Endocrine Abstracts

Most tests of the hypothalamo-pituitary-adrenal axis (HPA) use total cortisol measurements, although only free cortisol is biologically active. Total cortisol is 90% bound to cortisol binding globulin (CBG). CBG varies between individuals, is elevated by oestrogens and reduced by acute illness or surgery. Low CBG levels may result in individuals apparently failing such tests, and receiving inappropriate steroid replacement. We hypothesised that correcting total cortisol for CB...

The public tends to associate anabolic steroid abuse with elite athletes due to headline news in the newspapers, unaware that abuse also occurs in the local gyms. Regular users may be suspicious of some members of their local gym, or is it just envy? Studies have shown, however, that in some gyms over 50% of members may be taking steroids, and includes both men and women. Abusers tend to start taking steroids in their teens and some even as young as 12 years. Because many are ...

Patients on long term prednisolone therapy have suppression of their hypothalamo-pituitary-adrenal (HPA) axis. The short synacthen test (SST) is routinely employed to assess the viability of the HPA axis. However, as this test examines only adrenal function it may fail to identify those patients with secondary adrenal insufficiency. The overnight metyrapone test (OMT) may be a better test as it examines the whole HPA axis.We have compared the responses t...

Acute critical illness has an effect on normal physiology resulting in changes in the inter-relations of the endocrine system.Evidence suggests that these changes may be due to the pro-inflammatory cytokines (e.g. interleukin-6 (IL-6)), which are known to have a paradoxical effect on the hypothalamo-pituitary axis, stimulating the adrenal axis, whilst suppressing the remaining axes.Multiple myeloma (MM) patients have elevated IL-6 ...

Introduction: Proinflammatory cytokines, for example interleukin-6, have been found to stimulate the HPA axis at all levels. In animal models glucocorticoids have been shown to suppress cytokines. There may therefore be a balanced interaction during stress when both are raised. For this reason, we investigated patients undergoing routine coronary artery bypass grafting on day 3 post-operatively (CABG) to examine the mechanisms for failure of suppression of the HPA axis in resp...

Androgen deficiency may contribute to sexual dysfunction in hypoadrenalism but its role in normal female physiology is uncertain. The aim of this study was to determine the role of androgens in the aetiology of sexual dysfunction in healthy women. Twenty-nine premenopausal women with loss of libido (subjects) and 13 healthy females (controls) were studied. They were aged 18 to 45 years and in a stable heterosexual relationship. Venous blood was taken at 9 am in the follicular ...