What is the Origin of Chronic Hypercortisolism?

The term is a descriptive clinical diagnosis, derived from 'chronic' (long-lasting), 'hyper-' (excessive), and 'cortisolism' (a state related to cortisol). Cortisol itself is synthesized in the adrenal cortex, a process tightly governed by the hypothalamic-pituitary-adrenal (HPA) axis. The condition fundamentally represents a sustained failure of the HPA axis's negative feedback mechanisms to appropriately downregulate cortisol secretion.

What is the Mechanism of Chronic Hypercortisolism?

The mechanism involves continuous, high-level activation of glucocorticoid receptors across multiple tissues. This sustained signaling drives continuous hepatic gluconeogenesis, contributing significantly to hyperglycemia and the development of insulin resistance and Type 2 Diabetes. Furthermore, it exerts catabolic effects on protein and bone matrix, leading to muscle atrophy and osteoporosis, while also suppressing key aspects of the adaptive immune system, illustrating its widespread physiological impact.

Chronic Hypercortisolism

Meaning

Chronic Hypercortisolism is a sustained, pathological state characterized by persistently excessive levels of circulating cortisol, the primary glucocorticoid hormone, over an extended duration. This prolonged elevation profoundly disrupts the body’s metabolic, immune, and structural homeostasis, leading to a complex clinical presentation. While classically associated with Cushing’s syndrome, a more subtle, stress-induced form is increasingly recognized in clinical practice, impacting long-term health and well-being.