Cirrhosis steroid hormones

Changes in steroidal hormone production, conversion, and handling are also prominent features of cirrhosis. These changes can result in decreased libido, gynecomastia (development of breast tissue in men), testicular atrophy, and features of... 

Chronic alcohol use has important effects on the endocrine system and on fluid and electrolyte balance. Clinical reports of gynecomastia and testicular atrophy in alcoholics with or without cirrhosis suggest a derangement in steroid hormone balance. 

Since most steroid hormones are degraded in the liver one may anticipate that the pattern of steroid hormones in blood and urine will be altered in severe liver disease, such as cirrhosis of the liver. This is the case, but the interpretation of the observation is complicated by the existence of the enterohepatic circulation of steroid hormones. 

The increased levels of estradiol stimulate the biosynthesis of the steroid hormone binding protein. The reduction of estriol formation in liver cirrhosis is likely to result in part from cholestasis which interrupts the enterohepatic circulation and in more severe cases from poor uptake of estrogens by the hepatic cells, thus preventing the conversion of estrogen to estriol. 

Albumin 18-20 Maintains plasma oncotic pressure transports small molecules Dehydration, anabolic steroids, insulin, infection Overhydration, edema, kidney insufficiency, nephrotic syndrome, poor dietary intake, impaired digestion, burns, congestive heart failure, cirrhosis, thyro id/adrena / pitu itary hormones, trauma, sepsis... 

UGT activity is modulated by various hormones. Excess thyroid hormone and ethinyl oestradiol (but not other oral contraceptives) inhibit bilirubin glucuronidation. In contrast, the combination of progestational and oestrogenic steroids results in increased enzyme activity. Bihrubin glucuronidation can also be inhibited by certain antibiotics (e.g. novobiocin or gentamicin, at serum concentrations exceeding therapeutic levels) and by chronic hepatitis, advanced cirrhosis and Wilson s disease. 

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