Cortisol is made by the two adrenal glands located on both sides of the middle of the back above the kidneys. A hormone from the pituitary gland (ACTH) signals the adrenal gland to make small amounts of cortisol at various times during the day. Cortisol is also made during times of physical stress (such as during surgery, when suffering from an illness or injury, or when the body is dehydrated). The extra cortisol is necessary to help the body continue to create energy, control the blood sugar and allow for proper heart and lung function. The normal pituitary gland signals the adrenal gland during these periods of stress to make extra cortisol. Your child should have blood tests to see if he or she is able to make enough cortisol. If the level is found to be low, some children will need special tests (called cortisol stimulation tests) to find out if they make some cortisol or if they are not able to make any cortisol.

If your child is found to not make enough cortisol, he or she may need to take cortisol by mouth 1 or 2 times each day. Additional cortisol might also be necessary during times of physical stress. If your child has problems with cortisol, you should get additional information about caring for a child with this problem.

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