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(Normal range: 9-53 mg/24 hrs (248-1462 nmol/24 hrs

Comment: The diagnosis of Cushing syndrome (CS) requires evidence of cortisol hyper secretion. While serum cortisol levels fluctuate unpredictably and are strongly dependent on concurrent cortisol- binding globulin (CBG) levels, a 24-hour urine specimen integrates the cortisol production for an entire day and is not affected by CBG. Urinary cortisol reflects the portion of serum-free cortisol filtered by the kidney, and correlates well with cortisol secretion rate

Sample: 24 hr Urine