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Cortisone, a steroid hormone, is released by the adrenal gland during times of stress. It is the less active form of Cortisol. The β-hydroxysteroid dehydrogenases (11-HSD) are a pair of enzymes with the ability to convert cortisone to cortisol (11-HSD1) or deactivate cortisol by converting it to cortisone (11-HSD2). This glucocorticoid conversion event helps to initiate and regulate the anti-inflammatory response. Monitoring the ratio of cortisone:cortisol has applications in diabetes, obesity, metabolic syndrome, osteoporosis, and chronic fatigue syndrome in addition to adrenal diseases.

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