The zona fasciculata is the middle and widest layer of the adrenal cortex, with pale lipid-filled cells arranged in long straight columns. It is the main source of cortisol and is driven by ACTH from the pituitary.
| Location | Middle zone of the adrenal cortex, between the zona glomerulosa and zona reticularis |
|---|---|
| Secretes |
|
| Blood Supply | Cortical sinusoids from the subcapsular plexus |
Produces cortisol, which raises blood glucose, supports blood pressure, dampens inflammation and the immune response, and helps the body cope with stress.
This zone enlarges when ACTH is high (pituitary Cushing disease or ectopic ACTH) and shrinks when ACTH is suppressed by long-term steroid therapy. Cortisol excess causes central obesity, muscle wasting, easy bruising, osteoporosis and high blood sugar. Morning cortisol and the short Synacthen (ACTH stimulation) test assess its reserve.
A benign tumour of the fasciculata producing cortisol independently of ACTH, causing Cushing syndrome.
Low cortisol from adrenal or pituitary disease, causing fatigue, low blood sugar, low blood pressure and vulnerability to stress and illness.
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