Cortisol is a corticosteroid hormone produced by the adrenal cortex that is involved in the response to stress; it increases blood pressure, blood sugar levels, may cause infertility in women, and suppresses the immune system. Synthetic cortisol, also known as hydrocortisone, is used as a drug mainly to fight allergies and inflammation.

Synthesis

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Cortisol is synthesized from pregnenolone. The conversion involves hydroxylation of C-11, C-17, and C-21, the oxidation of C-3, and the isomerization of the C-5 double bond to C-4. The synthesis takes place in the zona fasciculata of the cortex of the adrenal glands. While the adrenal cortex also produces aldosterone (in the zona glomerulosa) and some sex hormones (in the zona reticulosa), cortisol is its main secretion. (The name cortisol comes from cortex.) The medulla of the adrenal gland lies under the cortex and mainly secretes epinephrine and norepinephrine under sympathetic stimulation.

The synthesis of cortisol in the adrenal gland is stimulated by the anterior lobe of the pituitary gland with adrenocorticotropic hormone (ACTH); production of ACTH is in turn stimulated by corticotropin-releasing hormone (CRH), released by the hypothalamus.

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