Adrenals and Cortisol
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Hormone Health

Adrenal Glands and Cortisol: The Stress Hormone

by Karan Y. Baucom, MD, FACOG, FAAAM
August 25, 2008

Adrenal Glands

The adrenal glands are two triangular orange-colored glands that are positioned one on top of each kidney. The glands are absolutely vital for our existence.

There are two parts of the adrenal gland:

1) The outside or shell cortical layer (like an M&M candy) has three layers. Each layer secretes different hormones directly into the bloodstream to take care of:

• blood sugar regulation
• electrolytes (NA+, K+); and
• cortisol or steroids for stress

2) The inside of each gland (chocolate part of M&M), or the adrenal medulla, secretes the neurotransmitter noradrenaline (also called norephinephrine) and epinephrine (also called adrenaline).

Adrenaline causes excitement and stimulation of the circulation and muscular action. Noradrenalin has little effect on muscles and cardiac output, but increases blood pressure resulting from vasconstriction.

The adrenal glands are vital for our immune system, as well as our overall hormone health. Click here to read more about the adrenals.


Cortisol is one of several hormones released by the powerful adrenal glands. It is released as a “stress hormone” and is vital to the feeling of well-being. Longevity and quality of life are severely compromised when this powerful hormone is barely available.

  • controls blood sugar
  • stimulates fat and protein mobilization
  • prevents inflammation
  • stimulates the liver to convert fat to sugar & store it

The pituitary gland activates the adrenal gland by secreting ACTH (adrenocorticotropic hormone). ACTH stimulates the “cortical” layer of the gland to make cortisol.

Cortisol has a distinct bio-rhythm. It is high in the morning and by the evening is lower. Stress alters the rhythm and may eventually cause the gland to become exhausted. “Adrenal Fatigue, The Twenty-First Century Syndrome”, a book by James Wilson, ND PhD is an excellent book explaining why and how cortisol depletion can result in severe exhaustion. Unfortunately, this hormone is not understood by most physicians. It is a test rarely ordered and a syndrome basically ignored.

Stress factors

  • anger
  • fear
  • death of family member
  • divorce
  • marriage
  • financial worries
  • job
  • relationships
  • personal illness
  • in-laws

These are just a few of the factors that are viewed as stress. These issues, if chronic and severe, can totally deplete this vital hormone.

Patients will rely on sugar and caffeine to “boost” their energy because they are unaware as to the real reason for their chronic fatigue.

Eventually the immune system falters. Lupus, Crohn’s, colitis, chronic sinus and infections plague the individual. Abdominal obesity (cortisol paunch) along with decreased HDL cholesterol, increased triglycerides and increased blood pressure herald the demise of this vital hormone.

There is acute adrenal fatigue, mild and high adrenal fatigue. Saliva testing of the morning, noon, evening, and night cortisol levels is the best way to determine the level of fatigue. Good treatment involves herbal support, and in severe cases Cortef or actual cortisol is prescribed.

The adrenals are needed for survival. When the adrenal glands are compromised, all other glands suffer as well. Thyroid inactivity and severe adrenal stress go hand in hand. Low blood pressure as well as low blood sugar may be the only symptoms. The thyroid gland, in trying to pick up the slack, will in time become hypo active itself, further compounding the clinical situation.

Even with adequate treatment, recovery from adrenal stress can take up to a year of treatment to resolve.


Wilson, James R., PhD, DC, ND. Adrenal Fatigue: the 21st Century Syndrome, Jan 25/02, ISBN - 10:1890572152 and ISBN - 13:9781890572150


For more information visit the website of
Karan Y. Baucom, MD, FACOG, FAAAM
Fellow American College of OB-Gyn
Fellow American Academy of Anti-Aging Medicine


other articles by Dr. Baucom:

The Thyroid Paradox
Male Andropause


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This content is not intended to substitute for professional medical advice. Always consult your physician or other qualified healthcare provider with your questions regarding a medical condition.

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