What is the function of cortisol in the body?

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From the Guidelines

Cortisol plays a crucial role in the body by regulating metabolism, responding to stress, reducing inflammation, maintaining blood pressure, and supporting various bodily functions. According to the most recent study 1, cortisol is the dominant glucocorticoid in humans, produced in the zona fasciculata of the adrenal cortex, with a pulsatile release that follows a circadian rhythm. This hormone is essential for the body's response to stress, often referred to as the "stress hormone," and its levels increase during times of physical or emotional stress to help the body respond appropriately.

Some of the key functions of cortisol include:

  • Regulating metabolism by controlling how the body uses carbohydrates, fats, and proteins
  • Increasing blood sugar when needed by promoting gluconeogenesis in the liver
  • Reducing inflammation throughout the body, which is why synthetic versions are used as anti-inflammatory medications
  • Maintaining blood pressure
  • Regulating sleep-wake cycles following a daily rhythm, with levels typically highest in the morning and lowest at night
  • Supporting fetal development during pregnancy

It is worth noting that an imbalance of cortisol, either too much (Cushing's syndrome) or too little (Addison's disease), can cause serious health problems, highlighting the importance of proper cortisol balance for overall health and normal bodily function 1. Additionally, elevated cortisol levels have been linked to visceral obesity and an increased risk of cardiovascular events, as demonstrated in a study published in 2009 1. However, the most recent and highest-quality study 1 provides the most relevant information on the role of cortisol in the body.

From the FDA Drug Label

ACTIONS Naturally occurring glucocorticoids (hydrocortisone and cortisone), which also have salt-retaining properties, are used as replacement therapy in adrenocortical deficiency states. Their synthetic analogs are primarily used for their potent anti-inflammatory effects in disorders of many organ systems. Glucocorticoids cause profound and varied metabolic effects. In addition, they modify the body's immune responses to diverse stimuli. The pharmacological effect of Metopirone is to reduce cortisol and corticosterone production by inhibiting the 11-beta-hydroxylation reaction in the adrenal cortex. Removal of the strong inhibitory feedback mechanism exerted by cortisol results in an increase in adrenocorticotropic hormone (ACTH) production by the pituitary

Cortisol's role in the body includes:

  • Modifying the body's immune responses to diverse stimuli
  • Causing profound and varied metabolic effects
  • Exerting a strong inhibitory feedback mechanism on adrenocorticotropic hormone (ACTH) production by the pituitary 2 3

From the Research

Cortisol's Role in the Body

Cortisol is a hormone that plays a crucial role in various bodily functions. Some of the key effects of cortisol include:

  • Regulating metabolism and blood sugar levels 4
  • Aiding in the reduction of inflammation and immune responses 5
  • Influencing the distribution of fat, particularly in the face, back of the neck, and visceral organs 4
  • Impacting blood pressure, with excessive cortisol levels potentially leading to hypertension 4
  • Affecting mood and cognitive function, with hypercortisolism linked to mood disorders and neurocognitive changes 4

Consequences of Excessive Cortisol

Prolonged elevation of cortisol levels can lead to a range of health issues, including:

  • Cushing syndrome, a condition characterized by hyperglycemia, protein catabolism, immunosuppression, and other metabolic and hormonal imbalances 4, 6, 7, 8
  • Severe hypercortisolism, a life-threatening condition that requires rapid normalization of cortisol concentrations and aggressive treatment of associated complications 7
  • Increased risk of comorbidities, such as obesity, diabetes, and cardiovascular disease 4

Regulation of Cortisol Levels

The body regulates cortisol levels through various mechanisms, including:

  • The hypothalamic-pituitary-adrenal (HPA) axis, which controls the production and release of cortisol 4
  • Negative feedback loops, which help to maintain cortisol homeostasis 5
  • The use of medications, such as steroidogenesis inhibitors, to reduce cortisol production in cases of hypercortisolism 6, 7, 8

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Immune regulation by glucocorticoids.

Nature reviews. Immunology, 2017

Research

Updates in adrenal steroidogenesis inhibitors for Cushing's syndrome - A practical guide.

Best practice & research. Clinical endocrinology & metabolism, 2021

Research

Medical therapy in severe hypercortisolism.

Best practice & research. Clinical endocrinology & metabolism, 2021

Research

Adrenally Directed Medical Therapies for Cushing Syndrome.

The Journal of clinical endocrinology and metabolism, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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