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CORTISOL



Cortisol is the most potent glucocorticoid produced by the human adrenal. It is synthesized from cholesterol and its production is stimulated by pituitary adrenocorticotropic hormone (ACTH) which is regulated by corticotropin releasing factor (CRF). ACTH and CRF secretions are inhibited by high cortisol levels in a negative feedback loop. In plasma a majority of cortisol is bound with high affinity to corticosteroid binding globulin (CBG or transcotin). Cortisol acts through specific intracellular receptors and affects numerous physiologic systems including immune function, glucose counter regulation, vascular tone, and bone metabolism.

Cortisol production has an ACTH-dependent circadian rhythm with peak levels in the early morning and a nadir at night. The factor controlling this rhythm is not completely defined and can be disrupted by a number of physical and psychological conditions. ACTH and cortisol are secreted independent of circadian rhythm in response to physical and psychological stress.

Elevated cortisol levels and lack of diurnal variation have been identified with Cushing's disease (ACTH hypersecretion). Elevated circulating cortisol levels have also been identified in patients with adrenal tumors. Low cortisol levels are found in primary adrenal insufficiency (e.g. adrenal hypoplasia, Addison's disease) and in ACTH deficiency. Due to the normal circadian variation in cortisol levels, distinguishing normal from abnormally low cortisol levels can be difficult, therefore several daily collections are recommended.

Interpretation of Results

Cortisol levels in saliva reflect the active unbound compound. Cortisol is measured in ng/ml.

Salivary Cortisol Ranges for Women and Men
A.M. 8.0 - 15.0 10 P.M. <1.5

Contact North Bay Diagnostics at 888-689-TEST (8378) to order your lab kit.

Custom Hormone Panel

         Test Corisol one, two, or three times throught the day.

         $47.00/one   $83.00/two   $120.00/three

Adrenal Stress Profile
The Adrenal Stress Profile measures Cortisol four times over a one day period. Symptoms of cortisol deficiency and “adrenal burn-out” include: Fatigue, allergies, asthma, low blood pressure, carbohydrate craving, depression. Cortisol excess sometimes occurs in chronic high stress states, symptoms include: Feeling “wired and tired”, weight gain, high blood pressure, sleep trouble, anxiety. Elevated cortisol can increase risk of bone loss and heart disease.
$151.00

References

  1. Migeon CJ, Lanes RL: Adrenal cortex : hypo- and hyperfunction. IN Lifshitz F (ed): Pediatric Endocrinology. A Clinical Guide, 2nd edition. Marcel Dekker, Inc., NY 1990:333-352
  2. Hyams JS, Carey DE: Corticosteroids and growth. J Pediatr 1988;113:249-254
  3. Kreiger DT: Rhythms of ACTH and corticosteroid secretion in health and disease and their experimental modification. J Steroid Biochem 1975;6:785-791
  4. Stewart PM, Secl JR, Corrie J, Edwards CRW, Padfield PL: A rational approach for assessing the hypothalamo-pituitary-adrenal axis. Lancet 1988;5:1208-1210
  5. Schlaghecke R, Komely E, Santen RT, Ridderskamp P: The effect of long-term glucocorticoid on pituitary-adrenal responses to exogenous corticotropin-releasing hormone. New Engl J Med 1992;326:226-230
  6. Aardal E, Holm AC: Cortisol in Saliva-Reference Ranges and Relation to Cortisol in Serum. Eur J Clin Chem Clin Biochem 1995;33:927-923
  7. Nicolson N, Storms C, Ponds R, Sulon J: Salivary Cortisol Levels and Stress Reactivity in Human Aging. J Gerontol 1997;52A:M68-M75
  8. Greenspan FS, Stewler GJ (eds): Basic and Clinical Endocrinology. Appelton & Lange, Stamford, CT 1997
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