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Hypothalamic-Pituitary Axis01:37

Hypothalamic-Pituitary Axis

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The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
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Physiological Foundation of Stress01:24

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Stress triggers a coordinated physiological response involving the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis. This dual activation ensures that the body is prepared for both immediate and prolonged stress management. The process begins with the perception of a stressor. This initial phase activates the SNS, leading to the rapid release of adrenaline (epinephrine) from the adrenal glands.
Role of the Sympathetic Nervous System
Adrenaline triggers the...
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Hormones of the Adrenal Glands01:31

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Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and...
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Anatomy of the Adrenal Glands01:17

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The adrenal or supra-renal glands, situated above the kidneys and aligned with the twelfth rib, are paired pyramid-shaped structures crucial for the body's stress response. During stress, these glands secrete hormones vital for adaptive physiological reactions.
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
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Exercise Stress Test01:26

Exercise Stress Test

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Introduction
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
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Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers01:19

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers

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Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
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Related Experiment Video

Updated: Mar 16, 2026

Cortisol Measurement in Koala Phascolarctos cinereus Fur
09:11

Cortisol Measurement in Koala Phascolarctos cinereus Fur

Published on: August 23, 2019

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The free cortisol index.

T G Brien1, D J Hingerty1

  • 1Department of Pathology and Biochemistry, University College, Dublin.

Irish Journal of Medical Science
|August 13, 2016
PubMed
Summary
This summary is machine-generated.

The Free Cortisol Index (FCI) measures active cortisol. FCI values align with total cortisol in adrenal disease and show normal diurnal patterns, confirming its utility in assessing cortisol activity.

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Area of Science:

  • Endocrinology
  • Clinical Chemistry

Background:

  • Cortisol is a vital hormone.
  • Measuring free cortisol is important for assessing adrenal function.
  • Existing methods may have limitations.

Purpose of the Study:

  • To describe the development of the Free Cortisol Index (FCI).
  • To evaluate FCI as an indirect measure of free, metabolically active cortisol.
  • To compare FCI with total plasma cortisol in various conditions.

Main Methods:

  • Development of the Free Cortisol Index (FCI) assay.
  • Measurement of FCI in normal subjects, patients with non-adrenal disease, and patients with adrenal disease.
  • Assessment of diurnal variation and ACTH response of FCI.
  • Evaluation of FCI during pregnancy.

Main Results:

  • FCI values were similar to normal subjects in patients with non-adrenal disease.
  • FCI values correlated with total plasma cortisol in adrenal disease.
  • FCI demonstrated diurnal variation and ACTH responsiveness comparable to total plasma cortisol.
  • A significant rise in FCI was observed during pregnancy.

Conclusions:

  • The Free Cortisol Index is a reliable indirect measure of free cortisol.
  • FCI reflects cortisol activity in various physiological and pathological states.
  • FCI supports the understanding of hyperadrenocorticalism in pregnancy.