On Sushmita Sen’s 44th birthday let’s revisit the rare and life-threatening condition she overcame

Commonly known as the stress hormone, cortisol increases the blood pressure and suppresses functions like digestion, growth, reproduction and our natural immune response. But is cortisol unequivocally bad for us? What would happen if our body stopped making this stress hormone one day?

Former Miss Universe Sushmita Sen knows the answer to these questions by experience. On her 44th birthday today, we revisit her tryst with a cortisol-free existence until a couple of years ago.

Representational image. Image source: Getty Images.

Case study

Sen, now a Hindi and Bengali film actor, is widely considered to be the epitome of elegance and beauty. Her love for good health and fitness is also well-known - she practices a combination of exercises including aerial yoga and combination martial arts.

However, Sen has not always had the best luck when it comes to health. In 2014, while shooting a Bengali film, she fainted and was rushed to the hospital. After an array of tests, doctors discovered that her adrenal glands had stopped making cortisol and she had gone into an adrenal crisis. This meant that she had to take steroids every eight hours to survive - for as long as she lived.

Two years later, Sen’s luck changed. Her glands miraculously started working and she was able to go off the steroids.

Adrenal glands

The adrenal glands are triangular-shaped masses on top of both the kidneys. The outer region of the gland is known as the cortex and the inner part is called the medulla. The adrenal glands release two important hormones: cortisol and aldosterone. They also help in the production of sex hormones (androgens and estrogen).

1. Cortisol: it is the most powerful glucocorticoid as it controls glucose production in the liver and protein breakdown in the muscles. It helps control the body’s use of fats, proteins and carbohydrates to provide energy, suppress inflammation, regulate blood pressure, and increase blood sugar.

Our body needs cortisol to function normally during stressful periods. However, if we’re constantly stressed, the body starts to have a bad reaction to cortisol - this is where it gets its poor public image from.

2. Aldosterone: the most powerful mineralocorticoid in the body, aldosterone controls blood pressure by controlling the amount of fluid that the body holds on to. The more fluid the body holds, the higher the blood pressure may become. 

Aldosterone also helps regulate the blood pH by controlling the levels of electrolytes (sodium and potassium) in the blood.

3. Sex hormones: Androgens and estrogens are sex-hormones. Androgens control the male reproductive system while estrogens control the female reproductive system.

These hormones control the growth of the reproductive organs (testicles and ovaries) and male-female characteristics. 

Adrenal crisis

Adrenal crisis, also called acute adrenal insufficiency, is a life-threatening condition in which the adrenal gland stops producing cortisol. Early identification and prompt management can save the patient's life and impact survival.

An adrenal crisis may happen when someone who doesn’t have properly functioning adrenal glands experiences a highly stressful situation. 

An injury to the pituitary gland (located in the brain) can also cause secondary adrenal insufficiency.

People suffering from Addison’s disease — marked by dysfunctioning of the adrenal cortex — or those who have had surgery on their adrenal glands are more susceptible to adrenal crisis.

Another reason for an adrenal crisis can be severe dehydration and trauma to the adrenal gland.

Signs and treatment for an adrenal crisis

Acute adrenal insufficiency is a severe disease that is difficult to diagnose. Patients may experience abdominal pain, low blood pressure that is unresponsive to vasopressor agents (that help in increasing blood pressure), high heart rate, rashes or pigmentation on the skin, clouding of vision and loss of consciousness. 

Emergency steroid therapy can save the person life, but for treatment, it's important to find the underlying cause for adrenal crisis.

In Sen’s case, neither the cause nor the reason for her recovery became clear. On her birthday today, we wish her streak of good health continues.

Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health. For more information, please read our article on the Cortisol Test.