Cortisol - What Is It? How To Take? The Rate Of Cortisol In The Blood

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Cortisol: what is it? Blood rate

Cortisol is a hormone from the glucocorticoid group. Its level in the blood rises during a wide variety of processes occurring in the body, in addition, it is directly involved in the metabolism of proteins, fats and carbohydrates.

Adrenocorticotropic hormone stimulates the production of cortisol. The production of cortisol is carried out by the adrenal glands, namely by their middle and bundle layers. Cortisol is produced from cholesterol. In an adult, 30 mg of this hormone is produced in the body per day. If a person is stressed, or injured, or their blood glucose levels rise, then more cortisol will be produced. The higher the level of cortisol, the lower the level of adrenocorticotropic hormone and corticoliberin.

Cortisol in the blood is determined in order to diagnose various pathological conditions that are most often associated with diseases of the adrenal glands. For example, if it is necessary to confirm such a diagnosis as: Addison's disease, hypercortisolism, secondary adrenal insufficiency.

Content:

• Indicators of the norm
• What is cortisol?
• Increased cortisol levels as a response to stress
• Increase and decrease in blood cortisol levels
• Blood donation for the study of the level of cortisol
• Determination of the level of cortisol in urine
• How to lower cortisol levels?

Indicators of the norm

Cortisol levels do not differ between women and men. It may increase slightly if a woman is in a position, and an increase in its level will occur every month. This is a variant of the norm, since there are no pathological processes in the body, and the growth of the hormone occurs due to an increase in plasma proteins in the blood that bind cortisol molecules.

Cortisol can be measured in μg / L and nmol / L. Also, the indicators of the norm may vary somewhat, which depends on the specific laboratory in which the diagnostics are carried out. Deciphering and interpreting the data obtained should be done by specialists.

Cortisol levels depend on the time of day. So, in the morning, its norm is 91-235 μg / l (250-650 Nmol / l), and in the evening, the hormone values vary between 18-101 mcg / l (50-280 Nmol / l).

The peak of cortisol in the body occurs at 6-8 o'clock in the morning, and its least in the blood after 20:00 pm. This time frame is taken into account when performing the analysis.

What is cortisol?

Cortisol can be called the leader among glucocorticoid hormones. Normally, they are always present in the blood. Cortisol binds to blood proteins and takes up about 90% of all hormones produced by the adrenal cortex. About 10% of the remaining hormones float in the blood in a free form. This cortisol does not take part in any processes, it is simply excreted from the body by the kidneys.

The protein carrier of cortisol in the blood can be albumin or corticosteroid-binding globulin. Besides the fact that proteins transport cortisol on themselves, they are also their storage place. Having formed in the liver, the carrier protein picks up cortisol, and then delivers it to the cells that need it. If there was no need for cortisol, then it enters the liver, where it is transformed into water-soluble metabolites. They no longer have the properties of hormones and are excreted from the body by the kidneys.

Cortisol is involved in metabolic processes, it regulates carbohydrate metabolism in the body. It is this hormone that is responsible for the activation of gluconeogenesis, that is, for the formation of glucose from other substances that do not contain carbohydrates, but have an energy potential. For example, such substances include: pyruvate, lactate, free amino acids, glycerol.

This property of cortisol helps the body continue to function when it is hungry. The glucose level does not fall below the maximum norm precisely because of this hormone. Cortisol protects a person from stress, which is why it even got a middle name: "stress hormone".

Cortisol is necessary for the body as it performs the following functions in it:

• Participates in the metabolism of proteins, reducing the production of protein in cells and stimulating catabolic processes.
• Has an effect on the level of calcium and sodium in the blood.
• Prevents cells from consuming too much sugar by increasing its concentration in the blood. If cortisol levels rise, it can lead to the development of steroidal diabetes.
• Promotes the breakdown of fats, increases the level of free fatty acids, which makes it possible to provide the body with sufficient energy.
• Takes part in the regulation of blood pressure.
• Helps reduce inflammation by stabilizing the membranes of cell lysosomes, reducing the permeability of the vascular wall and affecting the immune system

Increased cortisol levels as a response to stress

Any stressful factors that affect a person cause his nervous system to send signals to the hypothalamus. It, in turn, increases the production of corticoliberin (CRH), which reaches the pituitary gland with blood flow. The pituitary gland, having received a large amount of CRH, begins to produce adrenocorticotropic hormone (ACTH).

ACTH with the blood flow is transferred to the adrenal glands, which, having received it, begin to synthesize cortisol. It also enters the bloodstream and travels to target cells. Most often these are hepatocytes. They contain proteins with which cortisol molecules bind.

The next stage is the launch of the most complex reactions in the body, during which various genes are activated and the amount of special proteins increases. It is these proteins that make up the body's basic response to an irritating stress factor.

Increase and decrease in blood cortisol levels

The following conditions can lead to an increase in cortisol levels:

• Itsenko-Cushing's syndrome and disease.
• Tumor formations of the adrenal cortex.
• Stressful situations that occur in people suffering from a serious illness.
• Mental disorders.
• Acute infections.
• The presence of a malignant cancerous neoplasm, in which endocrine cells enter the thymus, lungs or pancreas.
• Diabetes mellitus of uncompensated type.
• Coma and clinical death.
• Taking hormonal drugs: corticosteroids, estrogens. Taking amphetamine.
• Asthma.
• Shock of any nature.
• Severe liver and kidney disease.
• Acute alcohol poisoning that develops in people who do not suffer from alcoholism.
• Long-term smoking.
• Obesity.
• Increased emotional background.
• Taking hormonal drugs to prevent unwanted pregnancies for a long period of time.
• The period of bearing a child.

If the level of cortisol in the blood is always elevated, even if it is not caused by any disease, then this will lead to a negative effect on the body. The following changes take place in it:

• Decrease in mental abilities, since the nervous system suffers, first of all.
• Disorders in the functioning of the thyroid gland.
• Increased pressure, which increases the likelihood of a hypertensive crisis.
• Increased appetite, which can lead to obesity.
• Hairing of women according to the male pattern. The physique changes, a person is gaining body fat in certain places. This type of obesity is called android.
• Difficulty falling asleep appears.
• The likelihood of developing strokes and heart attacks increases.
• Immunity falls, which causes the development of various diseases.

If a person has these symptoms, he should see a doctor and get tested to determine the level of cortisol in the blood.

A decrease in cortisol levels in the body also does not happen by itself. There are reasons for this:

• Primary adrenal insufficiency. Addison's disease, which has multiple causes, can lead to a decrease in cortisol levels. At the same time, cortisol is not produced in the body in the required amount due to the failure of the adrenal glands.
• Disorders in the work of the pituitary gland.
• Lack of hormones that the thyroid must produce, which leads to a decrease in the level of cortisol in the blood.
• The passage of therapy with hormonal drugs for a long time.
• Deficiency of enzymes that are directly involved in the synthesis of cortisol, for example, 21-hydroxylase.
• Bronchial asthma.
• Liver damage: hepatitis or cirrhosis.
• Treatment with Levadopa, Danazol, Morphine, Trilostan and some other drugs.
• Gout.

Symptoms of decreased cortisol levels in the body are hard to miss. A person will constantly feel tired, his muscles will become weak. The work of the digestive system is disrupted, the skin becomes bronze in color. The limbs tremble, the heartbeat quickens, the volume of blood circulating through the body decreases.

Blood donation for the study of the level of cortisol

The cortisol test requires some preparation from the patient. It is important to decide on the time of the procedure, since the level of the hormone in the blood depends on this. Her fence is carried out from a vein.

Preparatory activities for the study should begin 3 days before its completion:

• Limit salt intake 3 days before the procedure. It should not be allowed to exceed its daily level of 3 g.
• 2 days before the analysis, you should stop using drugs that can affect the level of cortisol in the blood. If this is not possible, then the doctor should be notified about this.
• They refuse food 10-12 hours before the procedure.
• Physical activity should be excluded 10 hours before the analysis.
• 30 minutes before donating blood, a person should try to relax as much as possible.

To obtain results that will reflect the actual level of cortisol in the blood, blood should be collected between 6-9 am.

Determination of the level of cortisol in urine

To determine the level of cortisol in the body, it will be necessary to donate not only blood, but also urine for analysis.

In urine, the level of the hormone can increase with Itsenko-Cushing's syndrome, against the background of mental disorders and when the body is under stress. In addition, an increase in the hormone in the urine occurs against the background of hypoglycemia, obesity, inflammation of the pancreas, alcoholism, hirsutism. Recent injuries or previous operations may affect the analysis results.

If the level of cortisol in the urine is reduced, then this may be due to insufficiency of the adrenal cortex in Addison's disease, or be caused by cancerous tumors, autoimmune diseases, or taking hydrocortisone.

The level of free cortisol is determined in daily urine. However, when interpreting the data obtained, it is necessary to take into account the fact that even intense sports and excessive body weight can lead to an increase in the level of cortisol in the blood. That is, an increase in the hormone in the urine is not always a consequence of any diseases.

How to lower cortisol levels?

Reducing or raising blood cortisol levels is a difficult task. Of course, when the level of the hormone rises against the background of stress caused by psycho-emotional overstrain, you just need to calm down, after which the analysis is retaken. Also, the level of cortisol in the blood after childbirth returns to normal. In smokers, the hormone in the blood takes on a normal value after they say goodbye to a bad habit. Sometimes doctors recommend that people with obesity lose weight, which helps to normalize hormones.

If the increase in the level of cortisol in the blood is caused by any disease, then the doctor should deal with its decrease. So, tumor neoplasms require removal. In other situations, symptomatic treatment is carried out: they fight stress, lower blood pressure, and relieve exacerbation of chronic diseases.

Serious illnesses require an individual approach. There can be no single treatment regimen.

If the level of cortisol is low, then you need to look for the cause that caused this violation. Until the hormone levels return to normal, the patient is prescribed drugs that can replace the body's own cortisol. In this case, the control of the hormonal status should be carried out on an ongoing basis.

Treatment aimed at correcting the level of cortisol in the body is within the competence of the specialist. An endocrinologist is definitely involved in the work. Self-medication can only aggravate the problem and provoke serious health problems.

The author of the article: Shutov Maxim Evgenievich | Hematologist

Education: In 2013 he graduated from the Kursk State Medical University and received a diploma "General Medicine". After 2 years, completed residency in the specialty "Oncology". In 2016 completed postgraduate studies at the National Medical and Surgical Center named after N. I. Pirogov.