Cortisol is a hormone made by the adrenal glands. Conditions such as inflammatory disorders, skin disorders and some cancers can be treated with synthetic cortisol-like compounds, sometimes called corticosteroids. A side effect of this treatment is osteoporosis. High doses of cortisol-like drugs over a long period of time can cause a drop in the body's own cortisol production.
Cortisol is a hormone made by the two adrenal glands (one is located on each kidney) and it is essential for life. Cortisol helps to maintain blood pressure, immune function and the body's anti-inflammatory processes. The amount of cortisol released by the adrenal glands is regulated by the pituitary gland inside the brain.
Some disorders can be treated with synthetic cortisol-like compounds, sometimes known as corticosteroids. If taken at high doses or for a prolonged period, this treatment can have a number of side effects, including osteoporosis (thinning of the bones).
The role of cortisol in the body
- Help the body to manage stress
- Convert protein into glucose to boost flagging blood sugar levels
- Work in tandem with the hormone insulin to maintain constant blood sugar levels
- Reduce inflammation
- Contribute to the maintenance of constant blood pressure
- Contribute to the workings of the immune system.
Conditions treated with corticosteroids
Some of the conditions treated with corticosteroids (cortisol-like drugs) include:
- Skin disorders – such as psoriasis
- Inflammatory diseases – such as asthma, ulcerative colitis, lupus and some forms of arthritis
- Cancer – particularly cancers related to the immune system, such as leukaemia and lymphoma
- Organ transplant – corticosteroids are used to inhibit the body's immune response so that a transplanted organ is not rejected
- Addison's disease – an autoimmune disorder that stops the adrenal glands from making sufficient hormones, including cortisol.
Different forms of corticosteroids
Corticosteroids can be administered in a number of forms depending on the condition. Potent synthetic forms include dexamethasone, prednisolone and betamethasone. Common treatment forms include:
- Creams – applied to the affected areas of the skin
- Tablets – dosage varies, but is generally kept to the lowest dose possible
- Injections – straight into the affected joint, which prevents many of the side effects that occur when the medication is taken by mouth
- Inhaler – administered to treat inflammation in the lungs or sinuses.
Side effects of corticosteroids
Since cortisol acts on so many organs and tissues of the body, several unwanted side effects can occur during treatment with corticosteroids. It can be dangerous to suddenly stop the medication, so continue taking your regular dose and see your doctor if you are troubled by side effects.
Some of the more common side effects of cortisol-like drugs include:
- Thin skin
- Susceptibility to bruising
- High or increased blood pressure
- Susceptibility to infections
- Build-up of fat around the face, chest and abdomen
- Thinning of the limbs
- Osteoporosis (thinning of the bones) leading to bone fractures, particularly in the spine
- Fluid retention (oedema).
Corticosteroids can cause a loss of bone density in men and women, especially among postmenopausal women. The bones of the spine are the most vulnerable to fracturing in this setting. Corticosteroids interfere with the proper functioning of bone cells and prevent the intestine from properly absorbing calcium, which also affects the bones.
Symptoms of osteoporosis can include:
- Bone fractures
- Severe back pain
- Kyphosis (hunching of the upper back)
- Loss of height.
Managing the side effects of corticosteroids
Suggestions to manage the side effects of cortisol treatment include:
- Reduce the daily dose under strict medical supervision.
- Seek immediate treatment for any infection.
- Use vitamin D and calcium supplements.
- Use other medications to maintain bone strength.
High doses of corticosteroids over a long period of time can disrupt the workings of the pituitary and the adrenal glands, and cause a severe drop in the body's own cortisol production. This may result in cortisol insufficiency when these drugs are stopped.
Symptoms of cortisol insufficiency can include:
- Nausea and vomiting
- Low blood pressure, particularly when standing up from a sitting or lying position (orthostatic hypotension)
- Low blood sugar
Where to get help
- Your doctor
Things to remember
- Cortisol is a hormone made by the two adrenal glands (one is located on each kidney).
- Some disorders can be treated with synthetic corticosteroids.
- One of the main side effects of long-term treatment with corticosteroids is osteoporosis (thinning of the bones).
You might also be interested in:
Want to know more?
Go to More information for support groups, related links and references.
This page has been produced in consultation with and approved by:
(Logo links to further information)
Prince Henry's Institute of Medical Research
Last reviewed: October 2012
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.
For the latest updates and more information, visit www.betterhealth.vic.gov.au
Copyight © 1999/2013 State of Victoria. Reproduced from the Better Health Channel (www.betterhealth.vic.gov.au) at no cost with permission of the Victorian Minister for Health. Unauthorised reproduction and other uses comprised in the copyright are prohibited without permission.