Cortisol is the primary glucocorticoid secreted by the adrenal gland in response to ACTH stimulation, stress, or low blood-glucose concentration. It functions to increase blood sugar through gluconeogenesis, to suppress the immune system, and to aid in the metabolism of fat, protein, and carbohydrates. It also decreases bone formation. It is secreted in a diurnal pattern with levels rising in the early morning, peaking around 8 am, and flattening in the evening.
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The production of too much cortisol can cause Cushing’s syndrome which, if left untreated, can lead to serious health problems such as heart attack, stroke, blood clots and Type 2 diabetes. The most common cause of Cushing’s syndrome is the long-term, high-dose use of the cortisol-like glucocorticoids which are used to treat other medical conditions like asthma, rheumatoid arthritis, and lupus. The second most common cause is pituitary tumors or a tumor on the adrenal gland itself. Too little cortisol can be caused by Addison’s disease (also called primary adrenal insufficiency), a condition in which your adrenal glands do not function well due to autoimmune disorders, tumors, or infections like tuberculosis or HIV.
Cortisol disorders are generally diagnosed using competitive quantitative immunoassays from urine, saliva, or blood samples.
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