ROLES of CORTISOL Blood sugar (glucose) levels Fat, protein and carbohydrate metabolism to maintain blood glucose (gluconeogenesis)

s) Immune responses Anti-inflammatory actions Blood pressure Heart and blood vessel tone and contraction Central nervous system activation Causes Pituitary Adenoma Pituitary adenomas cause 70 percent of Cushing s syndrome cases, excluding those caused by glucocorticoid use. These benign, or noncancerous, tumors of the pituitary gland secrete extra ACTH. Most people with the disorder have a single adenoma . Ectopic ACTH Syndrome Some benign or, more often, cancerous tumors that arise outside the pituitary can produce ACTH. This condition is known as ectopic ACTH syndrome. Adrenal Tumors In rare cases, an abnormality of the adrenal glands, most often an adrenal tumor, causes Cushing s syndrome. Most of these cases involve noncancerous tumors of adrenal tissue called adrenal adenomas, which release excess cortisol into the blood. Familial Cushing s Syndrome Most cases of Cushing s syndrome are not inherited. Rarely, however, Cushing s syndrome results from an inherited tendency to develop tumors of one or more endocrine glands.

Gluconeogenesis- formation of glucose from noncarbohydrate sources -excess sugar is stored as glygogen (1 day) then into fats -stored in the organs 1. Moon face. Fat deposits- increased glucose, not needed by the body-stored as glycogen then into fats 2. Thin extremities- cortisol breaks down proteins into amino acids. These are then brought to the liver to be reassembled into new protein, converting into glucose-stored as fat again 3. Personality changes-high levels of cortisol hormone damages neurons and distorts the neurotransmitters like dopamine and serotonin-responsible for mood and motivation 4. Susceptibility to infection-cortisol suppresses the immune response by suppressing the WBCs, lymph and immune cell function, reduced inflammatory process( no inflammatory mediators) 5. GI distress-cortisol increases the production of gastric acid 6. Hyperglycemia- increased glucose from gluconeogenesis; cortisol counteracts insulin. Increased cortisol by decreasing the function of glucose transporters. Or exhaustion of beta cells from overproduction of glucose 7. Osteoporosis- cortisol increases the activity of osteoclasts, inhibits calcium reabsorption in the renal tubules

8. Potassium excretion, Sodium and water retention-Cortisol causes excretion of potassium. In order for it to move out of the cell, cortisl moves in an equal amount of sodium. Increased sodium causes water retention --- HYPERTENSION, EDEMA, HYPOKALEMIA, and MUSCLE WEAKNESS