Adrenal Disorders

The adrenal glands, located above each kidney, produce the steroid hormones cortisol, aldosterone, and androgens when the hypothalamic-pituitary-adrenal axis is intact (see Figure 19-2). Cortisol is necessary for homeostasis and metabolism, aldoste-rone regulates sodium retention and potassium secretion, and adrenal androgens support pubertal development. Cortisol receptors are ubiquitously distributed throughout the human brain, and the cortex and hypothalamus may be particularly sensitive to excess production of this hormone (Belanoff et al. 2001). Two conditions of the adrenal glands— chronic hypercortisolemia, or Cushing's syndrome,

Cortisol Aldosterone Androgens

Figure 19-2.

Cortisol Aldosterone Androgens

Figure 19-2.

Hypothalamic-pituitary-adrenal axis.

Corticotropin-releasing hormone (CRH) secreted by the hypothalamus stimulates the anterior pituitary to secrete adrenocorticotropic hormone (ACTH). ACTH then stimulates the adrenal glands to produce cortisol, aldosterone, and adrenal androgens. Adrenal hormones exert negative feedback to the hypothalamus and anterior pituitary to maintain homeostatic regulation of this axis.

and adrenal insufficiency—have known behavioral sequelae.

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