This test is ideal if you're experiencing symptoms that may be related to abnormal cortisol levels, such as unexplained weight gain (especially around the midsection), persistent fatigue, high blood pressure, mood changes, or unusual fat deposits. It helps evaluate whether your body properly regulates cortisol, the stress hormone produced by your adrenal glands. Many people use this test when their doctor suspects Cushing's syndrome or other conditions affecting stress hormone control.
How should I prepare for this test?
You'll need to take a prescribed dexamethasone tablet at a specific time (usually around 11 PM) the night before your blood draw. Your blood sample is then collected the following morning, typically between 8-9 AM. Avoid strenuous exercise and excessive stress before the test, as these can affect cortisol levels. Follow your doctor's instructions carefully about the timing and dosage, and let them know about any medications you're taking, as some can interfere with test results.
What's included in this test?
This test measures your cortisol levels after taking a prescribed dose of dexamethasone, a synthetic steroid medication. The medication should normally suppress cortisol production, so this test evaluates whether your adrenal glands and pituitary gland are functioning properly. It's particularly useful for identifying Cushing's syndrome and other disorders where the body produces too much cortisol, helping explain symptoms like unusual weight gain, high blood pressure, and persistent fatigue.
What happens after I get my results?
You'll receive detailed doctor notes in simple language explaining how your body responded to the dexamethasone medication and what your cortisol suppression pattern means for your adrenal health. These notes include personalized recommendations like stress management strategies, lifestyle modifications, or whether you should follow up with an endocrinologist for further evaluation. You'll also get the standard lab report and can track your cortisol regulation over time using our trends feature to monitor changes or treatment effectiveness.
Who should consider getting this test?
This test is most commonly ordered for people showing signs of excess cortisol production, including rapid weight gain (especially facial rounding and upper back fat), purple stretch marks, easy bruising, muscle weakness, or high blood sugar. It's also important for those with difficult-to-control high blood pressure, bone loss at a young age, or symptoms suggesting Cushing's syndrome. Your doctor may also recommend it if other blood tests show abnormal cortisol patterns.
What symptoms indicate I may need this test?
Key symptoms include unexplained weight gain concentrated in the face, neck, and trunk while arms and legs remain thin, along with a rounded or moon-shaped face. Other signs include purple or pink stretch marks on the abdomen, high blood pressure that's hard to control, unusual fatigue and muscle weakness, easy bruising, depression or anxiety, and irregular periods in women. These symptoms together may suggest your body isn't properly controlling cortisol levels.
How can I naturally support healthy cortisol levels?
Managing stress is crucial for maintaining healthy cortisol balance through practices like meditation, deep breathing exercises, or yoga. Getting 7-8 hours of quality sleep per night helps regulate cortisol's natural rhythm, while regular moderate exercise (avoiding overtraining) can normalize levels. Eating a balanced diet with adequate protein, limiting caffeine and sugar, staying hydrated, and spending time in nature or with loved ones all support healthy stress hormone function.
What is cortisol and why does it matter?
Cortisol is your body's main stress hormone, produced by the adrenal glands and often called the fight-or-flight hormone. It plays essential roles in regulating blood sugar, blood pressure, immune function, and how your body responds to stress. Normal cortisol follows a daily rhythm, peaking in the morning to help you wake up and declining at night for sleep. When cortisol levels are too high or the normal rhythm is disrupted, it can lead to weight gain, high blood pressure, diabetes, weakened immunity, and other serious health problems.
What does high cortisol mean?
If your cortisol doesn't suppress properly after taking dexamethasone, it suggests your body may be producing too much cortisol, possibly indicating Cushing's syndrome or other adrenal disorders. High cortisol can cause weight gain (especially around the midsection and face), high blood pressure, high blood sugar, mood changes, weakened bones, and increased infections. This result typically requires follow-up testing and consultation with an endocrinologist to determine the underlying cause and appropriate treatment.
How often should I retest my cortisol levels?
If you're being evaluated for Cushing's syndrome or other cortisol-related conditions, your doctor may order this test as part of an initial workup, potentially with additional confirmatory tests. Once diagnosed and treated, retesting frequency depends on your specific condition and treatment response, often every 3-6 months initially. If your results are normal but symptoms persist, your doctor may retest after several months or order different tests to explore other causes of your symptoms.
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Demo results
Cortisol (Post-Dexamethasone)3.8 mcg/dL
Demo results
LowOptimal < 1.8High
3.8 mcg/dL
What this means
Your cortisol level after taking dexamethasone is elevated, which suggests your body may not be suppressing cortisol production properly. Normal suppression should result in cortisol below 1.8 mcg/dL, so this finding may indicate excess cortisol production and warrants follow-up evaluation with your healthcare provider.
Recommended actions
Schedule a follow-up with your doctor or endocrinologist to discuss these results
Practice stress-reduction techniques like meditation, yoga, or deep breathing exercises
Prioritize 7-8 hours of quality sleep each night to support healthy cortisol rhythms
Keep a symptom journal tracking weight, blood pressure, mood, and energy levels
* Regular blood test results (e.g., CBC) typically start arriving the next business day after sample collection. More complex tests, such as hormone panels, may take up to 10–15 business days due to their complexity.
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Blood Test for Stress Hormone and Cortisol Control