How to regulate cortisol with medications
There are several tretments in development to rectify dysregulation of cortisol. One is tissue-specific inhibitors of 11β-HSD1. Clinical trials have revealed that treatment with these inhibitors can reduce body weight, and blood pressure. However, these results have been inconsistent (Shah, et al., 2011; Feig, et al., 2011; Rosenstock, et al., 2010).
Another option is inhibition of cortisol production in the adrenal gland. This method is typically used to treat Cushing syndrome. Inhibitors of aldosterone synthase may also reduce cortisol since aldosterone synthase is similar to the enzymes that produce cortisol. These inhibitors would be particularly useful in conditions in which both aldosterone and cortisol are dysregulated.
The final option utilizes antagonists for the GRs and MRs. MR inhibitors are easily accessible, have low side effects and are currently used to improve survival following heart failure. Blocking this receptor has the additional benefit of blocking activation due to both cortisol and aldosterone. It has already been shown to stave off hypertension and abnormalities in the muscles of the heart in patients with metabolic syndrome.