, blood pressure, immune function, and how your body uses fat and protein. Chronically high cortisol from ongoing stress, poor sleep, or rare conditions like Cushing's syndrome contributes to weight gain around the midsection, insulin resistance, and bone loss. Chronically low cortisol from adrenal insufficiency causes fatigue, low blood pressure, and salt cravings. Timing matters: cortisol is best tested in the morning between 7 and 9 am for the most interpretable result.
On its own, Cortisol costs about $85. Empirical offers it as an add-on to the $190 membership, which already includes TSH ($45), Vitamin D ($75), hs-CRP ($69), and ApoB ($50) (add-on price at checkout).
Empirical is FSA/HSA eligible, so you can pay with pre-tax dollars. Fast for 8-12 hours beforehand for the most accurate lipid and metabolic results, and expect results in days rather than weeks.
A normal Cortisol is 6.2 – 19.4 µg/dL. Higher is better.
Elevated cortisol is most often driven by chronic psychological stress, insufficient or poor-quality sleep, and excessive alcohol use. Long-term high-dose corticosteroid medications (like prednisone) mimic cortisol directly and produce the same hormonal effects throughout the body. Cushing's syndrome, caused by a pituitary or adrenal tumor or by prolonged steroid use, produces persistently elevated cortisol along with weight gain, easy bruising, and high blood pressure.
Pregnancy, oral contraceptives, and estrogen therapy raise total serum cortisol by increasing cortisol-binding globulin, though biologically active free cortisol is usually unchanged. Major depression, alcohol use disorder, and uncontrolled diabetes can also push cortisol upward.
Low cortisol most often reflects adrenal insufficiency, either primary (Addison's disease, an autoimmune attack on the adrenal glands) or secondary (the body's own cortisol production suppressed after long-term steroid use). Symptoms include fatigue, low blood pressure, weight loss, and salt cravings. Abrupt withdrawal from long-term steroids can trigger a dangerous adrenal crisis.
Day-to-day lifestyle has a real effect on cortisol patterns. Consistent sleep timing, regular exercise (without chronic over-training), morning sunlight exposure, and stress-management practices like meditation or breathwork have all been shown to lower elevated cortisol over time. Cortisol is one of the biomarkers most responsive to behavior change.
Cortisol is drawn at 2,200+ Quest and BioReference patient service centers across the US, so there's usually one within a short drive. Browse the full directory to find the one closest to you.
Add Cortisol to your panel, alongside 100+ other biomarkers in a single blood draw.