Cortisol deficiency is when a person does not have enough of an important hormone, cortisol, in the body. Cortisol is produced by the adrenal glands, which are located on top of the kidneys and help the body handle stress among other functions. This deficiency can indicate malfunctioning adrenal glands, or a malfunctioning pituitary gland. It's a potentially serious problem, with a variety of symptoms. In the most severe cases it can lead to collapse or even death. Once diagnosed, treatment will usually consist of medication and monitoring.
The hormone cortisol has several vital functions in the human body and it acts as a naturally occurring steroid. Cortisol helps to regulate blood sugar levels, along with other hormones such as insulin. It also helps to control the metabolism of protein, fat and carbohydrates. Another function of cortisol is it helps the body to effectively combat stress. Cortisol also plays a role in controlling blood pressure and circulation.
Common symptoms of a cortisol deficiency include dizziness, fatigue, low blood sugar, generalized weakness and weight loss. A few digestive symptoms include loss of appetite, stomach pain, vomiting and diarrhea. Slightly less common complaints include depression, irritability, hair loss, increased sensitivity to cold, and vision problems. Patients are unable to tolerate physical or mental stress, which can lead to episodes of even more severe symptoms, such as sudden collapse.
Cortisol deficiency has several possible causes. One is Addison's disease, also known as primary hypoadrenalism. This condition is when there is a failure of the adrenal glands to function properly. The glands' failure is usually due to damage and scarring caused by the immune system attacking the adrenal glands from within for unknown reasons. This is considered an autoimmune disorder, where the immune system produces antibodies that attack the adrenal glands' cortex or outer layer instead of attacking a virus or bacteria.
Another cause of cortisol deficiency is ACTH deficiency, or secondary hypoadrenalism. This occurs when the pituitary gland is not producing enough of adrenocorticotropic hormone, or ACTH. Lack of ACTH can cause adrenal gland malfunctions as a secondary effect, because part of the job of ACTH is to signal cortisol production. This can be caused by diseases of the pituitary; or another possible cause is the use of steroid preparations by the patient. When steroid creams, tablets or other formulas are used the body can be tricked into stopping production of its own natural steroids because it thinks they are already present and more are unnecessary.
Doctors can diagnose cortisol deficiency with a simple blood test. Upon diagnosis further investigation is often necessary to determine the underlying cause. If the cortisol deficiency is caused by steroid use, discontinuing use will often allow the cortisol levels to recover and return to normal. For other causes, treatment usually consists of taking medication to replace the missing cortisol, usually a steroid like hydrocortisone that mimics cortisol's function in the body. Medication along with proper monitoring will often help the patient feel improvement quickly, and maintain their health.