Therefore aldosterone levels are normal while only cortisol is low. In secondary adrenocortical insufficiency, the low cortisol levels are due to low ACTH levels as a result of pituitary pathology and the adrenal gland itself is intact. Primary insufficiency may be divided into acute or chronic. In primary adrenocortical insufficiency, also known as Addison’s disease, the low cortisol and/or aldosterone levels can be attributed to pathology within the the adrenal cortex itself and may be accompanied by low aldosterone levels. Causes of HypocortisolismĪdrenocortical insufficiency may be either primary or secondary. The androgen levels may also be lower than normal but this is more prominent in women. This condition is known by several other names including adrenocortical hypofunction or simply as adrenal insufficiency and aldosterone deficiency may or may not also be present. Hypocortisolism is the deficiency of circulating cortisol in the body due to an underactive adrenal cortex. The adrenal glands also produce small amounts of androgens (male sex hormones) which are present in both males and females and also contributes to the clinical presentation. Low cortisol levels are often accompanied by low aldosterone levels as well if the adrenal gland is diseased. The main mineralocorticoid is aldosterone. Another group of hormones also secreted from the adrenal cortex is known as the mineralocorticoids which regulate blood pressure and the fluid-electrolyte balance in the body. This is discussed further under the functions of cortisol.
In order to understand the effect of low cortisol levels it is important to first be familiar with the functions of this hormone. High cortisol levels reduces CRF secretion which in turn decreases ACTH secretion.
Low cortisol levels stimulate the hypothalamus to release corticotropin-releasing factor ( CRF) which then acts on the anterior pituitary to stimulate ACTH secretion. It is also considered as one of the stress hormones in that it is secreted in large quantities over a long period of time when the body is under stress.Ĭortisol secretion is large regulated by the hormone ACTH ( adrenocorticotropin hormone) secreted from the pituitary gland. Cortisol is known to have a wide range of effects on carbohydrate, protein and fat metabolisms as well as regulates the inflammatory process in response to injury and the body’s immunity. These small glands sit on top of each kidney and secrete several important hormones. Cortisol is one of the sterol hormones known as glucocorticoids secreted by the outer cortex of the adrenal gland.
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