Cortisol is a hormone that is secreted by your adrenal gland. Its secretion is normally regulated by the anterior pituitary gland and the hypothalamus. This regulation serves to keep the cortisol levels within a normal range. There are several conditions, however, which can lead to high levels of this hormone.
Small Cell Lung Carcinoma
Also called oat cell carcinoma, this is one type of lung cancer which has a high association to cigarette smoke. It grows fast and can metastasize (spread) early to the bone, brain, liver and the adrenal glands. But this cancer also secretes ACTH. ACTH is the adrenocorticotropic hormone which is normally sent from the anterior pituitary gland to the adrenal gland. This hormone is meant to stimulate the adrenal gland to release cortisol. When small cell lung cancer secretes ACTH, it does so without any regulation or control. This results in high cortisol levels.
Carcinoid Tumor
Carcinoid tumors can be found in the last part of the small intestines called the ileum as well as the appendix and rectum. According to “Robbins Pathologic Basis of Disease,” the tumors in the appendix and the rectum rarely metastasize. But similar to small cell lung carcinoma, carcinoid tumors can also secrete ACTH. As a tumor, the secretion does not abide by any control or regulation and, therefore, can cause high cortisol levels.
Pituitary Adenoma
An adenoma is a benign tumor that has structures which resemble a gland. Being benign, it does not invade into adjoining tissues, but can cause damage by pressing against the tissues. A pituitary adenoma located in the anterior pituitary gland secretes ACTH. Thus, it stimulates the adrenal gland to cause high cortisol levels. This adenoma is also known as Cushing’s disease. Paul Fitzgerald, M.D., clinical professor of medicine at the University of California writes in “Current Medical Diagnosis & Treatment,” that 40 percent of high cortisol levels are the result of Cushing’s disease.
Adrenal Adenoma
An adrenal adenoma is a benign tumor that is located in the adrenal gland. Because it is in the adrenal gland, it secretes cortisol, not ACTH. According to Dr. Tobias Else of the Department of Internal Medicine at the University of Michigan, this tumor usually weighs 10 to 70g.
Adrenal Carcinoma
Unlike the adrenal adenoma, adrenal carcinoma is a malignant tumor. By comparison, it weighs from 100g to as much as several kilograms, and can usually be felt upon physical examination. Else writes that it is highly malignant, invading not only adjoining tissues and organs, but blood vessels as well, which allows it to metastasize to the lungs and liver. As an adrenal tumor, it secretes high levels of cortisol.
Adrenal Hyperplasia
Hyperplasia is the term used to describe an organ that is larger than normal because it has more tissues or cells than it normally should have. Although occasionally only one adrenal gland is enlarged, in most cases of adrenal hyperplasia, both of the adrenal glands are very large. This condition results in the release of high levels of cortisol.
About this Author
Based in North Carolina, Ruth Coleman has written articles and manuals for 25 years. Her writing has appeared in community newspapers, places of employment and comprises work done in medical college, of which she is a recent graduate. Ruth Coleman holds a Bachelor of Science in biology from Salem College, and is the recipient of numerous academic awards.
