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November 1956

Adrenal Cortical Function in Anxious Human Subjects: Plasma Level and Urinary Excretion of Hydrocortisone

Author Affiliations


From the Institute for Psychosomatic and Psychiatric Research and Training, Michael Reese Hospital.

AMA Arch NeurPsych. 1956;76(5):549-558. doi:10.1001/archneurpsyc.1956.02330290093013

The hormones of the adrenal cortex contribute significantly to processes of adjustment to noxious stimuli,1 although much disagreement exists as to their mode of action.* Physical stresses, such as trauma or surgery, considerably increase the blood level of the adrenocortical hormone hydrocortisone,4 as well as the excretion of several of its metabolites, tetrahydrocortisone and tetrahydrohydrocortisone.† Psychological stresses imposed in various ways also raise the blood and urine levels of these hydroxycorticoids.‡

From the available data, it seems justified to conclude that many kinds of stress increase the secretory activity of the adrenal cortex. However, it is possible that increased blood levels of hydrocortisone may result from diminished hepatic disposal and that increased urinary excretion is responsible for the larger quantities of urinary hydroxycorticoids. Direct proof of an increased secretory rate by the adrenal cortex could only be obtained through the determination of the adrenal vein minute-output of hydrocortisone

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