Steroid hormones function tests

Oral contraceptives have their most significant effect on endocrine parameters. Blood cortisol, thyroxine, protein-bound iodine, T3 uptake, and urinary free cortisol are elevated. Urinary 17,21-dihydroxy steroids, 17-ketosteroids, and estrogens are decreased. There is no effect on urinary catecholamines or VMA (Table 10) (LIO). The effect of thyroid functions tests is due to the administered hormone stimulating an increase in the production of thyroid-binding globulin which in turn binds 1-thyroxine. The lowering of free thyroxine stimulates the anterior pituitary to produce thyrotropin, which in turn stimulates the thyroid to produce more thyroxine. Since the additional thyroxine is bound to the extra protein, there is an equilibrium and the patient remains clinically euthyroid, but the protein-bound iodine and the thyroxine are elevated. 

Mitochondrial system The function of the mitochondrial cyto chrome P450 monooxygenase system is to participate in the hydroxylation of steroids, a process that makes these hydropho bic compounds more water soluble. For example, in the steroid hormone-producing tissues, such as the placenta, ovaries, testes, and adrenal cortex, it is used to hydroxylate intermediates in the conversion of cholesterol to steroid hormones. The liver uses this system in bile acid synthesis (see p. 222), and the kidney uses it to hydroxylate vitamin 25-hydroxycholecalciferol (vitamin D, see p. 384) to its biologically active 1,25-hydroxylated form. 

Uzzan B, Nicolas P, Perret G, Vassy R, Tod M, Petitjean O. Effects of troleandomycin and josamycin on thyroid hormone and steroid serum levels, liver function tests and microsomal monooxygenases in healthy volunteers a double blind placebo-controlled study. Fundam Clin Pharmacol 1991 5(6) 513-26. 

Reproductive organs are the primary source of the steroid hormones that influence sexual and reproductive functions. In men, the testes produce testosterone and similar androgens that are responsible for spermatogenesis and the secondary sexual characteristics of adult males.7,26 In women, sexual maturation and reproductive function are governed by the production of estrogens and progestins from the ovaries.27 The release of male and female sex steroids is controlled by hormones from the hypothalamus and anterior pituitary.32 The control of male and female hormone activity and the pharmacologic implications of these hormones are discussed in Chapter 30. 

In addition to Its structural role In membranes, discussed In Chapter 5, cholesterol Is the precursor for several Important bloactive molecules. They Include bile acids (see Figure 18-6), which are made In the liver and help emulsify dietary fats for digestion and absorption In the Intestines, steroid hormones produced by endocrine cells (e.g., adrenal gland, ovary, testes), and vitamin D produced In the skin and kidneys. Arthropods need cholesterol or other sterols to produce membranes and ecdysterold hormones, which control development however, they cannot make the precursor sterols themselves and must obtain these compounds In their diet. Another critical function of cholesterol Is Its covalent addition to Hedgehog protein, a key signaling molecule In embryonic development (Chapter 15). 

Steroid hormones (Section 21.8) are produced by the adrenal cortex and the gonads (testes in males, ovaries in females). The adrenocortical hormones include glucocorticoids, which affect carbohydrate metabolism, modulate inflammatory reactions, and are involved in reactions to stress. The mineralocorticoids control the level of excretion of water and salt by the kidneys. If the adrenal cortex does not function adequately, one result is Addison s disease, characterized by hypoglycemia, weakness, and increased susceptibility to stress. This disease is eventually fatal unless it is treated by administration of mineralocorticoids and glucocorticoids to make up for what is missing. The opposite condition, hyperfunction of the adrenal cortex, is frequently caused by a tumor of the adrenal cortex or of the... 

The testes and ovaries produce steroids that function as sex hormones. Secondary sex characteristics that appear at puberty, including a deep voice, beard, and increased muscular development in males and a higher voice, increased breast size, and lack of facial hair in females, develop under the influence of these sex hormones. 

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