Friday, April 26, 2013

We Need New Ways to Measure Cortisol

Every week, I read articles about cortisol, ACTH, hypercortisolemia, the pituitary, adult growth hormone deficiency, inflammation, and depression, always look for an understanding outside of just Endocrinology's knowledge of Cushing's. 

Every week, I read many articles about stress and its affect in some population. Stress is measured. Cortisol is measured. Results are announced. 

The results never really surprise me; they fall in line with the devastating effects of stress aka cortisol in Cushing's. I have, however, noticed that different studies measure cortisol differently than endocrinologists measure cortisol for Cushies.  Why is that?

In the following excerpt, I noticed I have never had these tests to determine my cortisol metabolism. Why not? 

I am convinced that as a patient struggling with standard diagnostic testing, additional testing should be made available. I mean, I'm getting serious brain surgeries over here ( TWO ), and there are still simple tests lying around?! I mean, COME ON! 


Serious Illness Causes Too Much Cortisol 

"In the study, researchers tested five aspects of cortisol metabolism in 158 critically ill patients as well as 64 controls. The aspects measured were the participants' levels of urinary cortisol metabolites, daily levels of corticotropin and cortisol, plasma clearance of 100 mg of hydrocortisone, levels of messenger RNA and protein in liver and adipose tissue, and plasma cortisol clearance, metabolism, and production.

As expected, critically ill participants had an 83% higher production of cortisol and lower corticotropin levels when compared to the control group. After looking at the plasma clearance of hydrocortisone and the plasma cortisol clearance, it became evident that participants in the intensive care unit do have reduced cortisol metabolisms. In fact, these participants had 50% less cortisol clearance than the healthy controls."