# Cortisol Test?

**URL:** <https://forum.barbellmedicine.com/t/cortisol-test/4241>\
**Category:** Medical Q&A \[Moderated\]\
**Created:** [December 6, 2018, 4:03pm UTC](https://forum.barbellmedicine.com/t/cortisol-test/4241 "2018-12-06T16:03:03Z")\
**Posts on this page:** 4\
**Page:** 1

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**Author:** ![Hegemon78](https://avatars.discourse-cdn.com/v4/letter/h/a88e4f/32.png) [@Hegemon78](https://forum.barbellmedicine.com/u/Hegemon78)\
**Post date:** [December 6, 2018, 4:03pm UTC](https://forum.barbellmedicine.com/t/cortisol-test/4241/1 "2018-12-06T16:03:03Z")

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Hello!

Thank you for taking time to review this post. If a person has struggled with weight (40+ BMI for over 20 years) is it worthwhile to have cortisol levels tested? If so, are there any interventions that are proven to be effective?

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**Author:** ![Austin\_Baraki](https://sea1.discourse-cdn.com/flex001/user_avatar/forum.barbellmedicine.com/austin_baraki/32/1095_2.png) [@Austin\_Baraki](https://forum.barbellmedicine.com/u/Austin_Baraki)\
**Post date:** [December 6, 2018, 6:47pm UTC](https://forum.barbellmedicine.com/t/cortisol-test/4241/2 "2018-12-06T18:47:50Z")

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Obesity alone is not a particularly specific sign of cortisol excess (i.e., Cushing’s syndrome / Cushing’s disease). So unless there are other suggestive signs / symptoms we would typically not recommend testing in this situation.

With that said, the appropriate first-line testing for Cushing’s includes any of:

1. late-night salivary cortisol (two measurements),
2. 24-hour urinary free cortisol (UFC) excretion (two measurements), or
3. overnight dexamethasone suppression test (1 mg)

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**Author:** ![Hegemon78](https://avatars.discourse-cdn.com/v4/letter/h/a88e4f/32.png) [@Hegemon78](https://forum.barbellmedicine.com/u/Hegemon78)\
**Post date:** [December 6, 2018, 9:09pm UTC](https://forum.barbellmedicine.com/t/cortisol-test/4241/3 "2018-12-06T21:09:02Z")

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Thank you very much doctor. I just have one follow up question. Can elevated cortisol levels cause obesity even if one doesn’t have Cushings? If so, are they interventions for that?

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**Author:** ![Austin\_Baraki](https://sea1.discourse-cdn.com/flex001/user_avatar/forum.barbellmedicine.com/austin_baraki/32/1095_2.png) [@Austin\_Baraki](https://forum.barbellmedicine.com/u/Austin_Baraki)\
**Post date:** [December 6, 2018, 9:50pm UTC](https://forum.barbellmedicine.com/t/cortisol-test/4241/4 "2018-12-06T21:50:02Z")

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> [@Hegemon78](#):
>
> Can elevated cortisol levels cause obesity even if one doesn’t have Cushings? If so, are they interventions for that?

Abnormal / inappropriately elevated cortisol levels are the hallmark of Cushing’s.

This is different than the usual discussion on the internet about “stress” _in general_ being a risk factor for obesity. In that case, the interventions shouldn’t be directed specifically at lowering physiologic cortisol levels, but rather at the psychosocial stressors and dietary habits.