Glucocorticoid Hormones
Effects of a Natural Steroid Hormone and Its Artificial Counterparts
The body produces cortisol for many purposes, which has led to clinical applications of synthetic glucocorticoids. However, too much can be problematic.
Glucocorticoid hormones are a type of corticosteroid hormone that is naturally made in the human body. They are necessary for the body to survive and handle various stressors. These steroid hormones are produced within the cortex of the adrenal glands, which reside above the kidneys.
Effects of Natural Glucocorticoids
Glucocorticoids, namely cortisol, have multiple functions related to metabolism and regulation. They raise blood glucose levels through breakdown of fat and muscle protein, increasing insulin resistance in tissues, and other processes. They also inhibit bone formation, raise the blood pressure, and suppress inflammatory processes as part of their additional regulatory function.
Clinical Uses of Synthetic Glucocorticoids
The anti-inflammatory properties of glucocorticoids are the main reason why they have clinical applications. Many conditions have some component of inflammation as part of their pathophysiology. By administering synthetic versions of these hormones (e.g., prednisone and methylprednisolone) orally or through some other route, the condition can be better managed.
Many of these conditions are autoimmune diseases or inflammatory conditions with unclear causes. They include, but are not limited to, Crohn's disease, ulcerative colitis, systemic lupus erythematosus (SLE), and rheumatoid arthritis. Glucocorticoids can also be used for chronic obstructive pulmonary disease (COPD), immune suppression following organ transplantation, and cortisol deficiency secondary to disease in the pituitary gland or adrenal glands (e.g., Addison's disease).
Manifestations of Excess Glucocorticoids
If blood levels of glucocorticoids are elevated, a variety of symptoms and signs occur, collectively termed Cushing's syndrome. Causes include administration of too much synthetic glucocorticoid, tumors of the adrenal gland, and other tumors (e.g., small cell carcinoma of the lung). Tumors of the pituitary gland also cause elevated glucocorticoids; the term Cushing's disease is used for this specific cause.
As a result of elevated glucocorticoid levels in the blood, people with Cushing's syndrome and Cushing's disease have abnormally high blood glucose levels, muscle weakness, osteoporosis, and high blood pressure. They become obese with fat tissue more concentrated in the trunk, fat accumulation behind the neck ("buffalo hump"), and a rounded face ("moon face"). They also have skin changes, mainly bruises and stretch marks.
Final Words
Glucocorticoids are an important hormone for the body at normal levels. If they are excessive, whether because of a tumor or because of overly administering steroid medications, the problem should be addressed promptly to minimize complications.
References
- Kronenberg, Henry M., Shlomo Melmed, Kenneth S. Polonsky, and P. Reed Larsen. "The Adrenal Cortex." Williams Textbook of Endocrinology. 11th ed. Philadelphia: Saunders Elsevier, 2008. 453-463.
- eMedicine - Cushing Syndrome
