Cortisol (Evening Sample) Test: Booking, Price, and Results
About Cortisol (Evening Sample) Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | PM Cortisol Test, Evening Cortisol, Late-Night Cortisol, Serum Cortisol (PM Sample), 4 PM Cortisol |
| Sample Type | Venous blood |
| Fasting Required | No (avoid vigorous exercise the day before) |
| Report Time | Same day to 24 hours |
| Recommended For | All genders and ages (adults and children) |
| Price | Starting at ₹200 |
What Is a Cortisol (Evening Sample) Test?
The Cortisol (Evening Sample) Test measures levels of cortisol, a hormone produced by the adrenal glands, in a blood sample collected in the evening. Cortisol follows a natural daily pattern: it peaks in the early morning and gradually falls throughout the day. Doctors order this test to check whether that daily pattern is intact. It is also known as the PM Cortisol Test, Evening Cortisol, or 4 PM Cortisol Test.
What Does a Cortisol (Evening Sample) Test Measure?
The test measures a single hormone: cortisol. Understanding what cortisol does and why its timing matters helps explain why an evening sample is useful.
The table below summarises what the test looks at:
| Component | What It Tells Us |
|---|---|
| Cortisol level at 4 PM | Whether cortisol has declined appropriately from the morning peak |
| Cortisol level from 11 PM to midnight | Whether cortisol is suppressed at its lowest expected point |
| Diurnal rhythm | Whether the natural rise-and-fall pattern is intact |
Cortisol affects almost every organ in the body. It helps the body manage stress, regulate metabolism, and control blood pressure. When its daily rhythm is disrupted, it can signal problems with the adrenal glands or the pituitary glands.
Why Is a Cortisol (Evening Sample) Test Done?
A doctor may order a Cortisol (Evening Sample) Test to investigate symptoms linked to abnormal cortisol levels or to assess adrenal gland function.
Common Symptoms That May Require This Test
The following symptoms may prompt a doctor to request this test:
- Unexplained weight gain, particularly around the abdomen or face
- A rounded, puffy face (sometimes described as a "moon face")
- Persistent fatigue or low energy
- Unexplained muscle weakness
- High blood pressure without a clear cause
- Purple stretch marks on the skin
- Mood changes such as anxiety, irritability, or low mood
Conditions This Test Can Help Detect
This test can help identify several conditions related to cortisol imbalance:
- Cushing's syndrome, a disorder caused by prolonged overproduction of cortisol
- Addison's disease, where the adrenal glands produce too little cortisol
- Secondary adrenal insufficiency, caused by insufficient signalling from the pituitary gland
- Adrenal tumours such as adenoma, carcinoma, or nodular hyperplasia
- Pituitary gland problems that affect ACTH production, the hormone that signals the adrenal glands
- Disruption of the normal cortisol diurnal rhythm
Cortisol (Evening Sample) Test for Chronic Disease Monitoring
Evening cortisol testing plays a useful role in long-term monitoring. After surgery for Cushing's syndrome, evening cortisol results can help detect whether the condition has returned. The test is also used to assess whether hormone replacement therapy is adequate in patients with adrenal insufficiency. Your doctor will advise how often monitoring is needed based on your individual situation.
How to Prepare and What to Expect
Preparing correctly ensures your Cortisol (Evening Sample) Test results are as accurate as possible.
Do You Need to Fast?
No, fasting is not required for this test. You can eat and drink normally beforehand.
However, there are a few important points to be aware of. If you are taking oestrogen-containing medications, including the contraceptive pill or hormone replacement therapy, your doctor may advise you to stop them at least six weeks before the test, as they can falsely raise cortisol levels. Inform your doctor about all current medications, particularly corticosteroids such as prednisone or prednisolone.
Practical Tips Before Your Test
A few simple steps can help ensure a reliable result:
- Avoid vigorous exercise the day before your test
- Drink plenty of water to stay hydrated
- Tell your doctor about all medications and supplements you are currently taking
- If you take high-dose biotin supplements (above 5 mg per day), inform your doctor, as these can interfere with the assay
- Try to remain calm before and during sample collection, as acute stress can affect cortisol levels
- Wear a top with short or loose sleeves for easy access to your arm
Step-by-Step Procedure
The blood collection process is straightforward and takes only a few minutes:
- Arrive at the collection centre or wait for the home collection phlebotomist at your scheduled evening time slot.
- A trained phlebotomist will clean the skin on the inside of your elbow or the back of your hand with an antiseptic swab.
- A small needle is inserted into a vein, and a blood sample is collected into a sealed vial.
- The needle is removed, and a cotton ball or gauze is pressed gently over the site to stop any bleeding.
- A small bandage is placed over the area. The entire process typically takes under five minutes.
- The sample is labelled and dispatched to the laboratory for analysis.
Factors That Can Affect Accuracy
Several factors can influence Cortisol (Evening Sample) Test results:
- Acute physical stress, including recent surgery, hospitalisation, or illness
- Alcohol consumption
- Depression or significant emotional distress
- Corticosteroid medications and certain anticonvulsants
- Oestrogen therapy or pregnancy
- Working night shifts, which can alter the body's natural cortisol rhythm
- High-dose biotin supplementation taken too close to the test
Understanding Your Cortisol (Evening Sample) Test Results
Your Cortisol (Evening Sample) Test results reflect the level of cortisol in your blood at the time of collection. The table below shows general reference ranges.
| Time of Collection | Normal Range |
|---|---|
| Morning (6 AM to 8 AM) | 10 to 20 mcg/dL (140 to 690 nmol/L) |
| Afternoon (4 PM) | 3 to 10 mcg/dL (80 to 270 nmol/L) |
| Evening | Less than 5 mcg/dL |
| Late night (11 PM) | Less than 7.5 mcg/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 alter cortisol readings and require careful interpretation:
Pregnancy and oestrogen therapy can raise measured cortisol levels by increasing the level of a protein called 'cortisol-binding globulin' in the blood. Your doctor will account for these factors when reviewing results. Patients taking prednisolone or prednisone may show falsely elevated cortisol readings due to cross-reactivity in the laboratory assay. Very high cortisol levels, above 1000 nmol/L, may be seen in acutely unwell patients or those who have experienced trauma and are not necessarily a sign of Cushing's syndrome in those circumstances.
How to Maintain Healthy Levels
If your cortisol levels are mildly elevated without a diagnosed medical cause, some general lifestyle habits may help support a healthier rhythm:
- Aim for consistent sleep and wake times each day to support the body's natural cortisol cycle
- Include regular, moderate physical activity such as walking or yoga in your routine
- Practise stress management techniques such as mindfulness, deep breathing, or meditation
Lupin Diagnostics Cortisol (Evening Sample) Test Price and Home Collection
The Cortisol (Evening Sample) Test is available at Lupin Diagnostics with home sample collection across India, starting at approximately ₹200 for a single evening sample. The combined morning and evening cortisol test is priced higher across cities.
| City | Approximate Price (₹) |
|---|---|
| Hyderabad | ₹600 |
| Chennai | ₹600 |
| Kolkata | ₹600 |
| Gurugram | ₹600 |
| Mumbai | ₹600 |
| Pune | ₹600 |
| Bangalore | ₹600 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred evening 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.
Home Collection
Lupin Diagnostics offers home collection for the Cortisol (Evening Sample) Test across multiple cities in India. Experienced technologists process all samples in NABL-accredited laboratories. Your digital report is delivered securely via email or WhatsApp, typically within 24 hours of sample collection.
Frequently Asked Questions
Cortisol follows a predictable daily pattern, rising to its peak in the early morning and falling to its lowest point by late evening. The Cortisol (Evening Sample) Test checks whether this decline is happening as expected. In conditions like Cushing's syndrome, the evening drop does not occur, making the evening sample a valuable diagnostic tool that a morning test alone would miss.
The timing depends on what your doctor is assessing. An afternoon sample is usually collected around 4 PM, while a late-night sample is collected between 11 PM and midnight. Your doctor will specify the correct collection time when requesting the test.
No fasting is required. You can eat and drink as normal before the test. The key preparation steps involve avoiding vigorous exercise the day before and disclosing all current medications to your doctor.
Yes, it can. Acute stress, whether from illness, surgery, or emotional distress, can raise cortisol levels and disrupt the normal daily pattern. Try to rest calmly before your sample is collected. If you have been unwell recently, let your doctor know before proceeding with the test.
A Cortisol (Evening Sample) Test result that remains elevated in the evening, when levels should naturally be low, may suggest that the normal daily rhythm has been disrupted. This pattern is associated with Cushing's syndrome, adrenal tumours, or prolonged stress. Further tests will be needed before any diagnosis is made.
The discomfort is minimal for most people. You may feel a brief sting when the needle is inserted, and the area may feel slightly tender or show mild bruising afterwards. These effects are temporary and typically resolve within a day.
Yes. Lupin Diagnostics offers home collection for this test, with a certified phlebotomist visiting at your chosen evening time slot. You can book through the Lupin Diagnostics website or app and receive your results digitally once ready.
Cortisol (Evening Sample) Test: Booking, Price, and Results
