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Abstract Corticosteroids are synthesized in the adrenal cortex and can be divided into mineralocorticoids and glucocorticoids. The main mineralocorticoid is aldosterone and the main glucocorticoid cortisol. In addition, the adrenal secretes a large amount of androgens through dehydroepiandrosterone (DHEA) and its sulphated derivative DHEAS. Aldosterone binds to mineralocorticoid receptors (MRs) and is important in sodium handling in the kidney and other mineralocorticoid target tissues. Cortisol is the main glucocorticoid synthesized in humans. An area of potential confusion is that cortisol is traditionally called hydrocortisone when administered as a pharmaceutical. Cortisol can bind to the glucocorticoid receptor (GR), which is expressed at varying levels in almost all cells. This binding accounts for the majority of responses seen in healthy individuals. Cortisol is rapidly synthesized in the adrenal cortex in response to ACTH synthesized in the pituitary. ACTH is secreted from the pituitary in response to corticotropin releasing hormone (CRH), which is secreted from the hypothalamus. CRH is released in response to a range of factors, including neurological inputs entraining the normal diurnal rhythm of cortisol secretion and a range of physiological and psychological stressors. |