Synthesis and Deficiencies of Adrenal Hormones
Rahul's Noteblog Notes on Endocrinology Synthesis and Deficiencies of Adrenal Hormones
Rate-Limiting Step of Adrenal Hormone Synthesis:
Rate-limiting step: desmolase converts cholesterol to pregnenolone; this is also the starting point.
Zone glomerulosa:
• Angiotensin II promotes synthesis.
• Pregnenolone to progesterone to 11-deoxycorticosterone to corticosterone to anderosterone.
Zona fasciculata and zona reticularis:
Adrenal Enzyme deficiencies:
21-beta-hydroxylase deficiency:
• Causes decreased aldosterone in zona glomerulosa.
Effect in the zona fasciculata and zona reticularis:
• Decreased mineralocorticoids (decreased Na/ECF/low BP) and glucocorticoids (increased ACTH/androgen).
• In 21-hydroxylase deficiency, cortisol and aldosterone production is below normal level and this prompts the anterior pituitary to secrete large amounts of ACTH in order to increase production of cortisol. However, the increased ACTH production is being channeled to make more androgen. Hence, in 21-hydroxylase deficiency, you'll see a young child with increased height and growth of pubic hair.
11 beta-hydroxylase deficiency:
Effect in the zona fasciculata and zona reticularis:
• Excessive androgen; increased BP.
• Causes decreased aldosterone in zona glomerulosa.
17 alpha-hydroxylase deficiency:
Effect in zona fasciculata and zona reticularis:
• Increased BP due to increased ACTH.
Effect in testes:
• Decreased testosterone.
Effect in ovaries:
• Decreased estrogens.
Additional Readings:
Basic Endocrinology
1. Introduction to Endocrinology
2. Hypothalamic-pituitary system
3. Adrenal Hormones
4. Antidiuretic Hormone (ADH) and ECF Regulation
5. Endocrine Pancreas
6. Growth Hormone
7. Adrenal Medulla
8. Hormonal Control of Calcium and Phosphate
9. Thyroid Hormones
10. Hormones of Male Reproduction
11. Hormones of Female Reproduction
12. Fluid Compartments of the Body
13. Notes on Hypothalamus Anterior Pituitary and Thyroid
14. Additional Notes on Female Reproduction
15. Hormonal Signaling Pathways
16. FAQ on Adrenal Hormones
17. FAQ on Male Reproduction
18. Synthesis and Deficiencies of Adrenal Hormones
19. Significance of Glycosylated Hemoblogin (HbA1c)
20. Significance of Measuring Albumin while with Calcium Levels
21. Stepwise Approach to Treatment of Ascites
22. How to differentiate between Diabetes Insipidus vs Psychogenic Polydipsia
Related Topics
1. Histology of the Endocrine System
2. Histology of the Male Reproductive System
3. Histology of the Female Reproductive System
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