II. Physiology

  1. Cortisol is synthesized in the Adrenal Cortex, derived from Cholesterol
    1. See Cortisol Synthesis
  2. Cortisol secretion is stimulated by Adrenocorticotropic Hormone (ACTH) in response to stress
    1. See Pituitary Gland
  3. Cortisol functionality
    1. Mobilizes available energy sources (Glucose, fats, amino acids)
      1. Increases Serum Glucose by stimulating liver Gluconeogenesis and glycogenolysis
      2. Increases serum Fatty Acids by promoting lipolysis of adipose Triglyceride stores
      3. Increases blood amino acids by breaking down proteins (outside liver)
        1. Within liver, Cortisol induces protein synthesis
    2. Antiinflammatory activity
      1. Inhibit histamine release
      2. Inhibit Lymphocyte production
      3. Stabilize MacrophageLysosomes
    3. Increases gastric acid production
  4. References
    1. Goldberg (2014) Clinical Physiology, Medmasters, Miami, p. 138-9

III. Interpretation: Normal

  1. Cortisol 8 am: 4-19 mcg/dl
    1. Consider dynamic testing if early morning testing<13 mcg/dl
  2. Cortisol 4 pm: 2-15 mcg/dl

IV. Interpretation: Increased

  1. Cushing's Disease
  2. Ectopic ACTH production
    1. Small-cell Lung Cancer
  3. Chronic Renal Failure
  4. Pregnancy

V. Interpretation: Decreased

  1. Primary or Secondary adrenocortical insufficiency
  2. Anterior pituitary dysfunction

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Related Studies

Ontology: Serum cortisol measurement (C0236396)

Concepts Laboratory Procedure (T059)
SnomedCT 269982009, 166477006, 143806005, 271535005
Dutch serum cortisol
French Cortisol sérique
German Kortisol im Serum
Italian Cortisolo sierico
Portuguese Cortisol sérico
Spanish Cortisol en suero, determinación de nivel sérico de cortisol, medición sérica de cortisol (procedimiento), medición sérica de cortisol
Japanese 血清コルチゾール, ケッセイコルチゾール
English Serum cortisol, serum cortisol measurement, serum cortisol measurement (lab test), serum cortisol, serum cortisol level, serum cortisol level test, Serum cortisol measurement, Serum cortisol (& level), Serum cortisol (& level) (procedure), Serum cortisol level, Serum cortisol measurement (procedure)
Czech Kortizol v séru
Hungarian Szérum kortizol

Ontology: Blood cortisol (C0853179)

Concepts Laboratory Procedure (T059)
Japanese 血中コルチゾール, ケッチュウコルチゾール
Czech Kortizol v krvi
English Blood cortisol
Italian Cortisolo ematico
Hungarian Kortizol vérszint
Portuguese Cortisol no sangue
Spanish Cortisol en sangre
Dutch bloed cortisol
French Cortisolémie
German Kortisol im Blut