HORMONAL CHANGES IN NONCIRRHOTIC MALE ALCOHOLICS DURING ETHANOL WITHDRAWAL

Serum concentrations of iodothyronines, cortisol, prolactin,testosterone and the respective tropic hormones were measuredin 32 noncirrhotic male alcoholics, aged 28–51 years,at the end of a long drinking period and subsequently duringethanol withdrawal over 1–2 weeks. Seven men had testicularatrophy. On admission one patient had high values for serumthyroxine (T4) and free thyroxine index (FT4I). A blunted responseof serum thyrotropin (TSH) to thyrotropin-releasing hormone(TRH) was found in 9 men. Apart from a blunted TSH-responsein one man the abnormalities disappeared during the first weekof alcohol abstinence. Simultaneously the mean levels of serumT4, FT4I, triiodothyronine, free triiodothyronine index andreverse triiodothyronine were reduced by 12, 14, 5, 8 and 21%,respectively, and the mean of the maximum TSH-response to TRHwas increased by 55%. At the time of stopping drinking two menhad high morning values and six an abnormal diurnal rhythm ofserum cortisol. High serum ACTH-levels associated with normalserum cortisol concentrations were found in 12 men. During thefirst week of alcohol abstinence the mean morning values forserum cortisol and ACTH were reduced by 18 and 42%, respectively.The serum ACTH-levels remained high in 6 men but the abnormalitiesin cortisol secretion disappeared. On admission four men hadlow serum concentrations of testosterone which were normalizedduring ethanol withdrawal over one week. At the same time themean level of serum testosterone was increased by 19%. Mildhyperprolactinaemia found in 7 patients on admission disappearedin 4 men during the first week of ethanol withdrawal. Duringthe second week of alcohol abstinence no further changes wereoccurring in the hormonal parameters studied. The present study indicates that clinically significant hormonalchanges are only occasionally seen in chronic alcoholic menwithout liver damage. Whether high serum ACTH-levels in chronicalcoholics without hypercortisolism indicate an ethanol-inducedACTH-resistance remains to be determined by further studies.