The adrenal glands are a pair of hormone producing organs found above the kidneys. Each adrenal gland has two parts--the adrenal medulla and the adrenal cortex. Cortisol is a hormone that is produced in the adrenal cortex. High levels of this hormone may be caused by tumors or excess corticotropin hormone.
Functions
Cortisol is a corticosteroid hormone that regulates blood pressure--the force exerted on the arterial walls by blood flow, maintains cardiovascular functioning and controls the amount of glucose in the blood. It also plays a part in how the body responds to illness, stress and injury. In addition to these functions, cortisol regulates the immune system and its response to infections
Causes
High blood levels of cortisol may be caused by problems with the adrenal glands or with the pituitary gland. According to the National Endocrine and Metabolic Diseases Information Service, taking large amounts of cortisol-like medications can cause high levels of cortisol in the body and Cushing's syndrome. Such medications are used to treat conditions like asthma, lupus and other inflammatory diseases.
Corticoptropin is a hormone produced by the pituitary gland. It induces the adrenal glands to produce cortisol. Over-production of corticotropin leads to excessive production of cortisol in the adrenal glands. Pituitary tumors can cause high blood levels of corticotropin. Small-cell lung cancer and a tumor called carcinoid also produce excess corticotropin.
According to the Merck Manuals Online Medical Library, tumors in the adrenal glands can cause excessive production of cortisol.
Effects
Patients with high cortisol levels develop excess fat around their stomach area or abdomen, face, neck and in the upper part of their back. Tiredness and high blood pressure, along with muscle weakness due to a reduction in muscle tissue are also effects of high cortisol levels.
Diagnosis
To diagnose high cortisol levels, the amount of cortisol in the blood is measured. If this reveals a high level of cortisol, a dexamethasone suppression test is done. First, dexamethasone--a synthetic hormone that suppresses the pituitary gland--is administered. After dexamethasone administration, the cortisol content of the blood is measured again. If the problem stems fom the pituitary gland, the amount of cortisol in the blood should be lower. If the problem is from someplace else, it will remain high. Measurement of corticotropin in the blood can also be done if over production of corticotropin is suspected.
The National Endocrine and Metabolic Diseases Information Service reports that imaging technologies such as computed tomography or magnetic resonance imaging scan are used to visualize the pituitary gland and adrenal glands to check for possible tumors.
Treatment
Treatment for high cortisol levels depends on the cause. Surgical removal of tumors in the lungs pituitary and adrenal glands is used to treat high cortisol levels caused by tumors. Sometimes, both adrenal glands may have to be removed. Drugs such as ketoconazole are used to lower cortisol levels until more definitive treatment like surgery can be done.
For patients who develop high cortisol levels through cortisol-like medication, physicians gradually reduce the dose of the medication to the lowest possible dose or prescribe medicines that don't cause high cortisol levels.
