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Port Moresby Medical Laboratories (POMMEDLAB) |
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Www.pommedlab.com |
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Question 1. What is cortisol?
Cortisol is a important steroid hormone produced by tiny glands called adrenal glands located in the upper poles of kidneys. The hormone is usually referred to as the "stress hormone" as it is involved in response to stress. It regulates tissue/bone growth and metabolism and helps control blood pressure and glucose metabolism and immune responses. In pharmacology, the synthetic form of cortisol is referred to as hydrocortisone, and is used to treat allergies and inflammation, and to supplement natural cortisol when its production is too low.
The amount of cortisol produced are not constant and varies throughout the day, being highest in the mornings and lowest around midnight, 3-5 hours after the onset of sleep. Cortisol is important in cooping with stresses of infection, trauma, mental or psychological illness, pain and extremes of temperature.
Cortisol helps us to deal with various forms of stresses and the variation in blood level is important in us overcoming these stresses. However, lack of or too much of cortisol is dangerous and may lead to various problems such as electrolytes disorder, diabetes, hypoglycaemia (low sugar), inability to overcome stresses and blood pressure problems.
Too much cortisol is referred to as Cushing’s Syndrome and commonly results from cortisol-producing cancer and low level is known as Addison’s Disease and often results from destruction of adrenal gland, for example from infections (TB) or inflammation.
Cortisol measurement hence, assist doctors in identifying suspected cases of Cushing’s Syndrome or Addison’s Disease. |
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Question 3. How is it measured?
A simple blood tests is required for cortisol measurement. Early morning sample is preferred as it gives a better reflection of your cortisol status. More accurate result is obtained by performing a test called Dexamethasone Suppression Test. We will advice detail protocol for this test at your appointment but it basically involves giving you a dose of dexamethasone and collecting blood an hour after dose.
Question 4. How is my tests reported?
Results of cortisol will be reported against a reference of normal population. You will need to discuss your result with your doctor . If your level is abnormal or even if level is normal and your doctor still suspects problem with cortisol, you may be referred for dexamthasone suppression test. You doctor will also discuss with you if you need further CT, ultrasound, CT or MRI or head and abdomen.
Question 5. How accurate is the Test?
Cortisol is a stress hormone. It is normally high when we are under stress. Hence, Mild to moderate elevations are seen during stress, use of medications, during acute infections, and levels vary throughout the day. Hence, it is important to see your doctor for explanation as cortisol level only supplements clinical examination findings for a correct diagnosis of high or low cortisol states.
Question 6. What is the treatment for cortisol problem? Treatment will depend on the specific cause of you cortisol problem. Generally if you have low cortisol, your doctor will start you on cortisol or similar steroids. High cortisol usually involves surgery to remove the cancer producing cortisol. Discuss with your doctor for advice on treatment. |
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Question 2. When do I know I may have problems with my cortisol? You symptoms may depend on whether you have high or low levels of cortisol in your blood. Tables below show some of the symptoms you could have when you have cortisol problem. |
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High Cortisol (Cushing’s Disease)
Over-weight/buffalo hump on neck Thin extremities Headache Sudden vision problems Swollen face/moon face Muscle weakness/difficulty climbing stairs Hypertension/high blood pressure Complaint of Diabetes Psychosis/Mental Illness Skin Changes (pigmentation/easy bruising) Strange marks over abdomen (striae) Menstrual Disorder |
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Low Cortisol (Addison’s Disease)
Fatigue/Tired Easily for no clear reason Loss of appetite/anorexia Dizzy Low blood Pressure Pigmented mucous (mouth/lips) Abdominal pain Nausea and vomiting Shock and drowsy or coma Dehydration and increased urination Weight loss Hypoglycaemia (excessive hunger) |
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Cortisol– Cushing’s Syndrome or Addison’s Disease |