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Cortisol
Cortisol is a steroid hormone that regulates a wide range of processes
throughout the body, including metabolism and the immune response. It also
has a very important role in helping the body respond to stress.

(/hormones/corticotrophin-releasing-hormone/)

(/hormones/dehydroepiandrosterone/) Glossary (/glossary/c#cortisol)

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Cortisol
Cortisol is a steroid hormone that regulates a wide range of vital processes throughout the
body, including metabolism (/glossary/m#metabolism) and the immune response. It also has a
very important role in helping the body respond to stress.

Alternative names for cortisol

Hydrocortisone

What is cortisol?
Cortisol is a steroid hormone, one of the glucocorticoids (/glossary/g#glucocorticoids), made
in the cortex of the adrenal glands and then released into the blood, which transports it all
round the body. Almost every cell contains receptors (/glossary/r#receptors) for cortisol and
so cortisol can have lots of different actions depending on which sort of cells it is acting upon.
These effects include controlling the body’s blood sugar levels and thus regulating metabolism,
acting as an anti-inflammatory, influencing memory formation, controlling salt and water
balance, influencing blood pressure and helping development of the foetus
(/glossary/f#foetus). In many species cortisol is also responsible for triggering the processes
involved in giving birth.

A similar version of this hormone, known as corticosterone (/glossary/c#corticosterone), is

produced by rodents, birds and reptiles.

How is cortisol controlled?

Blood levels of cortisol vary throughout the day, but generally are higher in the morning when
we wake up, and then fall throughout the day. This is called a diurnal rhythm. In people that
work at night, this pattern is reversed, so the timing of cortisol release is clearly linked to daily
activity patterns. In addition, in response to stress, extra cortisol is released to help the body to
respond appropriately.

(/media/gxdfql0k/230413-figure-1.png)
click to enlarge (/media/gxdfql0k/230413-figure-1.png)

The hypothalamus secretes corticotrophin-releasing hormone (CRH) which stimulates the anterior pituitary
gland to secrete adrenocorticotrophic hormone (ACTH). ACTH travels via the bloodstream and stimulate
the secretion of cortisol from the adrenal glands. As the cortisol levels rise, this blocks the release of CRH
from the hypothalamus and ACTH from the anterior pituitary gland. As a result, the reduction in CRH and
ACTH levels lead to reduced cortisol levels. This is called a negative feedback loop.
The secretion of cortisol is mainly controlled by three inter-communicating regions of the
body; the hypothalamus in the brain, the pituitary gland and the adrenal gland. This is called
the hypothalamic–pituitary–adrenal axis. When cortisol levels in the blood are low, a group of
cells in a region of the brain called the hypothalamus releases corticotrophin-releasing
hormone, which causes the pituitary gland to secrete another hormone, adrenocorticotropic
hormone, into the bloodstream. High levels of adrenocorticotropic hormone are detected in
the adrenal glands and stimulate the secretion of cortisol, causing blood levels of cortisol to
rise. As the cortisol levels rise, they start to block the release of corticotrophin-releasing
hormone from the hypothalamus and adrenocorticotropic hormone from the pituitary. As a
result, the adrenocorticotropic hormone levels start to drop, which then leads to a drop in
cortisol levels. This is called a negative feedback loop.

What happens if I have too much cortisol?

Too much cortisol over a prolonged period of time can lead to a condition called Cushing's
syndrome. This can be caused by a wide range of factors, such as a tumour that produces
adrenocorticotropic hormone (and therefore increases cortisol secretion), or taking certain
types of drugs.

(/media/wqblgxoo/230413-figure-3.png)
click to enlarge (/media/wqblgxoo/230413-figure-3.png)

Too much cortisol may be due to a problem in the hypothalamus, anterior pituitary gland also known as
Cushing’s disease, the adrenal glands, prolonged use of certain types of drugs or tumour that produces
adrenocorticotrophic hormone. Signs and symptoms of raised cortisol include rapid weight gain
particularly in the face, chest & abdomen, high blood pressure, thinning of the bones (osteoporosis),
skin changes (bruises and purplish stretch marks), muscle weakness, changes in mood & high blood
sugar.
The symptoms include:

rapid weight gain mainly in the face, chest and abdomen contrasted with slender arms
and legs
a flushed and round face
high blood pressure
osteoporosis
skin changes (bruises and purple stretch marks)
muscle weakness
mood swings, which show as anxiety, depression (/glossary/d#depression) or irritability
increased thirst and frequency of urination.

High cortisol levels over a prolonged time can also cause lack of sex drive and, in women,
periods can become irregular, less frequent or stop altogether (amenorrhoea).

In addition, there has been a long-standing association between raised or impaired regulation
of cortisol levels and a number of psychiatric conditions such as anxiety and depression.
However, the significance of this is not yet clearly understood.

What happens if I have too little cortisol?

(/media/1imdnrbi/230413-figure-2.png)
click to enlarge (/media/1imdnrbi/230413-figure-2.png)

Too little cortisol may be due to a problem in the hypothalamus, anterior pituitary gland or the adrenal
glands also known as Addison’s disease. Signs and symptoms of low cortisol may include fatigue, dizziness,
weight loss, reduced muscle mass / muscle weakness, darkening of regions of the skin, low blood sugar and
 low blood pressure.

Too little cortisol may be due to a problem in the pituitary gland or the adrenal gland
(Addison's disease). The onset of symptoms is often very gradual. Symptoms may include
fatigue, dizziness (especially upon standing), weight loss, muscle weakness, mood changes and
the darkening of regions of the skin. Without treatment, this is a potentially life-threatening
condition.

Urgent assessment by a specialist hormone doctor called an endocrinologist

(/glossary/e#endocrinologist) is required when a diagnosis of Cushing's syndrome or
Addison's disease is suspected.

Last reviewed: Jan 2019

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Tags for this content

Coordination and Control (/resources/?topic=1379) Key Stage 4 (/resources/?topic=1383)

Age 14 - 16 (/resources/?topic=1387)

Related Glands (/glands/)

Pituitary gland (/glands/pituitary-gland/)

Adrenal glands (/glands/adrenal-glands/)

Hypothalamus (/glands/hypothalamus/)

View all Glands (/glands/)

Related Endocrine Conditions (/endocrine-

conditions/)
Cushing's disease (/endocrine-conditions/cushing-s-disease/)

Amenorrhoea (/endocrine-conditions/amenorrhoea/)

Addison's disease (/endocrine-conditions/addison-s-disease/)

Osteoporosis (/endocrine-conditions/osteoporosis/)

Congenital adrenal hyperplasia (/endocrine-conditions/congenital-adrenal-hyperplasia/)

Cushing's syndrome (/endocrine-conditions/cushing-s-syndrome/)

View all Endocrine conditions (/endocrine-conditions/)

Related Hormones (/hormones/)

Adrenaline (/hormones/adrenaline/)

Adrenocorticotropic hormone (/hormones/adrenocorticotropic-hormone/)

Corticotrophin-releasing hormone (/hormones/corticotrophin-releasing-hormone/)

View all Hormones (/hormones/)

Related Glossary Supplements (/glossary/glossary-

supplements/)

depression (/glossary/glossary-supplements/d#depression)

abdomen (/glossary/glossary-supplements/a#abdomen)

corticosterone (/glossary/glossary-supplements/c#corticosterone)

inflammation (/glossary/glossary-supplements/i#inflammation)

metabolism (/glossary/glossary-supplements/m#metabolism)

View all Glossary (/glossary/glossary-supplements/)

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