Cortisol, according to the Mayo Clinic, is produced by the outside portion of the adrenal glands, also known as the adrenal cortex. Cortisol plays an important role in the body's ability to metabolize food into energy. It also affects the immune system, the body's response to stress, and plays a role in sleep/wake cycles.
Addison's
Cortisol levels that are too high or too low can cause problems throughout the body. Abnormally low cortisol levels are often the result of Addison's disease, in which the adrenal glands do not produce enough of cortisol and other hormones. Patient's with abnormally low cortisol levels will often feel chronically fatigued and have low blood sugar. Patients may also develop abnormally pigmented skin as a side effect of the body trying to stimulate cortisol production.
Cushing's
Abnormally high cortisol levels, on the other hand, can lead to a condition known as Cushing's syndrome. Cushing's syndrome, according to FamilyDoctor.org, can lead to high blood sugar, thinning skin and stretch marks, a weakened immune system, and some characteristic body changes. These include an increase in fat in the thorax as well as a round and puffy face.
Causes
Abnormally high cortisol levels are, according to FamilyDoctor, most commonly the result of patients taking glucocorticoids. Otherwise, abnormal cortisol levels can be a result of a problem with the adrenal glands or the pituitary. The pituitary makes a hormone called adrenocorticotropin hormone or ACTH, which stimulates the adrenal glands to make cortisol. Thus, problems with either the pituitary or the adrenal glands can lead to abnormal cortisol levels. Elevated cortisol secretion is often the result of a tumor, which may secrete ACTH or cortisol.
Diagnosis
Abnormal cortisol levels can be the result of a problem with the adrenal glands or with the pitiuitary. As LabTestsOnline explains, an ACTH stimulation test can be used to identify the cause of the low cortisol levels. With an ACTH stimulation test, a patient's cortisol levels are measured before and after a dose of ACTH is given; if the cause of the cortisol deficiency lies in the adrenals, cortisol levels will not rise after ACTH treatment. Conversely, the cause of elevated cortisol levels can be determined using a dexamethasone suppression test. Dexamethasone is a drug which inhibits cortisol production in healthy adrenal glands. Similar to the ACTH stimulation test, this test measures cortisol levels before and after dexamethasone administration.
Treatment
Treatment of abnormally low cortisol, according to the Mayo Clinic, usually relies of having patients take regular doses of synthetic cortisol for the rest of their lives. Treatment for patients with elevated cortisol involves eliminating the cause of the abnormal cortisol secretion. In the case of a tumor, this usually involves surgery.
