Do you sometimes feel unusually tired, gain weight for no reason, or feel very anxious and stressed? Although we often think that these are normal things, things that happen due to everyday problems, there may be some changes in the 'stress hormone' called cortisol in our body behind this. So if your doctor sees these symptoms, he may suggest doing this cortisol test. Today, we will talk about what this cortisol test is, why it is done, and what it can tell you.
First of all, what is cortisol?
Simply put, cortisol is an essential hormone in our body. It is produced by two small glands located above our kidneys, the adrenal glands. We all know this as the 'stress hormone'. Imagine, when we are faced with a sudden danger, pressure, or fear, it is this cortisol hormone that gives our body the strength and preparation needed to face it.
But cortisol's work doesn't end there. It has many other important functions.
- Controlling blood pressure.
- Helps maintain blood sugar levels.
- Our body's metabolism, which is the process by which the food we eat is broken down into carbohydrates, proteins, and fats and converted into energy, helps.
- Controlling inflammation in the body.
- Controlling our sleep-wake cycle.
See? Cortisol isn't just something related to stress, it's something that's essential for many things in our bodies to function properly.
What are the symptoms of high cortisol levels?
If your cortisol levels are too high, it could be a sign of a condition called Cushing's syndrome . Here are some of the symptoms you may see.
| Symptom | Description |
|---|---|
| Sudden weight gain | Fat accumulation, especially in the stomach, chest, and face. |
| Round face | The face becomes swollen and round. |
| A lump of fat on the back of the neck | Fatty hump is formed by the accumulation of fat between the shoulders behind the neck. |
| Skin changes | Thinning of the skin, easy bruising, and the appearance of purple-colored stretch marks on areas such as the stomach and thighs. |
| High blood pressure and diabetes | Increased blood pressure and blood sugar levels. |
| Other features | Muscle weakness, bone weakness, depression, anxiety, and irregular menstrual cycles in women. |
What are the causes of increased cortisol?
- Steroid medications: Taking large doses of steroid medications such as dexamethasone or prednisolone for a long time for other medical conditions (e.g. asthma, rheumatoid arthritis).
- Pituitary gland tumor: A tumor in the pituitary gland, which is located at the base of our brain and is like the master gland that controls the other hormonal glands in the body.
- Adrenal gland tumor: A tumor or abnormal growth in the gland itself, which produces cortisol.
What happens if cortisol levels drop?
If cortisol levels become dangerously low, it can be a sign of a condition called Addison's disease . Here are the symptoms.
- Constant fatigue
- Dizziness
- Weight loss
- Low blood pressure
- Brown or black discoloration of the skin in places
What are the causes of low cortisol?
- Addison's disease: This is when our own body's immune system attacks and destroys our adrenal glands for no reason.
- Adrenal gland damage: Damage to these glands due to an infection or other cause.
- Pituitary gland dysfunction: When the 'master' is not working properly, the adrenal glands do not receive the signal to produce cortisol.
- Stopping steroids suddenly: This is very important. If you have been taking steroids for a long time for a condition, stopping them suddenly can cause your cortisol levels to drop dangerously low. Always stop taking the medication under your doctor's supervision, gradually reducing the dose.
What types of cortisol tests are there?
If your doctor orders a test to check your cortisol levels, there are three main ways to do it.
1. Blood Test: This is the most common method. Since cortisol levels vary throughout the day (highest in the morning, lowest at night), your doctor may ask you to take two blood samples, usually one at around 8 am and another at around 4 pm. This will help you see what your cortisol levels are like at those times.
2. Saliva Test: This is often done at night before going to bed, between 11 and 12 midnight. This is because a healthy person's cortisol levels should be at their lowest at that time. If the cortisol levels are still high at that time, it is a good reason to suspect a condition like Cushing's syndrome. Your doctor will give you a special kit for this.
3. Urine Test: Sometimes your doctor may ask you to collect all of your urine over a 24-hour period and test it. This is called a ``24-hour urine test.`` Although it can be a bit of a hassle, this method gives you the best idea of the amount of ``free cortisol`` your body produces throughout the day.
Interpreting a cortisol test result should always be done in conjunction with your doctor. Don't base your decisions solely on information found on the internet.
Other special tests performed with this test
Sometimes, to find the exact cause of low or high cortisol levels, your doctor may suggest some more specialized tests.
- ACTH Stimulation Test: This tests how your adrenal glands respond to the 'command' (the hormone `ACTH`) from your pituitary gland. It's like a boss checking to see if an employee is doing the right thing when asked to do something. This is especially done to find out the cause of low cortisol levels.
- Dexamethasone Suppression Test: This is like the other side of that test. It checks whether the high cortisol levels in the body are controlled by giving a small amount of the steroid medicine ``(dexamethasone)``. This helps to find out if Cushing's syndrome is present and whether it is caused by a tumor in the pituitary gland or elsewhere.
If your doctor suspects something like a tumor, he or she may also refer you for a CT scan or MRI scan.
Other reasons why results may be abnormal
Cushing's syndrome and Addison's disease are relatively rare conditions. There are more common causes of abnormal cortisol levels.
- Severe stress
- Excessive exercise
- Pregnancy
- Obesity
- Some medications, such as birth control pills
So don't be afraid of a sudden change in the result. Your doctor will take all of this into account and tell you the real reason.
Take-Home Message
- Cortisol is not only our body's 'stress hormone', but also an essential hormone that controls blood pressure, sugar levels, and metabolism.
- Cortisol levels vary depending on the time of day. They are usually higher in the morning and lower at night.
- Very high cortisol levels can be a sign of Cushing's syndrome. Very low levels can be a sign of Addison's disease.
- Stress, exercise, pregnancy, and some medications can also cause changes in cortisol levels.
- If you need to take a cortisol test, always discuss the results with your doctor. He or she will give you the best guidance.
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