There are many types of steroids. “Steroid” is a name for a group of chemical compounds which all exhibit a very similar structure. They are used in sports pharmacology (illegal anabolic steroids) and legitimately in medicine (hydrocortisone, cortisone, progesterone, etc.).
Below we’ll try to answer your questions, “What is cortisone?” and, “What are its functions?” You will also find the answer to the question: “What is cortisone used for?”
What is Cortisone — Description of the Hormone
Cortisone (17α,21-dihydroxypregn-4-ene-3,11,20-trione or 17α-Hydroxy-11-dehydrocorticosterone) is a hormone that belongs to the group called corticosteroids. Chemically, this hormone consists of colourless crystals, liquefying at 215° C, which are poorly soluble in organic solvents. What produces cortisone? This hormone is produced by the adrenal cortex that is located along the perimeter of the adrenal gland.
However, some scientists consider it not a hormone of the adrenal cortex, but a product of hydrocortisone transformation. It can also be produced by synthetic means, and special medical drugs are manufactured on this basis. Cortisone is also used in veterinary practice. In industry, this preparation is derived from steroids of plant and animal origin through complex chemical and microbiological transformations.
Cortisone has an anti-allergic and anti-inflammatory effect, inhibiting the processes associated with the development of an inflammatory reaction.
Cortisone History – How Was the Substance Discovered?
As reported by J Glyn (1998), it all started in 1929 when a scientist called Hench observed a noticeable remission in an intractable rheumatoid patient who had an intercurrent jaundice attack. Unlike previous observers (including Garrod), the doctor refused to accept this observation as fortuitous. He judged that early rheumatoid arthritis was not relentlessly progressive, it could be strikingly reversionary. Then he observed several remissions whilst the diseased persons remained jaundiced. He performed really revolutionary investigations related to iatrogenic mimicking of icterus. Hench thereby created a liftoff for cortisone developments.
By the end of the 1930s, it was astutely concluded that adrenals produced both hormones regulating the saline (mineral) balance, the so-called mineralocorticoids, and hormones that controlled the metabolism of sugars (carbohydrates), the so-called glucocorticoids. The adrenal cortex produced a mixture of different compounds, studied by Edward Kendall (United States of America) and an Ukrainian refugee, Tadeusz Reichstein (Basel, Switzerland). The scientists called the substances compound A, B, C, etc. Kendall discovered that compounds A, B, E, and F returned to adrenal-free animals the ability to resist particularly stressful situations.
During the Second World War, the US secret services discovered that some substances studied by Kendall, specifically the compound E, had been administered to the Luftwaffe pilots, who felt at ease even at a height of over 13,000 meters. The investigation had to be accelerated so that the compound E could become available to US pilots as well.
At a conference held in early 1941, Kendall and Hench made a formal commitment to test the compound in patients with rheumatoid arthritis as soon as the substance became available. In 1944, Lewis Sarett, a chemist of Merck, succeeded in synthesizing compound E, starting from another molecule, deoxycholic acid (cholanoic acid, Kybella, Belkyra), obtained from the bile of slaughtered cattle. So, Hench asked the pharmaceutical company to experiment with the new substance on a 29-year-old woman with a severe form of rheumatoid arthritis. The answer was affirmative, and on September 28, 1948, the first historical injection of the drug was made. The response was immediate: after just three days the patient felt improvement and continued to get better in the following days. The substance was then also tested in patients with Addison’s disease (hypocortisolism) and the effects were excellent. The news went around the world, but there was confusion, as many people thought that compound E and vitamin E were the same thing. In order to avoid any misunderstanding, Kendall and Hench decided to call the substance, cortisone. As cortisone freed the painful joints of the patients from inflammation, the discovery of cortisone was deemed to be of a similar magnitude to that of penicillin (PCN). Cortisone was then produced in different ways, ranging from Mexican sweet potatoes to female hormones. In 1950, Kendall, Hench and Reichstein won the Nobel Prize in Physiology. (You might also be interested in a general history of steroids.)
What Does Cortisone Do — Its Functions in the Body
What does cortisone do? This hormone regulates the level of glucose in the blood. It acts as a mobilization agent, leading to an increase in the level of sugar and fatty acids in the blood. This hormone raises the level of glucose in the bloodstream of the brain, preparing the organism for a fight or flight response as a result of stress.
Cortisone is the most active hormone along with other hormonal substances. Cortisone plays an important role in the immune system that protects the body from infections and injuries (however, with an increased level of hormone, the activity of immunity is suppressed).
There is some level of cortisone (the permissible upper value), exceeding which, for example, in the process of treatment, a situation can arise when resistance to infection decreases. Note that such a situation is impossible in a natural way, and only occurs with the use of special medicines.
What is Cortisone Used For?
Cortisone is available as steroid pills for oral use and in other forms. The drug is slightly soluble in water but can be more effectively diluted with ethanol. It is used to treat orthopaedic conditions and sometimes for psoriasis, breathing disorders, and severe allergic reactions. What does it do in the body when used medically? The drug has anti-inflammatory, immunoinhibitory, desensitizing and anti-allergic properties. The fight against “incendiary” processes is caused by the inhibition of phospholipase A2 (PLA2s) so that the secretion of prostaglandins is greatly inhibited. After administration, the migration of macrophages and lymphocytes to the inflammatory focus stops, so the inflammatory manifestations weaken and do not make themselves felt for a long time afterwards.
However, the activity of this drug is associated with some side effects of steroids. For example, gluconeogenesis rises as a result of taking the medicine, the amount of glucose in the blood increases, a powerful catabolic background appears, which causes the proteins in the body to decompose. The level of harmful triglycerides rises, which promotes the formation of cholesterol plaques on the vessel walls. After its administration, the production of adrenocorticotropic hormone (also adrenocorticotropin, corticotropin) decreases in the pituitary gland, according to the feedback principle, which in the case of prolonged use can lead to atrophy of adrenal cortex functions. Also, the medication can lead to weight gain for no apparent reason (read more here on the effects of cortisol hormone on the body including weight gain).
Because of countless side effects, in modern medical practice, cortisone is commonly replaced by more effective synthetic corticosteroids.
Different Forms of Cortisone Drugs
- What is an injection? The drug in the form of an injection reduces the inflammation in and around the site of the injection, decreasing painful sensations & thereby improving joint movement. If cortisone shots are used, they should be followed by appropriate rest time & rehabilitation to provide the maximum results.
- What is a shot? The shots are the same as injections; injection is a more formal name than shot.
- What is a pill? Oral cortisone acetate tabs may be used for endocrine disorders, rheumatic disorders, collagen diseases, ophthalmic diseases, respiratory diseases, and some other illnesses.
- What is a cream? You are unlikely to find genuine topical steroid cream containing cortisone on the market. It is believed that this medication is inactive topically. Many people refer to hydrocortisone cream by the name, cortisone cream.