It’s an “emergency” according to our endocrinologist.
Cortisol is a hormone that we all secrete and which is essential for life. It is also one of the main adrenal hormones (produced by the adrenal glands located just above the kidneys). “It has several functions, including the regulation of blood pressure and the regulation of sugar metabolism”explains Dr Pierre Nys, endocrinologist-nutritionist. Cortisol is also nicknamed the “stress hormone” because it is secreted significantly in the event of aggression in the body. This is not the “stress” that we use in everyday language, but rather a stress on the body that can occur during an acute infection, a surgical operation, hypoglycemia or still under intense stress. A cortisol dosage may be prescribed by the doctor to highlight possible dysfunctions of the adrenal glands. “Adrenal disorders are very rare, but remain therapeutic emergencies. We estimate between 1 and 5 patients per 10,000 inhabitants”adds the doctor. These dysfunctions lead to several signs in the body that we must know how to spot.
Cortisol levels vary throughout the day. It is most often measured using a blood test in the morning at 8 a.m., preferably on an empty stomach. “If the sample is taken at this time, it is because it is the time of the day when the level of cortisol in the body is at its highest. It then goes down during the day, until it reaches its peak. lowest rate at 4 a.m.specifies the doctor. When taking a blood sample, the dosage must be carried out quickly, otherwise there is a risk of a false result. “It is possible to measure the cortisol level using a urine sample, but it is more restrictive, because a 24-hour urine collection is necessary.” Certain symptoms can also point to a lack of cortisol, in particular:
► intense fatigue
► arterial hypotension: “It occurs because in addition to cortisol, the adrenal glands secrete aldosterone, a powerful regulator of blood pressure.”
► hypoglycemia: “As cortisol is a regulator of sugar metabolism, hypoglycemia and associated symptoms can occur, such as food cravings for example.”
► digestive disorders
► weight loss: this is a symptom “later”but also a consequence of the dysregulation of cortisol levels
► excessive pigmentation of the skin: much rarer, it occurs in cases of excessive adrenal insufficiency. Indeed, in the event of a lack of adrenal hormone, the pituitary gland will secrete ACTH, the hormone which stimulates the adrenal glands and which can affect the pigmentation of the skin.
When you notice these symptoms, it is necessary to make an appointment with the doctor who will request a blood test. “The first thing to do in the event of too low cortisol levels (confirmed by blood test, editor’s note) is then to carry out tests at the hospital. It is absolutely necessary to look for the cause” continues Dr. Nys. During treatment, we then speak of drug supplementation and not of cure. “In France we prescribe hydrocortisone” to compensate for the lack of cortisol, the expert tells us. An adrenal insufficiency card is given to the patient.