Cortisol Resistance is a state in which target tissues exhibit a reduced sensitivity or responsiveness to the biological actions of cortisol, despite the presence of normal or even elevated circulating levels of the hormone. This functional impairment means that the body’s cells cannot properly execute the anti-inflammatory, metabolic, and regulatory functions that cortisol typically mediates. The clinical consequence is often a persistent state of low-grade inflammation, impaired glucose regulation, and a compromised stress response system. It represents a significant disruption in glucocorticoid signaling.
Origin
The term is analogous to the well-established concept of insulin resistance, reflecting a general principle in endocrinology where a receptor or post-receptor defect leads to functional hormone insensitivity. It stems from clinical observations of patients with stress-related symptoms who do not exhibit the expected physiological responses to their measured cortisol levels. The root cause is often linked to chronic stress-induced receptor downregulation or post-receptor signaling defects.
Mechanism
The mechanism involves a defect at the level of the glucocorticoid receptor (GR) or downstream signaling pathways. This can manifest as reduced GR expression, impaired binding affinity of cortisol to the receptor, or a failure of the activated GR to properly translocate to the nucleus and modulate gene expression. This molecular uncoupling means that the necessary gene transcription for anti-inflammatory and metabolic regulation is attenuated, leading to a state of functional hypocortisolism at the cellular level despite systemic hormone availability.
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