Hypercortisolism as a potential concern for submariners.

Cortisol is a stress-response hormone that is important for survivability in fight or flight situations. Hypercortisolism is a state of chronically elevated cortisol levels due to a failure to return to, or maintain baseline levels. It is a condition that is often undiagnosed and can aid in the development of many physiological and psychological health problems. Some of the health ailments associated with hypercortisolism include metabolic syndrome, decreases in bone mineral density, and depression. Chronic stress and sleep deprivation are two common causes of hypercortisolism, both areas of concern within the submarine community. This review discusses the etiology of hypercortisolism and the likelihood of submariner vulnerability to the condition along with health problems associated with it. Lastly, strategies to prevent chronic elevation of cortisol and mitigate the potential health risks associated with the condition are covered.