What is a hormone?

A hormone is a chemical that is made by specialist cells, usually within an endocrine gland, and it
is released into the bloodstream to send a message to another part of the body. It is often referred
to as a chemical messenger. Hormones are found in all multicellular organisms and their role is to
provide an internal communication system between cells located in distant parts of the body.
In the human body, hormones are used for two types of communication. The first is for
communication between two endocrine glands, where one gland releases a hormone which
stimulates another target gland to change the levels of hormones that it is releasing. The second is
between an endocrine gland and a target organ, for example when the pancreas releases insulin
which causes muscle and fat cells to take up glucose from the bloodstream.
Since hormones are released into the bloodstream and can therefore be carried around the entire
body, they can perform both of these actions on many different targets. The complex interplay
between the glands, hormones and other target organs is referred to as the endocrine system.
Hormones affect many physiological activities including growth, metabolism, appetite, puberty and
fertility.

Thyroxine
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Thyroxine is the main hormone secreted into the bloodstream by the thyroid gland. It plays vital
roles in digestion, heart and muscle function, brain development and maintenance of bones.
Alternative names for thyroxine
T4; tetraiodothyronine; thyroxin.
What is thyroxine?
Thyroxine is the main hormone secreted into the bloodstream by the thyroid gland. It is the
inactive form and most of it is converted to an active form called triiodothyronine by organs such
as the liver andkidneys. Thyroid hormones play vital roles in regulating the bodys metabolic rate,
heart and digestive functions, muscle control, brain development and maintenance of bones.
How is thyroxine controlled?
The production and release of thyroid hormones, thyroxine and triiodothyronine, is controlled by a
feedback loop system which involves the hypothalamus in the brain and the pituitary and thyroid
glands. The hypothalamus secretes thyrotropin-releasing hormone which, in turn, stimulates
thepituitary gland to produce thyroid stimulating hormone. This hormone stimulates the production
of the thyroid hormones, thyroxine and triiodothyronine, by the thyroid gland.
This hormone production system is regulated by a negative feedback loop so that when the levels
of the thyroid hormones, thyroxine and triiodothyronine increase, they prevent the release of

both thyrotropin-releasing hormone and thyroid stimulating hormone. This system allows the body
to maintain a constant level of thyroid hormones in the body.
What happens if I have too much thyroxine?
The release of too much thyroxine in the bloodstream is known as thyrotoxicosis. This may be
caused by overactivity of the thyroid gland (hyperthyroidism), as in Graves' disease, inflammation
of the thyroid or a benign tumour. Thyrotoxicosis can be recognised by a goitre which is a swelling
of the neck due to enlargement of the thyroid gland. Other symptoms of thyrotoxicosis include
intolerance to heat, weight loss, increased appetite, increased bowel movements, irregular
menstrual cycle, rapid or irregular heartbeat, palpitations, tiredness, irritability, tremor, hair loss
and retraction of the eyelids resulting in a staring appearance.
What happens if I have too little thyroxine?
Too little production of thyroxine by the thyroid gland is known as hypothyroidism. It may be
caused by autoimmune diseases, poor iodine intake or brought on by the use of certain
drugs. Sometimes, the cause is unknown. Thyroid hormones are essential for physical and mental
development so hypothyroidism during development or before birth and during childhood causes
mental impairment and reduced physical growth.
Hypothyroidism in adults causes a decreased metabolic rate. This results in symptoms which
include fatigue, intolerance of cold temperatures, low heart rate, weight gain, reduced appetite,
poor memory,depression, stiffness of the muscles and infertility.
Follicle stimulating hormone
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Follicle stimulating hormone is produced by the pituitary gland. It regulates the functions of both
the ovaries and testes. Lack or insufficiency of it can cause infertility or subfertility both in men
and women.
Alternative names for follicle stimulating hormone
FSH; follitropin (pharmaceutical preparations).
What is follicle stimulating hormone?
Follicle stimulating hormone is one of the gonadotrophic hormones, the other being luteinising
hormone. Both are released by the pituitary gland into the bloodstream. Follicle stimulating
hormone is one of the hormones essential to pubertal development and the function of
womens ovaries and mens testes. In women, this hormone stimulates the growth of ovarian
follicles in the ovary before the release of an egg from one follicle at ovulation. It also
increases oestradiol production. In men, follicle stimulating hormone acts on the Sertoli cells of the
testes to stimulate sperm production (spermatogenesis).
How is follicle stimulating hormone controlled?
The production and release of follicle stimulating hormone is regulated by the levels of a number
of circulating hormones released by the ovaries and testes. This system is called the hypothalamic-

pituitary-gonadal axis. Gonadotrophin-releasing hormone is released from the hypothalamus and

binds to receptors in the anterior pituitary gland to stimulate both the synthesis and release of
follicle stimulating hormone and luteinising hormone. The released follicle stimulating hormone is
carried in the bloodstream where it binds to receptors in the testes and ovaries. Using this
mechanism follicle stimulating hormone, along with luteinising hormone, can control the functions
of the testes and ovaries.
In women, when hormone levels fall towards the end of the menstrual cycle, this is sensed by
nerve cells in the hypothalamus. These cells produce more gonadotrophin-releasing hormone which
in turn stimulates the pituitary gland to produce more follicle stimulating hormone and luteinising
hormone and release these into the bloodstream. The rise in follicle stimulating hormone
stimulates the growth of the follicle in the ovary. With this growth, the cells of the follicles
produce increasing amount of oestradiol and inhibin. In turn, the production of these hormones is
sensed by the hypothalamus and pituitary gland and less gonadotrophin-releasing hormone and
follicle stimulating hormone will be released. However as the follicle matures, and more and
more oestrogen is produced from the follicles, it simulates a surge in luteinising hormone and
follicle stimulating hormone which stimulates the release of an egg from a mature follicle
ovulation.
Thus, during each menstrual cycle there is a rise in follicle stimulating hormone secretion in the
first half of the cycle that stimulates follicular growth in the ovary. After ovulation the ruptured
follicle forms acorpus luteum that produces high levels of progesterone. This inhibits the release of
follicle stimulating hormone. Towards the end of the cycle the corpus luteum breaks down,
progesterone production declines and the next menstrual cycle begins when follicle stimulating
hormone starts to rise again.
In men, the production of follicle stimulating hormone is regulated by the circulating levels
oftestosterone and inhibin, both produced by the testes. Follicle stimulating hormone regulates
testosterone levels and when these rise they are sensed by nerve cells in the hypothalamus so that
gonadotrophin-releasing hormone secretion and consequently follicle stimulating hormone is
decreased. The opposite occurs when testosterone levels decrease. This is known as a negative
feedback control so that the production of testosterone remains steady. The production of inhibin
is also controlled in a similar way but this is sensed by cells in the anterior pituitary gland rather
than the hypothalamus.
What happens if I have too much follicle stimulating hormone?
Most often, raised levels of follicle stimulating hormone are a sign of malfunction in the ovary
or testis. If the gonads fail to create enough oestrogen, testosterone and/or inhibin, the correct
feedback control of follicle stimulating hormone production from the pituitary gland is lost and the
levels of both follicle stimulating hormone and luteinising hormone will rise. This condition is
called hypergonadotrophic-hypogonadism, and is associated with primary ovarian failure or
testicular failure. This is seen in conditions such as Kallmanns syndrome in men and Turner
syndrome in women.

In women, follicle stimulating hormone levels also start to rise naturally in women around the
menopausal period, reflecting a reduction in function of the ovaries and decline of oestrogen and
progesterone production.
There are very rare pituitary conditions that can raise the levels of follicle stimulating hormone in
the bloodstream. This overwhelms the normal negative feedback loop and can cause ovarian
hyperstimulation syndrome in women. Symptoms of this include enlarging of the ovaries and a
potentially dangerous accumulation of fluid in the abdomen (triggered by the rise in ovarian steroid
output), which leads to pain in the pelvic area.
What happens if I have too little follicle stimulating hormone?
In women, a lack of follicle stimulating hormone leads to incomplete development at puberty and
poor ovarian function (primary ovarian failure). In this situation ovarian follicles do not grow
properly and do not release an egg, thus leading to infertility. Since levels of follicle stimulating
hormone in the bloodstream are low, this condition is called hypogonadotrophic-hypogonadism.
Sufficient follicle stimulating hormone action is also needed for proper sperm production. In the
case of complete absence of follicle stimulating hormone in men, lack of puberty and infertility
due to lack of sperm (azoospermia) can occur. Partial follicle stimulating hormone deficiency in
men can cause delayed puberty and limited sperm production (oligozoospermia), but fathering a
child may still be possible. If the loss of follicle stimulating hormone occurs after puberty, there
will be a similar loss of fertility.
Luteinising hormone
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Luteinising hormone is produced by the pituitary gland and is one of the main hormones that
control the reproductive system.
Alternative names for luteinising hormone
Interstitial cell stimulating hormone; luteinizing hormone; lutropin; LH.
What is luteinising hormone?
Luteinising hormone, like follicle stimulating hormone, is a gonadotrophic hormone produced and
released by cells in the anterior pituitary gland. It is crucial in regulating the function of
the testes in men and ovaries in women.
In men, luteinising hormone stimulates Leydig cells in the testes to produce testosterone, which
acts locally to support sperm production. Testosterone also exerts effects all around the body to
generate male characteristics such as increased muscle mass, enlargement of the larynx to
generate a deep voice and the growth of facial and body hair.
In women, luteinising hormone carries out different roles in the two halves of the menstrual
cycle. In weeks one to two of the cycle, luteinising hormone is required to stimulate the ovarian
follicles in theovary to produce the female sex hormone, oestradiol. Around day 14 of the cycle, a

surge in luteinising hormone levels causes the ovarian follicle to tear and release a mature oocyte
(egg) from the ovary, a process called ovulation. For the remainder of the cycle (weeks three to
four), the remnants of the ovarian follicle form a corpus luteum. Luteinising hormone stimulates
the corpus luteum to produceprogesterone which is required to support the early stages of
pregnancy, if fertilisation occurs.
How is luteinising hormone controlled?
The secretion of luteinising hormone from the anterior pituitary gland is regulated through a
system called the hypothalamic-pituitary-gonadal axis. Gonadotrophin-releasing hormone is
released from thehypothalamus and binds to receptors in the anterior pituitary gland to stimulate
both the synthesis and release of luteinising hormone (and follicle stimulating hormone). The
released luteinising hormone is carried in the bloodstream where it binds to receptors in the testes
and ovaries to regulate their hormone secretions and the production of sperm or eggs.
The release of hormones from the gonads can suppress the secretion of gonadotrophin-releasing
hormone and, in turn, luteinising hormone from the anterior pituitary gland. When levels of
hormones from the gonads fall the reverse happens and gonadtrophin releasing hormone and hence
luteinising hormone rise. This is known as negative feedback.
In men, testosterone exerts this negative feedback and in women oestrogen and progesterone exert
the same effect except at the midpoint in the menstrual cycle. At this point, high oestrogen
secretions from the ovary stimulate a surge of luteinising hormone from the pituitary gland, which
triggers ovulation.
The fine tuning of luteinising hormone release is vital to maintaining fertility. Because of this,
compounds designed to mimic the actions of gonadotrophin-releasing hormone, luteinising hormone
and follicle stimulating hormone are used to stimulate gonadal function in assisted conception
techniques such as in vitro fertilisation (IVF). Measuring the levels of luteinising hormone present in
urine can be used to predict the timing of the luteinising hormone surge in women, and hence
ovulation. This is one of the methods employed in ovulation prediction kits used by couples wishing
to conceive.
What happens if I have too much luteinising hormone?
Too much luteinising hormone can be an indication of infertility. Since the secretion of luteinising
hormone is tightly controlled by the hypothalamic-pituitary-gonadal axis, high levels of luteinising
hormone in the bloodstream can indicate decreased sex steroid production from the testes or
ovaries (eg, as in premature ovarian failure).
Polycystic ovary syndrome is a common condition in women associated with high levels of
luteinising hormone and reduced fertility. In this condition, an imbalance between luteinising
hormone and follicle stimulating hormone can stimulate inappropriate production of testosterone.
Genetic conditions, such as Klinefelters syndrome and Turner syndrome, can also result in high
luteinising hormone levels. Klinefelters syndrome is a male-only disorder and results from carrying
an extra X chromosome (so that men have XXY, rather than XY chromosomes). As a result of this,

the testes are small and do not secrete adequate levels of testosterone to support sperm
production. Turner syndrome is a female-only disorder caused by a partial or full deletion of an X
chromosome (so that women have XO, rather than XX). In affected patients, ovarian function is
impaired and therefore luteinising hormone production increases to stimulate ovarian function.
What happens if I have too little luteinising hormone?
Too little luteinising hormone will also result in infertility in both men and women, as a critical
level of luteinising hormone is required to support testicular or ovarian function.
In men, an example of a condition where low levels of luteinising hormone are found is Kallmanns
syndrome, which is associated with a deficiency in gonadotrophin-releasing hormone secretion from
the hypothalamus.
In women, a lack of luteinising hormone means that ovulation does not occur. An example of a
condition which can be caused by too little luteinising hormone is amenorrhoea.

Adrenaline
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Adrenaline is a hormone released from the adrenal glands and its major action, together with
noradrenaline, is to prepare the body for fight or flight.
Image of an eye showing a dilated or enlarged pupil - one of the effects of adrenaline released
during a "fight or flight" response.
Alternative names for adrenaline
Epinephrine.
What is adrenaline?
Adrenaline and noradrenline are two separate but related hormones and neurotransmitters. They
are produced in the medulla of the adrenal glands and in some neurons of the central nervous
system. They are released into the bloodstream and serve as chemical mediators, and also convey
the nerve impulses to various organs. Adrenaline has many different actions depending on the type
of cells it is acting upon. However, the overall effect of adrenaline is to prepare the body for the
fight or flight response in times of stress, ie, for vigorous and/or sudden action. Key actions of
adrenaline include increasing the heart rate, increasing blood pressure, expanding the air passages
of the lungs, enlarging the pupil in the eye (see figure), redistributing blood to the muscles and
altering the bodys metabolism, so as to maximise blood glucose levels (primarily for the brain). A
closely related hormone, noradrenaline, is released mainly from the nerve endings of the
sympathetic nervous system (as well as in relatively small amounts from the adrenal
medulla). There is a continuous low level of activity of the sympathetic nervous system resulting in
release of noradrenaline into the circulation, but adrenaline release is only increased at times of
acute stress.
Adrenaline, like noradrenaline, is also used as a transmitter by some nerve cells to communicate
with other cells (a neurotransmitter). Very little adrenaline is used in this way.

How is adrenaline controlled?

Adrenaline is mainly released in response to stressful events to prepare the body for the fight or
flight response. These events lead to the activation of nerves connected to the adrenal glands,
which trigger the secretion of adrenaline and thus increase the levels of adrenaline in the
blood. This process happens relatively quickly, within 2 to 3 minutes of the stressful event being
encountered. When the stressful situation ends, the nerve impulses to the adrenal glands are
lowered, meaning that the adrenal glands stop producing adrenaline.
Stress also stimulates the release of adrenocorticotropic hormone from the pituitary gland, which
promotes the production of the steroid hormone cortisol from the cortex of the adrenal glands.
This steroid hormone is more important in altering the bodys metabolism (ie, raising plasma
glucose) under conditions of longer-term, ongoing (chronic), rather than acute, stress.
What happens if I have too much adrenaline?
Overproduction of adrenaline is rare. Too much adrenaline can be caused by a variety of things,
including a rare tumour of the adrenal medulla (a phaeochromocytoma). Symptoms may include
rapid heart beat, high blood pressure, anxiety, weight loss, excessive sweating and palpitations.
What happens if I have too little adrenaline?
Suffering from too little adrenaline is very unusual. Among other things, it would result in an
inability to prepare the body for action in response to a stressful or physically demanding situation.
Aldosterone
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Aldosterone is a steroid hormone. Its main role is to regulate salt and water in the body, thus
having an effect on blood pressure.
Alternative names for aldosterone
Electrocortin, 11,21-dihydroxy-3,20-dioxopregn-4-en-18-al.
What is aldosterone?
Aldosterone is a hormone produced in the outer section (cortex) of the adrenal glands, which sit
above the kidneys. It plays a central role in the regulation of blood pressure mainly by acting on
organs such as the kidney and the colon to increase the amount of salt (sodium) reabsorbed into
the bloodstream and the amount of another salt called potassium removed in the urine.
Aldosterone also causes water to be reabsorbed along with sodium; this increases blood volume and
therefore blood pressure. Thus, aldosterone indirectly regulates blood levels of electrolytes
(sodium, potassium and hydrogen) and helps to maintain the blood pH.
How is aldosterone controlled?
Aldosterone is part of a group of linked hormones, which form the renin-angiotensin-aldosterone
system. Activation of this system occurs when there is decrease in blood flow to the kidneys
following loss of blood volume or a drop in blood pressure (eg due to a haemorrhage) or decrease in
plasma sodium concentration. Renin is an enzyme that leads to a series of chemical reactions

resulting in the production of angiotensin II, which in turn stimulate aldosterone

release. Aldosterone causes an increase in salt and water reabsorption into the bloodstream from
the kidney thereby increasing the blood volume, restoring salt levels and blood pressure. Once salt
levels and blood pressure are corrected and the body becomes rehydrated, the level of renin in the
bloodstream falls and therefore the amount of aldosterone in the blood also falls, meaning more
water is excreted in the urine. The renin-angiotensin-aldosterone system is an example of a
negative feedback system.
The other two main regulators of aldosterone secretion are increase in the plasma potassium
concentration and adrenocorticotropic hormone (ACTH) secreted by the anterior pituitary, which
can act via either positive or negative feedback mechanisms, depending on the extent of changes
in the levels of these two regulators.
What happens if I have too much aldosterone?
The most common cause of high aldosterone levels is excess production frequently from a
small benignadrenal tumour (hyperaldosteronism). The symptoms include high blood pressure, low
blood levels of potassium, an abnormal increase in blood volume and sometimes the blood becomes
alkaline indirectly as a consequence of aldosterones action in promoting acid secretion.
What happens if I have too little aldosterone?
There are two conditions where there are low aldosterone levels.
In Addison's disease, there is a general loss of adrenal function resulting in low blood pressure,
lethargy and an increase in potassium levels in the blood (see the article on Addison's disease for
further information).
An enzyme called aldosterone synthase is responsible for the last steps in the production of
aldosterone. Rare mutations in the gene that codes for aldosterone synthase can result in low or
absent production of aldosterone (aldosterone synthase deficiency). With this rare genetic
condition, the symptoms are similar to that of Addison's disease but milder.

Anti-diuretic hormone
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Anti-diuretic hormone acts to maintain blood pressure, blood volume and tissue water content by
controlling the amount of water and hence the concentration of urine excreted by the kidney.
Alternative names for anti-diuretic hormone
Vasopressin; arginine vasopressin; AVP; ADH.
What is anti-diuretic hormone?
Anti-diuretic hormone is made by special nerve cells found in an area at the base of the brain
known as the hypothalamus. The nerve cells transport the hormone down their nerve fibres (axons)
to thepituitary gland where the hormone is released into the blood stream. Anti-diuretic hormone

helps to control blood pressure by acting on the kidneys and the blood vessels. Its most important
role is to conserve the fluid volume of your body by reducing the amount of water passed out in the
urine. It does this by allowing water in the urine to be taken back into the body in a specific area
of the kidney. Thus, more water returns to the bloodstream, urine concentration rises and water
loss is reduced. Higher concentrations of anti-diuretic hormone cause blood vessels to constrict
(become narrower) and this increases blood pressure. A deficiency of body fluid (dehydration) can
only be finally restored by increasing water intake.
How is anti-diuretic hormone controlled?
The release of anti-diuretic hormone from the pituitary gland into the bloodstream is controlled by
a number of factors. A decrease in blood volume or low blood pressure, which occurs during
dehydration or a haemorrhage, is detected by sensors (receptors) in the heart and large blood
vessels. These stimulate anti-diuretic hormone release. Secretion of anti-diuretic hormone also
occurs if the concentration of salts in the bloodstream increases, for example as a result of not
drinking enough water on a hot day. This is detected by special nerve cells in the hypothalamus
which simulate anti-diuretic hormone release from the pituitary. If the concentration of salts
reaches abnormally low levels, this condition is called hyponatraemia. Anti-diuretic hormone is also
released by thirst, nausea, vomiting and pain, and acts to keep up the volume of fluid in the
bloodstream at times of stress or injury. Alcohol prevents anti-diuretic hormone release which
causes an increase in urine production and dehydration..
What happens if I have too much anti-diuretic hormone?
High levels of anti-diuretic hormone cause the kidneys to retain water in the body. There is a
condition called Syndrome of Inappropriate Anti-Diuretic Hormone secretion (SIADH; a type of
hyponatraemia) where excess anti-diuretic hormone is released when it is not needed (see the
article on hyponatraemia for more information). With this condition, excessive water retention
dilutes the blood, giving a characteristically low salt concentration. Excessive levels of antidiuretic hormone might be caused by drug side-effects and diseases of the lungs, chest wall,
hypothalamus or pituitary. Some tumours (particularly lung cancer), can produce anti-diuretic
hormone.
What happens if I have too little anti-diuretic hormone?
Low levels of anti-diuretic hormone will cause the kidneys to excrete too much water. Urine
volume will increase leading to dehydration and a fall in blood pressure. Low levels of anti-diuretic
hormone may indicate damage to the hypothalamus or pituitary gland, or primary polydipsia
(compulsive or excessive water drinking). In primary polydipsia, the low level of anti-diuretic
hormone represents an effort by the body to get rid of excess water. Diabetes insipidus is a
condition where you either make too little anti-diuretic hormone (usually due to a tumour, trauma
or inflammation of the pituitary or hypothalamus), or where the kidneys are insensitive to
it. Diabetes insipidus is associated with increased thirst and urine production.
Oxytocin
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Oxytocin is a hormone that acts on organs in the body (including the breast and uterus) and as a
chemical messenger in the brain controlling key aspects of the reproductive system including
childbirth and lactation, and aspects of human behaviour.
Alternative names for oxytocin
Alpha-hypophamine; manufactured versions carbetocin, syntocinon and pitocin.
What is oxytocin?
Oxytocin is produced in the hypothalamus and is secreted into the bloodstream by the
posterior pituitary gland. Secretion depends on electrical activity of neurons in the hypothalamus
it is released into the blood when these cells are excited.
The two main actions of oxytocin in the body are contraction of the womb (uterus) during
childbirth and lactation. Oxytocin stimulates the uterine muscles to contract and also increases
production ofprostaglandins which increase the contractions further. Manufactured oxytocin is
sometimes given to induce labour if it has not started naturally or it can be used to strengthen
contractions to aid childbirth. In addition, manufactured oxytocin is often given to speed up
delivery of the placenta and reduce the risk of heavy bleeding by contracting the uterus. During
breastfeeding, oxytocin promotes the movement of milk into the breast, allowing it to be excreted
by the nipple. Oxytocin is also present in men, playing a role in sperm movement and production
of testosterone by the testes.
More recently, oxytocin has been suggested to be an important player in social behaviour.
In the brain, oxytocin acts as a chemical messenger and has been shown to be important in human
behaviours including sexual arousal, recognition, trust, anxiety and mother-infant bonding. As a
result, oxytocin has been called the love hormone or cuddle chemical.
Many research projects are undertaken, looking at the role of oxytocin in addiction, brain
injury,anorexia and stress amongst other topics.
How is oxytocin controlled?
Oxytocin is controlled by a positive feedback mechanism where release of the hormone causes an
action which stimulates more of its own release. When contraction of the uterus starts, for
example, oxytocin is released which stimulates more contractions and more oxytocin to be
released. In this way, contractions increase in intensity and frequency.
There is also a positive feedback involved in the milk-ejection reflex. When a baby sucks at the
breast of its mother, the stimulation leads to oxytocin secretion into the blood which then causes
milk to be let down into the breast. Oxytocin is also released into the brain to help stimulate
further oxytocin secretion. These processes are self-limiting; production of the hormone is stopped
after the baby is delivered or when the baby stops feeding.
What happens if I have too much oxytocin?

At present, the implications of having too much oxytocin are not clear. High levels have been linked
tobenign prostatic hyperplasia, a condition which affects the prostate in more than half of men
over the age of 50. This may cause difficulty in passing urine.
It may be possible to treat this condition by manipulating oxytocin levels; however, more research
is needed before any possible treatments are available.
What happens if I have too little oxytocin?
Similarly, it is not fully understood at present if there are any implications of having too little
oxytocin in the body. A lack of oxytocin in a nursing mother would prevent the milk-ejection reflex
and prevent breastfeeding.
Low oxytocin levels have been linked to autism and autistic spectrum disorders (eg, Asperger
syndrome) a key element of these disorders being poor social functioning. Some scientists believe
oxytocin could be used to treat these disorders. In addition, low oxytocin has been linked to
depressive symptoms and it has been proposed as a treatment for depressive disorders. However,
there is not enough evidence at present to support its use for any of these conditions.
Androstenedione
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Androstenedione is a steroid hormone that has weak, androgenic actions on the body itself.
However, it mainly acts as a stepping stone in the manufacture of testosterone and oestrogen
within the body.
Alternative names for androstenedione
Andro; andros; 4-Androstenedione. 17 ketotestosterone; 4-androsten-3,17-dione.
What is androstenedione?
Androstenedione is described as a pro-hormone because it has few effects itself. Instead, it is
important because of the ability of different parts of the body to convert it into the
hormones,testosterone and oestrogen, which exert many effects on the body.
In females, the outer part of the adrenal glands (known as the cortex) and the ovaries release
androstenedione into the bloodstream where it is converted to provide around half of all
testosterone and almost all of the bodys oestrone, a form of oestrogen. Although
the testes produce large amounts of androstenedione in males, they secrete little of this into the
blood and, instead, rapidly convert it into testosterone within the testes. The adrenal glands also
produce androstenedione in men, but this contribution is swamped by the testes overwhelming
production of the other androgenic hormone, testosterone.
How is androstenedione controlled?
Due to its secretion from a number of different glands and its often rapid conversion to other
hormones, the control of androstenedione within the body is very complex. However, two key

parts of the brain (the hypothalamus and pituitary gland) are known to be important in the control
of androstenedione secretion from the testes, ovaries and adrenal cortex. The release of
androstenedione by the adrenal cortex is thought to be related to the pituitary glands secretion of
a specialised hormone,adrenocorticotropic hormone. Precisely how adrenocorticotropic hormone
and other hormones control the adrenal glands production of androstenedione is, however,
unclear. The testes and ovaries are stimulated to release androstenedione by luteinising
hormone and follicle stimulating hormone. These are released from the anterior pituitary gland in
response to a hormone signal from the hypothalamus.
What happens if I have too much androstenedione?
The effects of too much androstenedione are likely to result from its conversion in the body to
oestrogen or testosterone.
In men, too much androstenedione may lead to an imbalance in oestrogen and testosterone
production, leading to changes such as breast development. Depending on the cause of the excess
androstenedione, other changes, such as the testes becoming smaller, might also occur.
In women, excess body and facial hair growth (called hirsutism), stopping of periods
(amenorrhoea), worsening acne and changes to the genitalia may result from too much
androstenedione.
Although androstenedione is often abused by bodybuilders in an effort to build muscle bulk, a small
number of studies have suggested that its long-term use may actually decrease muscle strength.
The precise consequences of having too much androstenendione are, therefore, still unclear.
What happens if I have too little androstenedione?
Boys with too little androstenedione may fail to develop the sexual characteristics associated with
puberty, including pubic and body hair, growth of the sexual organs and deepening of the voice.
Similarly, girls may fail to start their periods and may not undergo many of the changes usually
seen in puberty. Additionally, if a male foetus has too little androstenedione, he may be born with
abnormal genitalia. Too little androstenedione in later life would cause the same changes for both
men and women as too little testosterone and oestrogen.
Cortisol
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Cortisol is a steroid hormone which regulates a wide range of processes throughout the body
including metabolism and the immune response. It also has a very important role in helping the
body respond to stress.
Alternative names for cortisol
Hydrocortisone.
What is cortisol?

Cortisol is a steroid hormone, known as a glucocorticoid, made in the cortex of the adrenal
glands and then released into the blood which transports it all round the body. Almost every cell
contains receptors for cortisol and so cortisol can have lots of different actions depending on which
sort of cells it is acting upon. These effects include controlling the bodys blood sugar levels and
thus regulating metabolism, acting as an anti-inflammatory, influencing memory formation,
controlling salt and water balance, influencing blood pressure and helping development of the
foetus. In many species cortisol is also responsible for triggering the processes involved in giving
birth.
A similar version of this hormone, known as corticosterone, is produced by rodents, birds and
reptiles.

How is cortisol controlled?

Blood levels of cortisol vary dramatically, but generally are high in the morning when we wake up,
and then fall throughout the day. This is called a diurnal rhythm. In people that work at night, this
pattern is reversed, so the timing of cortisol release is clearly linked to daily activity patterns. In
addition, in response to stress, extra cortisol is released to help the body to respond appropriately.
The secretion of cortisol is mainly controlled by three inter-communicating regions of the body,
thehypothalamus in the brain, the pituitary gland and the adrenal gland. This is called the
hypothalamic-pituitary-adrenal axis. When cortisol levels in the blood are low, a group of cells in a
region of the brain called the hypothalamus release corticotrophin-releasing hormone which causes
the pituitary gland to secrete another hormone, adrenocorticotropic hormone, into the
bloodstream. High levels of adrenocorticotropic hormone are detected in the adrenal glands and
stimulate the secretion of cortisol, causing blood levels of cortisol to rise. As the cortisol levels
rise, they start to block the release of corticotrophin-releasing hormone from the hypothalamus
and adrenocorticotropic hormone from the pituitary. As a result the adrenocorticotropic hormone
levels start to drop which then leads to a drop in cortisol levels. This is called a negative feedback
loop.

What happens if I have too much cortisol?

Too much cortisol over a prolonged period of time can lead to a condition called Cushing's
syndrome. This can be caused by a wide range of factors such as a tumour that produces
adrenocorticotropic hormone (and therefore increases cortisol secretion), or taking certain types of
drugs. The symptoms include:

Rapid weight gain mainly in the face, chest and abdomen contrasted with slender arms and
legs

A flushed and round face

High blood pressure

Osteoporosis

Skin changes (ie, bruises and purple stretch marks)

Muscle weakness

Mood swings which show as anxiety, depression or irritability

Increased thirst and frequency of urination.

High cortisol levels over a prolonged time can also cause lack of sex drive and, in women, periods
can become irregular, less frequent or stop altogether (amenorrhoea).
In addition there has been a long-standing association between raised or impaired regulation of
cortisol levels and a number of psychiatric conditions such as anxiety and depression. However, the
significance of this is not yet clearly understood.

What happens if I have too little cortisol?

Too little cortisol can be due to a condition called Addison's disease. It has a number of causes, all
rare, including damage to the adrenal glands by auto-immune disease. The onset of symptoms is
often very gradual. Symptoms may include fatigue, dizziness (especially upon standing), weight
loss, muscle weakness, mood changes and the darkening of regions of the skin. Urgent assessment
by a specialist hormone doctor called an endocrinologist is required when a diagnosis of Cushing's
syndrome or Addison's disease is suspected.