What is the Origin of Cortisol Clearance?

The concept of clearance in endocrinology and pharmacology is derived from the physiological process of metabolism and excretion, particularly involving the liver and kidneys. Cortisol itself is a steroid hormone, with its name stemming from its origin in the adrenal cortex. Clearance specifically describes the volume of plasma from which the hormone is completely removed per unit of time.

What is the Mechanism of Cortisol Clearance?

Cortisol is predominantly cleared by the liver, where it is reversibly inactivated by the 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) enzyme to cortisone, or irreversibly metabolized by A-ring reductases. These metabolic steps render the hormone water-soluble for conjugation and subsequent urinary excretion. Genetic polymorphisms, liver function, and thyroid status can all impact the enzymatic activity, thus modulating the speed of cortisol clearance and influencing systemic glucocorticoid effects.

Cortisol Clearance

Meaning

The rate at which the active stress hormone cortisol is metabolized and eliminated from the systemic circulation, primarily through enzymatic inactivation in the liver and subsequent excretion via the kidneys. This process is a key determinant of the body’s overall exposure to cortisol, reflecting the efficiency of the hypothalamic-pituitary-adrenal (HPA) axis regulation. Alterations in cortisol clearance, rather than just secretion, can significantly influence clinical presentation and tissue-level hormone action.

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Cortisol Clearance

Meaning

Origin

Mechanism

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How Does Urine Metabolite Testing Inform Personalized Hormone Therapy Adjustments?

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