Cortisol is an important hormone in the body, the secretion of which is tightly regulated

Too high or low cortisol is associated with metabolic diseases.

In this article, we explain why cortisol is being studied and why it is an important hormone. In addition, we describe what kind of reference values ​​are used with cortisol and what high or low blood cortisol levels mean.

Cortisol in brief

• Cortisol affects all cells and its secretion increases under stress. However, it is not a measure of stress.
• Cortisol secretion rises sharply in the context of sudden body stress, such as severe pain. However, the level of cortisol in the body is tightly controlled.
• Cortisol is measured when excessive or deficient secretion of cortisol is suspected.

What is Cortisol?

Cortisol is a necessary general hormone for the body. It affects all cells and is secreted especially in the stressful state of the body. Cortisol deficiency can cause severe symptoms, but too much cortisol secretion is also harmful.

How can I measure my cortisol value?

Cortisol is measured when excessive or deficient secretion of cortisol is suspected , which are disease states. Hypercortisolism causes Cushing's disease and insufficiency (hypocortisolism) causes Addison's disease.

You can order a cortisol measurement (S-Korsol) from the Cleaner online store. The test is a blood test taken in a laboratory. Sampling only takes a few minutes. Through the cleaner, you will receive examinations without a doctor's referral, and you can order a remote doctor's consultation directly from the results report, if necessary.

The role of cortisol in the body

Cortisol is produced in the cortex of the adrenal glands. The function of the adrenal cortex is regulated by the adrenocorticotropin, or ACTH, produced by the pituitary gland. ACTH is secreted from the pituitary gland, from where it enters the bloodstream into the cortical layer of the adrenal gland, where it specifically increases cortisol secretion.

The pituitary gland is a pea-sized gland located behind the eyes in the midline. In addition to ACTH, other important hormones are also produced in the pituitary gland.

Cortisol is popularly known as a “stress hormone” that prepares a person for a “fight or flight” state in which the body works in overdrive. The purpose of the reaction is to protect the person, and when it works normally, it helps to concentrate, stay energetic, and alert. During the reaction, it is common for a person to experience dry mouth, increased heart rate, and increased abdominal function.

However, cortisol also plays an important role in many other bodily functions. It includes:

• regulates blood pressure
• regulates sleep-wake rhythm
• raise blood sugar
• takes care of how the body utilizes carbohydrates, fats and proteins.

Why is cortisol studied?

Blood cortisol levels are measured using a blood sample. A blood sample can be used to determine if your cortisol level is too high or too low. Some diseases, such as Cushing's disease and Addison's disease, affect the production of cortisol secreted by the adrenal glands. In addition to diagnosing diseases, a blood sample can be used to assess adrenal and pituitary function. Cortisol measurement is not used as a measure of overall stress.

You can identify the study by the code S-Korsol .

Reference values ​​for cortisol S-Korsol

Cortisol levels vary with the time of day. Cortisol levels are highest in the morning and lowest at midnight.

Morning values, 6 to 10 p.m. 133-540 nmol / l

Evening values, 4 to 8 p.m. 68-330 nmol / l

Reference values ​​vary by laboratory and depending on the method of analysis of the studies.

High cortisol

High cortisol levels occur in various disease states, e.g., Cushing’s disease.

High cortisol is harmful to the body.

Cushing's syndrome

In rare Cushing’s syndrome, the adrenal cortex produces too much cortisol. In Finland, Cushing's syndrome is diagnosed in 20–25 people a year.

Usually, Cushing’s syndrome is caused by a small tumor in the pituitary gland. The tumor produces too much of the hormone ACTH, which forces the adrenal cortex to produce more cortisol than would be needed. A less common cause is a tumor in the cortex of the adrenal gland that produces too much cortisol.

Symptoms of the disease usually develop slowly over months and sometimes years. Common symptoms include muscle weakness, thinning and bruising of the skin, weight gain , and rounding of the face. In addition, menstrual disorders and excessive hair loss may occur in women, and sexual desire may be impaired in men.

Too much cortisol can predispose to type 2 diabetes , high blood pressure, and osteoporosis .

Low cortisol

Cortisol levels can fall for a number of reasons. Here are the most common:

• Adrenogenital syndrome, in which the adrenal cortex secretes too much androgens , or male hormones, into the bloodstream. In women, this occurs as excessive hair loss, or hirsutism.
• Untreated hypothyroidism, or hypothyroidism
• Addison's disease, i.e., adrenal and pituitary insufficiency.

Addison's disease, i.e. adrenal insufficiency

Addison's disease is a rare adrenal disease. The cortex of the adrenal gland produces cortisol and aldosterone, or salt. In adrenal insufficiency, the production of these hormones is reduced.

The disease is caused by the body starting to produce antibodies to cells in the adrenal cortex. As a result, cortisol and aldosterone-producing cells are destroyed.

Typical symptoms of the disease include weakness, loss of appetite, nausea, and weight loss. Usually, the blood pressure is also lower than usual. In addition, the skin may tan without sunbathing due to the accelerated production of the pituitary ACTH hormone.

The disease is treated with drugs that replace the missing hormone secretion. The treatment is lifelong.

Instructions for going to a cortisol exam

• Cortisol is examined when the disease is suspected. Always seek medical advice if you have any symptoms. Many diseases cause symptoms similar to excessive or deficient secretion of cortisol, and measurement in a laboratory test alone is not enough to determine the cause of the symptoms.
• The sample is usually taken in the morning (6-10). Stress can elevate the results of the study.
• When examining diurnal variability An evening sample should preferably be taken at approximately 8 pm and no earlier than 4 pm. When examining diurnal variability, other strenuous examinations should be avoided.
• Medications can affect the result of cortisol. Talk to your doctor, especially if you use cortisone regularly. Medication issues should be discussed with the attending physician. Discontinuation of any medication prior to sampling should always be agreed with the treating physician.

Stress hormone cortisol - recognize signs of hyper secretion

Our daily lives are busy these days and in the moments when we are finally in their fields, we dig up the phone and immerse ourselves in the world of social media and other applications. We are available all the time, around the clock, but less often present. Our bodies are in a constant state of “fight or flight” and we are more stressed than ever.

Cortisol is a hormone secreted by the adrenal glands that help us adapt to stress. The main function of cortisol is to keep blood sugar levels high enough during stressful situations. In normal amounts, it is healthy and beneficial; it keeps us motivated, energetic, and actionable. However, if cortisol levels are constantly elevated, it causes a wide variety of nasty and even vague symptoms. When prolonged, it can also cause adrenal exhaustion. The following 10 symptoms may well speak to you that your cortisol levels are too high.

Headache and Memory Problems

Elevated cortisol levels raise blood pressure, which can manifest as headache or muscle pain, for example. Cortisol also affects the hippocampus in the brain and can cause e.g. memory impairment. The formation of new brain cells and nerve connections in the brain is impaired as a result of stress. When stressed, we may also make harmful lifestyle choices - alcohol use and smoking increase the amount of harmful free radicals in the brain, disrupting healthy brain cell growth.

You sleep poorly

Cortisol levels should drop during the night so your body can relax and recharge. However, if your cortisol levels are too high, sleep will not come, even if you have been tired all day. The night goes on wheels and the next day you are even more tired. Over time, too high cortisol levels exhaust the adrenal glands and predispose to anxiety. So if you feel that despite sleep, you can’t get up in the morning, it may be that the reason for that lies in stress.

Legs and hands get tired, vague symptoms strike - when the stress hormone cortisol tricks you, the whole body gets stuck

Cortisol is a body stress hormone secreted by the adrenal glands. If the body is in a prolonged stressful situation, it can begin to travel and the most important functions of the body begin to suffer.

Too much cortisol can cause problems in several places around the body: metabolism, adipose tissue, muscles, brain, bones, stomach, intestines, and fertility.

Cortisol is a hormone that has effects on almost all organs and tissues. The main effects are on energy metabolism: cortisol secures the body's energy supply in all situations, such as fasting, physical exertion, and stress, says Leo Niskanen, a specialist in internal medicine and endocrinology and docent at the HUS Abdominal Endocrinology Clinic.

According to Niskanen, cortisol also has effects on the body's defense mechanisms, calcium, and skeletal metabolism, and height, among other things.

Necessary in stressful situations

According to Niskanen, cortisol is a complex entity and its functions are not clear even to many doctors.

- Cortisol affects all cells and is always needed, but especially in different stressful situations. Thus, the problems can be divided into too little cortisol and too much on the other hand. If, for one reason or another, cortisol is produced in the adrenal glands, the condition is called Cushing's syndrome.

Cushing's syndrome is a relatively rare disease. In Finland, it is diagnosed in only a few dozen people a year.

To keep things simple, synthetic derivatives of cortisol are widely used in high doses because they control inflammation.

Use ranges from vats to lotions and inhalers, as well as various injections.

The side effects are the same - whether there is too much cortisol congenitally, as in Cushing's syndrome, or with medication.

When the disorder is in the adrenal gland, there is talk of primary adrenal insufficiency, the most common of which is Addison’s disease.

Hard to identify

Symptoms of cortisol overproduction can appear very slowly over months or even years, or very quickly.

Not all symptoms are the same but vary from patient to patient. Symptoms of cortisol overproduction are difficult to identify because many of them, such as obesity, high blood pressure, or diabetes, are very common as such.

Common general symptoms also include depression of the mind and an unreal feeling of being like a different person.

The face starts to round and blush and fat accumulates in the soles, neck and waist. The weight goes up and you feel swollen. The skin becomes thin, bruises tend to appear, and reddish streaks or “pregnancy scars” appear on the body, which are signs of tearing of the connective tissue structure of the skin.

Likewise, muscle weakness and muscle loss are early symptoms: legs and arms get tired and getting up from a chair becomes difficult. In women the hair increases, the menstruation becomes irregular, while in men the sexual drive dilutes. Bone loss is common, and in some patients, fractures may be the first symptom of the disease.

Vague symptoms

According to Niskanen, the symptoms of dysfunction, i.e. cortisol deficiency, start to creep more commonly, and the symptoms are very vague.

Common symptoms include tiredness and weakness, weight loss, loss of appetite, feeling sick and sometimes vomiting, weight loss, muscle weakness and salt hunger.

In women, the menstrual cycle is disrupted and in men, potency disorders are found. Mood swings, such as depression, are also common in untreated disease. Blood pressure is low. It is not uncommon for a person with the disease to have gone through many studies in vain for years before the cause has been found. Darkening of the skin is the most well-known symptom, however, not found by everyone.

How to verify?

Blood cortisol levels are measured with a blood sample and determine whether cortisol is high or low. What are the normal values ​​of cortisol?

A healthy person - even if they are stressed - should not have their cortisol levels in their blood without a doctor's recommendation. There are many sources of error and interpretation is problematic.

However, if your own adrenal insufficiency is suspected, the morning value of cortisol is determined by a blood test and the serum ACTH level. Cortisol preparations should be paused before testing.

Verification of adrenal hypertension is not possible with a simple determination of cortisol levels, as all have their own endogenous circadian rhythm and cortisol secretions are highest in the mornings. Due to the large variation, the values ​​of overproduction and a healthy person overlap badly.

Stress tests, daily urinary cortisol secretion and nowadays also saliva cortisol taken from the evening are used as screening tests for overproduction.

Everyone has their pros and cons, and often more tests have to be done to verify the existence of Cushing's syndrome.

And can there be excessive or deficient cortisol even in the absence of Cushing’s or Addison’s disease?

The clinical manifestation of cortisol overproduction is said to be Cushing's syndrome - regardless of the cause. By far the most common cause is pharmacological cortisone treatment for a disease state. There are many of these such as rheumatism, ulcerative colitis, rheumatic muscle, vasculitis.

Good bad stress

Stress is often blamed for problems in cortisol production.

Can stress trigger hormonal disorders?

Cortisol is part of the body's normal response to 'stress'. During evolution, stress-induced responses were vital when the predator threatened and had to be able to act quickly. The decrease in sex hormones associated with a stress response is appropriate because it is not appropriate for a stressed organism to pay attention to issues secondary to survival. The same reactions still work in us.

Niskanen admits that stress hormones rise in a stressful situation and depress, among other things, sex hormones. But the problem lies in how stress is measured.

Stress responses can be measured, for example, under carefully controlled conditions for short periods in research use, but this is not possible in living life. Therefore, there are no reference values ​​for high serum cortisol.

According to Niskanen, a stress-free life is also an impossibility.

Even a lack of stress causes stress. To my knowledge, there is no actual clinical “stress meter”, but in practical work, for example, the severity of the disease or the extent of surgery is a kind of stress meter, in which case cortisol values ​​must be interpreted against the body's reserves.

Niskanen reminds that at a general level, stress per se is usually not the root cause of illness, but intense stress can disrupt the body's defense mechanisms and cause the onset of an underlying illness.

Overproduction of cortisol can be associated with a variety of symptoms. Early symptoms include muscle loss and muscle weakness.