s3emblance
Silver
- Joined
- Nov 1, 2025
- Posts
- 567
- Reputation
- 427
Cortisol is usually talked about as a cause of water retention by binding to mr receptor, and it have up to 1000x the affinity of aldosterone. That’s why taking a selective MR receptor antagonist is so cardioprotective.
That said, in normal physiology, 11β-HSD2 in the distal nephron converts cortisol to cortisone, which cannot bind to the mineralocorticoid receptor. That said, in people with some kind of hypercortisolism like Cushings or drugs that mimic cortisol like prednisone, the enzyme can become overwhelmed and cortisol can reach the distal nephron and bind to MR.
That said, in normal physiology, 11β-HSD2 in the distal nephron converts cortisol to cortisone, which cannot bind to the mineralocorticoid receptor. That said, in people with some kind of hypercortisolism like Cushings or drugs that mimic cortisol like prednisone, the enzyme can become overwhelmed and cortisol can reach the distal nephron and bind to MR.