Cortisol in men: high and low, what does it mean, how to lower and increase?

Glucocorticoid steroid hydrocortisone (also called stress hormone) plays an important role in metabolism, immune and stress responses, synthesis of sex hormones. Cortisol in men affects well-being, reproductive function. Both too low and high levels lead to unpleasant consequences.

What is the hormone cortisol responsible for in the body of men, what does it affect?

The main function of cortisol is to trigger an adequate adaptive response to stress in the body.

As a result of its action, the following processes occur:

• ensuring metabolism;
• activation of glucose synthesis from glycogen, amino acids, glycerol, proteins, lactic acid;
• increased blood sugar;
• suppression of inflammation, immune reactions;
• elimination of water from the body;
• pressure increase;
• decrease in pain sensitivity;
• improvement of brain function, memory.

In addition, the hormone cortisol is indirectly responsible in men for reproductive function, testosterone production.

Is there a need for it?

Hydrocortisone is an important steroid that is responsible for the response to psycho-emotional or physical shock, for example, injury, conflict or dangerous situation. Initially, the hormone was designed to quickly find the optimal solution to a problem, which is facilitated by the "bonuses" it provides:

• activation of brain activity;
• decreased susceptibility to pain;
• an increase in blood pressure to cope with shock;
• accelerated power generation;
• fast healing of minor injuries, including muscle microtrauma, due to the absence of inflammation.

Failures begin under conditions of constant stress, as well as when the natural suppression of the natural reaction to it - for example, fight or flight, is forced.

3 tests for cortisol in men: which, when and how to take?

The content of the steroid in the body is not constant, it depends on the time of day, the state of the person. A decrease in the level is noted in the afternoon, it will be higher in the morning or due to excitement.

A cortisol test is indicated if there is a suspicion of a dysfunction of the pituitary or adrenal glands. And also when the patient has chronic hypertension that cannot be treated with standard drugs, depression, abnormal skin pigmentation. Before passing the examination, you should refrain from alcohol, fatty foods, smoking, physical and mental stress, sexual contact for at least 24 hours (preferably 48 hours).

Blood donation usually takes place in the morning: the earlier, the better. An exception is the diagnosis of Cushing's syndrome, when the analysis is performed in the evening. If the steroid level is low, the doctor may order a follow-up examination after the patient is injected with synthetic ACTH, which stimulates the adrenal glands to increase the production of cortisol. If elevated, a dexamethasone suppression test may be performed. This glucocorticoid suppresses ACTH, which should reduce hydrocortisone synthesis if triggered by stress.

To assess the production of the hormone throughout the day, a daily urine test is prescribed. The patient will need to collect all urine, with the exception of the first morning portion, in a sterile container over a 24-hour period. Keep refrigerated. After the end of the day, record the volume obtained during each trip to the toilet, mix the urine thoroughly and pour out 100-150 ml for analysis. During the collection, you can not have sex, take diuretic drugs.

Another option is to test for cortisol in saliva. Comfortable, does not cause painful sensations, allows you to assess the acute reaction to stress. 3 hours before the event, you must not eat, brush your teeth, smoke, drink anything other than water. To check the daily fluctuations in the level, 3 saliva samples are taken with an 8-hour break.

Table with the norms of cortisol in men by age

Hydrocortisone production depends on the time of day and mental state. The amount can be measured in μg / dL (micrograms per deciliter), but it is more commonly used (nmol / L) (nanomoles per liter). The age differences are summarized in the following table:

The norm of free cortisol in men in daily urine ranges from 55 to 490 nmol / day, in saliva - from 7 to 25 nmol / l.

High: causes, symptoms, how to reduce

An increase in hormone levels is possible for various reasons:

• an adenoma in the pituitary gland or hypothalamus, other formations that produce proteins similar to ACTH;
• adrenal tumors;
• prolonged emotional stress;
• excessive physical activity;
• taking cortisol medications;
• inflammation, pain syndrome;
• obesity;
• diabetes mellitus;
• liver damage;
• thyroid dysfunction;
• drug, alcohol abuse;
• hereditary pathologies.

When cortisol is elevated, men may experience the following symptoms:

• decrease in bone strength;
• decrease in muscle mass;
• gynecomastia;
• constantly high blood pressure;
• the formation of adipose tissue on the abdomen, back, face, neck, simultaneously with weight loss of the limbs;
• poor resistance to infection;
• problem skin with wounds, stretch marks, rash, bruises;
• depression, irritability;
• renal colic;
• deterioration of libido, erection (up to testicular atrophy);
• enduring hunger;
• development of diabetes;
• weakness.

Treatment consists in eliminating the root cause, in the presence of tumors, surgical intervention is indicated. Symptomatic therapy, drugs that suppress the synthesis of steroids, and sedatives are also prescribed. During the recovery period, it is recommended to follow a balanced diet, give up bad habits, and avoid overexertion.

Low: why, main symptoms, treatment

Hypocorticism is less common, since only a few conditions can lower cortisol in men to a critical value:

• trauma and pathology of the brain, especially the hypothalamus, pituitary gland;
• adrenal tumor or other lesion;
• taking drugs that suppress the synthesis of hydrocortisone;
• abrupt withdrawal of glucocorticoid therapy.

The condition is manifested by a number of symptoms:

• pressure reduction at light loads;
• lack of appetite;
• wanton weight loss;
• abdominal pain, diarrhea alternating with constipation;
• frequent drop in blood sugar;
• headache;
• depression, psychosis.

Based on the results of the examination, the doctor prescribes hormonal drugs that will help increase the glucocorticoid content until the source of the problem is eliminated. Symptomatic treatment is underway.

Effect of cortisol on potency

Cortisol is a testosterone antagonist, which means it indirectly affects potency. With an increase in the level of the first steroid, the concentration of the second decreases, which ensures disruptions in the reproductive system. With a decrease in cortisol, the body suffers a number of other problems, health deteriorates, the production of estradiol and prolactin, female hormones increases, as a result, testosterone levels also gradually decrease.

Lack of androgen leads to a decrease in libido, deterioration in sperm quality, erection, in the long term - to impotence and infertility.

Accordingly, for normal potency, cortisol should always be normal.

Consequences of deviations from the reference values

A decrease or increase in the secretion of hydrocortisone leads to equally unpleasant consequences. With any imbalance, psychoemotional disturbances are observed - depression, anxiety, suicidal thoughts, outbursts of anger, irritation. A metabolic disorder develops.

Hypercortisolism leads to diseases of the heart and blood vessels, osteoporosis, diabetes mellitus, and becomes an indirect cause of the development of acute and chronic infections. Hypocorticism, if left untreated, can cause a serious eating disorder, including anorexia.

The relationship between cortisol and testosterone

Testosterone and cortisol are "rivals", anabolic and catabolic hormones that perform the function of mutual suppression. A noticeable change in the level of one of them almost inevitably leads to an imbalance of the second, whereas normally they regulate each other.

Therefore, with moderate physical exertion, provoking the production of testosterone, the synthesis of hydrocortisone decreases, while, against the background of overvoltage, the opposite process occurs. It should be remembered that both are important for maintaining health, including "male" health.