What is the Origin of Cortisol Dysregulation?

The term arises from the clinical observation of stress physiology and endocrinology, building upon Hans Selye's foundational work on the General Adaptation Syndrome in the mid-20th century, which established the concept of a systemic stress response. The recognition of "dysregulation" as a specific pathology distinct from acute, adaptive changes or overt Cushing's/Addison's disease has evolved with advanced diagnostic testing and a deeper understanding of chronic stress-related endocrine dysfunction. This term accurately reflects the loss of precise control within the HPA axis feedback loop.

What is the Mechanism of Cortisol Dysregulation?

The mechanism involves a sustained or erratic disruption of the negative feedback loop between the hypothalamus, pituitary gland, and adrenal glands. Chronic psychological or physiological stress can lead to adrenal fatigue or, conversely, persistent hypercortisolism, which saturates glucocorticoid receptors and alters gene expression. This sustained endocrine imbalance disrupts circadian rhythmicity, compromises insulin sensitivity, promotes visceral adiposity, and suppresses the synthesis of other vital hormones, including DHEA and testosterone, creating a cascading systemic impact.

Cortisol Dysregulation

Meaning

Cortisol Dysregulation describes an aberrant pattern or level of the glucocorticoid hormone cortisol, secreted by the adrenal cortex, which deviates from the normal diurnal rhythm and homeostatic range. This condition is not simply high or low cortisol, but a pathological alteration in the hypothalamic-pituitary-adrenal (HPA) axis signaling that impacts systemic metabolism, immune response, and stress adaptation. Chronic dysregulation can lead to profound physiological consequences, including impaired glucose metabolism and diminished immune surveillance. The clinical assessment of this state often requires comprehensive salivary or serum measurements across a 24-hour cycle.

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