![]() ![]() ![]() Historically, measurements of free cortisol have been achieved from indirect means using a ratio known as the free cortisol index. Only free cortisol can access the enzyme transporters in liver, kidney, and other tissues that mediate metabolic and excretory clearance. Normally, less than 5% of circulating cortisol is free (unbound). The majority of cortisol circulates bound to corticosteroid-binding globulin (CBG) and albumin. CRH is released in a cyclic fashion by the hypothalamus, resulting in diurnal peaks (6 a.m.-8 a.m.) and troughs (11 p.m.) in plasma ACTH and cortisol levels. Cortisol is also used to treat skin disease, allergic disorders, respiratory system disease, inflammatory disorders, and nephrotic syndrome.Ĭortisol levels are regulated by adrenocorticotropic hormone (ACTH), which is synthesized by the pituitary in response to corticotropin releasing hormone (CRH). Both hypercortisolism (Cushing disease) and hypocortisolism (Addison disease) can cause disease. Cortisol, the main glucocorticoid (representing 75%-95% of the plasma corticoids), plays a critical role in glucose metabolism and in the body's response to stress. ![]()
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