The Effect Of Cortisol On The Levels Of Cortisol

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Cortisol is a cholesterol derivative steroid hormone. It is produced in the cortex of the adrenal gland. Cortisol is secreted because of stress related events and its part of our adaptive stress response. The total plasma cortisol taken in the morning, in a healthy individual is 200 – 700nmol. Secretion of cortisol follows the diurnal rhythm so naturally levels of cortisol are at their highest 20 – 30 minutes after awakening; with an average of 50% increase. This is referred to as the cortisol awakening response (CAR) Cortisol levels start to decline in a steady manner throughout the day; reaching its lowest point late in the evening. High levels of cortisol in the morning are linked to sleep cycle, therefore jet lag, night shifts are some of the factors that can disrupt ACTH secretion and consequently cortisol too. The patient presented with weight gain, flushed skin, tiredness, inability to concentrate, hirsutism, depression and facial swelling; which all indicate that the patient might be suffering from Cushings Syndrome. Cushings sydrome is characterised by a group of symptoms that occur as a result of elevated levels of cortisol. The source can be endogenous, the first would be Cushings disease which is a cortcotropinoma (tumour in the anterior pituitary gland) which can be a microadenoma or a macroadenoma. The second is the adrenal adenoma and adrenal carcinoma, which are tumours in the adrenal cortex On the other hand the source of hypercortisolism, can be
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