Mystery Hormone #5: Cortisol

1. Mystery Hormone #5:Cortisol The Stress Hormone

2. What is cortisol? • A steroid hormone • part of the endocrine system • A glucocorticoid • one of the three main groups of steroid hormones

3. What does cortisol do? • Homeostasis • Helps the body to manage stress • Fight or Flight Response • Contributes to the maintenance of constant blood pressure • Metabolism • Converts protein into glucose to boost blood sugar levels • Works with insulin to maintain the balance of blood sugar levels • Health • Reduces inflammation • Contributes to the workings of the immune system.

5. Pathway & Synthesis

6. Too Much or Too Little? • Hypersecretion of cortisol • Cushing’s Disease • Hyposecretion of cortisol • Addison’s Disease • Hypopituitarism • Acute Adrenal Crisis

7. Cushing’s Disease • What is it? • Too much ACTH is produced due to a tumor in/on the pituitary gland or hyperplasia leading to an increase in the production of cortisol

8. Symptoms • Appearance • Weight gain around the abdomen with skinny arms and legs, fat build up between shoulder blades • Round, red face, acne/Skin infection • Purple marks on body and easy bruising • Women tend to have excess hair growth on their body (i.e. neck, face and chest) • Body • Bone pain, thinning of bones • Weak muscles, back ache • Mental • Depression, anxiety, fatigue

9. Treatment • Surgery to remove tumor on the pituitary gland or radiation • Hormone replacement therapy • Cortisol hormone replacement either through injection or oral medication

10. Addison’s Disease • What is it? • Damage to the adrenal cortex leads to a decrease in the production of cortisol • Damage to the gland can be caused by infections, tumors, autoimmune diseases or haemorrhaging • Symptoms • Patches of darkening skin, paleness • Weakness and fatigue • Diarrhea, nausea, vomiting • Mouth lesions referred to as buccal mucosa

11. Treatment • Pharmaceutical corticosteroids • A combination of glucocorticoids and mineralocorticoids

12. Acute Adrenal Crisis • What is it? • Similar to Addison’s Disease, Acute Adrenal Crisis is caused by a combination of three factors: • The adrenal glands are damaged • ACTH cannot be released due to a damaged pituitary • The lack of steroid hormones is not treated

13. Symptoms • Abdominal pain, headache, weakness/dizziness, fatigue, joint pain • Nausea, vomiting, fever • Loss of appetite, weight loss • Low blood pressure, dehydration, excessive sweating • Rapid heart rate and respiratory rate • Chills, slow movement, loss of consciousness • Darkening of skin, skin lesions or rash

14. Treatment • Very dangerous and life threatening • Immediate injection of intravenous fluids and hydrocortisone

15. Hypopituitarism • What is it? • In general, hypopituitarism is caused by a lack of one or more pituitary hormones • In this case, hypopituitarism would be caused by a lack of ACTH leading to a decrease in the cortisol production • Symptoms • Abdominal pain, headache, weakness, fatigue • Decreased appetite, weight loss, low blood pressure

16. Infertility, lack of sex drive in women, lack of sexual interest in men, failure to lactate, slowed growth and sexual development in children, stopping of menstrual periods • Vision problems, sensitivity to cold, short height • Loss of body/facial hair in men and women • Treatment • Hormone replacement therapy • Corticosteroids, growth and thyroid hormones, sex hormones

17. RESULTS Of hormone experiments on normal and castrated mice

18. Figure 1 – The control mouse mass was 300 g, the normal experiment mouse yielded a body mass of 150 g, a decrease in mass by 50%. The mass of the testes in each mouse did not deviate from 3 200 mg. The only body parts that resulted in at least a 20% difference in mass were the: Pituitary (24% decrease), thymus (68.4% decrease) and the adrenals (25% decrease). The thyroid, seminal vesicles and the prostate decreased in mass slightly, but not significantly.

19. Figure 2 – The castrate control mouse had a mass of 270 g, the castrate mouse had a mass of 135 g, a decrease in mass by 50%. The only body parts that resulted in a difference in mass by at least 20% were the: Pituitary (24.8% decrease), thymus (70.2% decrease), and the adrenals (27.5% decrease). The thyroid, seminal vesicles and the prostate decreased in mass slightly, but not significantly.

20. Future Research • Effects of cortisol on the handling of emotional information and any possible neural correlations. • Monitoring the effects of continuous stress by the same event. • Diagnosis of diseases causing increased cortisol levels (i.e., Cushing’s Disease) by measuring cortisol and dexamethasone (synthetic glucocorticoid, acts like cortisol) levels concurrently.

21. References • Hormones - cortisol | Better Health Channel [online]. 2013. Available from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Hormones_cortisone [accessed March 3 2013]. • Fast, M.D., Hosoya, S., Johnson, S.C., and Afonso, L.O.B. 2008. Cortisol response and immune-related effects of Atlantic salmon (Salmosalar Linnaeus) subjected to short- and long-term stress. Fish Shellfish Immunol. 24(2): 194-204. • Li, L., Xia, D., Wei, S., Hartung, J., and Zhao, R. 2008. Characterization of adrenal ACTH signaling pathway and steroidogenic enzymes in Erhualian and Pietrain pigs with different plasma cortisol levels. Steroids. 73(8): 806-814. • Moyes, C. D., Schulte, P. M. 2008. Principles of Animal Phhysiology 2ndEd.Pearson Education Inc. (Benjamin Cummings), San Francisco, C.A. • Putman, P. and Roelofs, K. 2011. Effects of single cortisol administrations on human affect reviewed: Coping with stress through adaptive regulation of automatic cognitive processing. Psychoneuroendocrinology. 36(4): 439-448. • Ray, J.A., Kushnir, M.M., Rockwood, A.L., and Meikle, A.W. 2011. Analysis of cortisol, cortisone and dexamethasone in human serum using liquid chromatography tandem mass spectrometry and assessment of cortisol: Cortisone ratios in patients with impaired kidney function. ClinicaChimicaActa. 412(13–14): 1221-1228. • Rennert, N. J., Zieve, D. 2013. Cortisol Level: MedlinePlus Medical Encyclopedia [online]. Available from http://www.nlm.nih.gov/medlineplus/ency/article/003693.htm [accessed March 3 2013].