II. Physiology
- Cortisol is synthesized in the Adrenal Cortex, derived from Cholesterol
- Cortisol secretion is stimulated by Adrenocorticotropic Hormone (ACTH) in response to stress
- See Pituitary Gland
- Cortisol functionality
- Mobilizes available energy sources (Glucose, fats, Amino Acids)
- Increases Serum Glucose by stimulating liver Gluconeogenesis and glycogenolysis
- Increases serum Fatty Acids by promoting lipolysis of adipose Triglyceride stores
- Increases blood Amino Acids by breaking down Proteins (outside liver)
- Within liver, Cortisol induces Protein synthesis
- Antiinflammatory activity
- Inhibit Histamine release
- Inhibit Lymphocyte production
- Stabilize MacrophageLysosomes
- Increases gastric acid production
- Mobilizes available energy sources (Glucose, fats, Amino Acids)
- References
- Goldberg (2014) Clinical Physiology, Medmasters, Miami, p. 138-9
III. Interpretation: Normal
- Cortisol 8 am: 4-19 mcg/dl
- Consider dynamic testing if early morning testing<13 mcg/dl
- Cortisol 4 pm: 2-15 mcg/dl
IV. Interpretation: Increased
- Cushing's Disease
- Ectopic ACTH production
- Small-cell Lung Cancer
- Chronic Renal Failure
- Pregnancy
V. Interpretation: Decreased
- Primary or Secondary adrenocortical insufficiency
- Anterior pituitary dysfunction