ArticleBMC endocrine disorders2014
Plasma, salivary and urinary cortisol levels following physiological and stress doses of hydrocortisone in normal volunteers.
Article in BMC endocrine disorders, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
55 citing papers in PubMed, 1 synthesis or guideline pooled it, 112 citations in OpenAlex.
- Perinatal maternal depression and cortisol function in pregnancy and the postpartum period: a systematic literature review.BMC pregnancy and childbirth · 2016Pooled it
- Accelerated forgetting of a trauma-like event in healthy men and women after a single dose of hydrocortisone.Translational psychiatry · 2022Trial
- Acute hydrocortisone administration reduces cardiovagal baroreflex sensitivity and heart rate variability in young men.The Journal of physiology · 2018Trial
- Influence of exposure to coarse, fine and ultrafine urban particulate matter and their biological constituents on neural biomarkers in a randomized controlled crossover study.Environment international · 2017Trial
- A 3D-Printed Scaffolded Hydrogel Microneedle Array Biosensor for Real-Time, Continuous Monitoring.Advanced materials (Deerfield Beach, Fla.) · 2026Article
- Effects of Maternal and Cumulative Stress on Immune Phenotype and Stress Reactivity in Sows Later in Life.Animals : an open access journal from MDPI · 2026Article
- Determination of hydrocortisone and cortisone in artificial saliva by spray assisted fine droplet formation liquid phase microextraction coupled to LC-MS/MS.Scientific reports · 2026Article
- Plasma hepcidin level is elevated by water immersion-induced central fatigue via hepatic inflammatory response in male and female rats.Physiological reports · 2025Article
- Endogenous glucocorticoids and human immunity: Time to revisit old dogmas.Seminars in immunology · 2025Review
- Do Cortisol Levels Play a Role in Suicidal Behaviors and Non-Suicidal Self-Injuries in Children and Adolescents?-A Narrative Review.Brain sciences · 2025Review
- Binding for life: corticosteroid binding globulin from vertebrate physiology to human diseases.Frontiers in endocrinology · 2025Review
- Factors predictive of serum cortisol in pediatric patients with acute physiological stress: a cohort study.Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology · 2025Article
- Basal cortisol level modulates stress-induced opioid-seeking behavior.Neurobiology of stress · 2024Article
- No requirement of perioperative glucocorticoid replacement in patients with endogenous Cushing's syndrome - a pilot study.Endocrine · 2024Article
- Cognitive reserve, cortisol, and Alzheimer's disease biomarkers: A memory clinic study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Myeloid Cell Glucocorticoid, Not Mineralocorticoid Receptor Signaling, Contributes to Salt-Sensitive Hypertension in Humans via Cortisol.bioRxiv : the preprint server for biology · 2024Article
- Association between Eosinophil Count and Cortisol Concentrations in Equids Admitted in the Emergency Unit with Abdominal Pain.Animals : an open access journal from MDPI · 2024Article
- Assessment of stress levels and reproductive condition in giant pandas: insights from hair, faecal and saliva samples.Conservation physiology · 2024Article
- The adrenal stress response is an essential host response against therapy-induced lethal immune activation.Science signaling · 2023Article
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Corrections and comments
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGlucocorticoid replacement is essential in patients with primary and secondary adrenal insufficiency, but many patients remain on higher than recommended dose regimens. There is no uniformly accepted method to monitor the dose in individual patients. We have compared cortisol concentrations in plasma, saliva and urine achieved following "physiological" and "stress" doses of hydrocortisone as potential methods for monitoring glucocorticoid replacement.
methodsCortisol profiles were measured in plasma, saliva and urine following "physiological" (20 mg oral) or "stress" (50 mg intravenous) doses of hydrocortisone in dexamethasone-suppressed healthy subjects (8 in each group), compared to endogenous cortisol levels (12 subjects). Total plasma cortisol was measured half-hourly, and salivary cortisol and urinary cortisol:creatinine ratio were measured hourly from time 0 (between 0830 and 0900) to 5 h. Endogenous plasma corticosteroid-binding globulin (CBG) levels were measured at time 0 and 5 h, and hourly from time 0 to 5 h following administration of oral or intravenous hydrocortisone. Plasma free cortisol was calculated using Coolens' equation.
resultsPlasma, salivary and urine cortisol at 2 h after oral hydrocortisone gave a good indication of peak cortisol concentrations, which were uniformly supraphysiological. Intravenous hydrocortisone administration achieved very high 30 minute cortisol concentrations. Total plasma cortisol correlated significantly with both saliva and urine cortisol after oral and intravenous hydrocortisone (P <0.0001, correlation coefficient between 0.61 and 0.94). There was no difference in CBG levels across the sampling period.
conclusionsAn oral dose of hydrocortisone 20 mg is supraphysiological for routine maintenance, while stress doses above 50 mg 6-hourly would rarely be necessary in managing acute illness. Salivary cortisol and urinary cortisol:creatinine ratio may provide useful alternatives to plasma cortisol measurements to monitor replacement doses in hypoadrenal patients.
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Registered trials
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