Cortisol Hormone

Cortisol Hormone

The cortisol hormone is secreted in the adrenal cortex and its production is regulated by adrenocorticotropic hormone (ACTH). It plays a vital role in processes such as:

  • Glucose metabolism
  • Regulation of the immune system response
  • Maintaining vascular tone
  • Body response to stressful situations

Elevated cortisol levels increase blood sugar levels, obesity, and high blood pressure.

The formation rhythm of this hormone in infants occurs at 6-12 months of age and stabilizes after three years. For adults, the adjustment period takes about 15-20 days. In women postpartum or after discontinuing contraceptive use, cortisol level adjustment may take up to 6 weeks.

Less than 5% of total cortisol in the blood is in a free state, which is the biologically active form. Therefore, the total hormone level does not reflect the current clinical state accurately.

Indications for Testing:
It is recommended to conduct a cortisol level analysis in the following cases:

  • Symptoms of Cushing’s syndrome, including high blood pressure, muscle weakness, obesity, etc.
  • Delayed growth and weight gain in children
  • Suspected adrenal insufficiency or Addison’s disease
  • Unexpected tumor in the adrenal gland or suspicion thereof
  • Regular testing during Addison’s disease or Cushing’s syndrome treatment to monitor treatment efficacy.

Test Description:
Cortisol level analysis is performed using the competitive chemiluminescence enzyme immunoassay method. The patient must provide a venous blood sample.

Pre-Test Recommendations:

  • Fasting for 8-12 hours before the procedure, avoiding fatty foods the day before.
  • Abstaining from coffee, tea, or juice for 1-2 hours before blood collection. Drinking non-carbonated water is allowed.
  • Avoiding smoking, alcohol, emotional stress, and excessive physical exertion 48 hours before the test.
  • Consulting a doctor about medication usage, especially vitamin C, oral contraceptives, corticosteroids, or other medications that may affect cortisol levels.

Interpretation of Results:
Measurement unit: Nanomoles per liter (nmol/L).

Reference values:

  • Morning samples (6 am to 10 am): 166-507 nmol/L.
  • Evening samples (4 pm to 8 pm): 73.8-291 nmol/L.

Analytical Result:
Increased cortisol levels (Cushing’s syndrome or disease) may be associated with conditions such as:

  • Hypothalamic or pituitary tumors secreting ACTH.
  • Adrenal gland tumors or other organs secreting cortisol.
  • Hyperactivity of the adrenal cortex.
  • Obesity.
  • Hyperthyroidism (increased thyroid hormone levels in the blood).

Decreased cortisol levels may occur due to:

  • Adrenal cortex dysfunction (Addison’s disease).
  • Congenital adrenal hyperplasia.
  • Hypothyroidism (decreased thyroid hormone levels in the blood).

Additional Tests:
If a change in cortisol levels is detected, repeat testing several times, including at different times of the day, to determine concentration fluctuations. Additionally, estimating hormone levels in urine and saliva, testing for ACTH and aldosterone, and imaging the adrenal glands (ultrasound, CT, MRI) and/or searching for tumors in other sites may be required.