kokonaiskortisoli

Kokonaiskortisoli refers to the total amount of cortisol circulating in the bloodstream. Cortisol is a steroid hormone produced by the adrenal glands, playing a crucial role in the body's stress response, metabolism, immune function, and blood pressure regulation. It is released in a pulsatile manner, with levels typically peaking in the early morning and declining throughout the day.

Measuring total cortisol in blood provides an overall picture of cortisol production. However, cortisol exists in two main forms in the blood: free cortisol and protein-bound cortisol. Free cortisol is the biologically active form that can exert its effects on tissues, while protein-bound cortisol is inactive until it detaches from its binding proteins. Total cortisol measurements include both free and bound forms.

Elevated total cortisol levels can indicate conditions such as Cushing's syndrome, a disorder caused by prolonged exposure to high cortisol levels, or stress. Conversely, low total cortisol levels may suggest adrenal insufficiency, like Addison's disease, where the adrenal glands do not produce enough cortisol.

Interpreting total cortisol levels requires consideration of the time of day, as diurnal variation is significant. Therefore, blood samples are often drawn at specific times, such as in the morning, to establish a baseline or compare against expected ranges. In some diagnostic contexts, measuring free cortisol or cortisol levels after specific stimulation or suppression tests might be necessary for a more precise diagnosis.