Estimated reading time: 5 minutes
Medically reviewed and verified by Kate Burke, MD, MHA
Cortisol is one of the most important hormones in your body. It helps you respond to stress, regulates your metabolism, controls blood pressure, and reduces inflammation. People with congenital adrenal hyperplasia (CAH) need to pay special attention to their cortisol levels, as their bodies may not produce enough of it. Here, PatientsLikeMe will explain how cortisol works in the body, why it’s essential for overall health, and how it impacts people with CAH.
What is Cortisol?
Cortisol is a steroid hormone produced by your adrenal glands, which sit on top of your kidneys. It is often called the "stress hormone" because your body releases more of it in response to stress. However, cortisol has many other important functions beyond stress management. It also helps:
- Control your blood sugar levels
- Regulate your metabolism
- Manage blood pressure
- Reduce inflammation
- Assist in your body’s “fight or flight” response to danger
How Cortisol Works in the Body
Your brain plays a big role in regulating cortisol. When you wake up, exercise, or face a stressful situation, your pituitary gland, found at the base of your brain, sends signals to your adrenal glands to release cortisol. The goal is to prepare your body for the situation. This is the same if it's managing stress, keeping your energy levels stable, or controlling inflammation. When your body is under stress, cortisol kicks into action. It increases the sugar in your bloodstream to give your body an energy boost. It also redirects energy away from non-essential functions like digestion and reproduction to ready your muscles for the "fight or flight" response. Once the stressful event is over, your cortisol levels should go back to normal. This lets your heart rate, digestion, and other systems return to their normal state.
The Importance of Cortisol
You need cortisol for normal growth and development. It helps regulate the metabolism of carbohydrates, fats, and proteins. These are the building blocks for energy and tissue growth. Without enough cortisol, the body can't keep these functions up! This in turn can affect physical and mental development. Cortisol also helps manage your body’s circadian rhythm, the natural cycle of sleep. It ensures that you have the energy to start your day by increasing levels in the morning and tapering off in the evening to help you sleep. Usually, your body maintains the right balance of cortisol. However, you can run into problems when you have too much or too little of this hormone.
Knowing what’s going on inside the body can help explain congenital adrenal hyperplasia (CAH) symptoms.
Watch now: Why don’t I feel good?
There’s a range of CAH signs and symptoms.
People with CAH make too little cortisol and aldosterone, while producing too many androgens. These hormone imbalances affect the body’s ability to function properly. Learn more about the range of CAH signs and symptoms and how steroids help treat both cortisol deficiency and androgen overproduction.
Learn more about these key hormones at: whatthecah.com.
Cortisol and CAH
CAH is a genetic disorder that affects the adrenal glands' ability to produce cortisol. There are two types of CAH: classic and nonclassic. People with classic CAH are usually diagnosed at birth, while those with nonclassic CAH may not be diagnosed until later in life. For people with CAH, the body either doesn't produce enough cortisol or produces too much of other hormones like androgens (male hormones). This hormonal imbalance can cause a variety of symptoms, including abnormal genital development in females, early puberty in both genders, and growth problems.
Why is Cortisol Important for People with CAH?
Because people with CAH don’t produce enough cortisol, they need to take synthetic versions of the hormone to make up for the deficiency. Without proper cortisol levels, people with CAH are at risk of developing an adrenal crisis, a potentially life-threatening condition. In an adrenal crisis, the body can't handle stress properly, which can lead to dangerously low blood pressure, severe dehydration, and shock. Daily hormone replacement therapy is needed for people with CAH to maintain normal cortisol levels. They may also need "stress doses" of cortisol during times of illness, surgery, or other physical stressors to prevent an adrenal crisis.
Treatments for CAH Involving Cortisol
People with CAH typically take medications like hydrocortisone, prednisone, or dexamethasone to replace the missing cortisol. The dose is carefully monitored by doctors to mimic the body’s natural cortisol production. In addition, people with CAH may need to take other hormones like fludrocortisone to balance salt and fluid levels in their bodies. You will also need regular blood tests and doctor visits to make sure that your hormone levels are balanced and to adjust doses as needed.
Cortisol plays an essential role in keeping your body functioning properly, especially in stressful situations. For people with congenital adrenal hyperplasia, managing cortisol levels is a lifelong necessity to avoid serious health complications. By taking hormone replacement medications and following a doctor’s guidance, people with CAH can live healthy, fulfilling lives while managing this important hormone.
Nearly 1 million people have joined PatientsLikeMe. You can track your health, monitor the efficacy of treatment, and talk to people experiencing the same thing as you. Creating an account is free! Join today.