Hormonal changes during alcohol intoxication and withdrawal.

The endocrine effects of alcohol are briefly reviewed. Alcohol enhances glucose-induced insulin secretion and may thus cause reactive hypoglycemia. However, inappropriate insulin secretion is not the reason for alcohol-induced hypoglycemia in fasted subjects. The direct effects of alcohol in thyroid function in humans are small, although alcoholics often have low concentrations of thyroid hormones in their plasma because of liver damage. Alcohol increases cortisol secretion from adrenal cortex either by increasing ACTH secretion or, more probably, by directly stimulating the adrenals. Alcohol also increases aldosterone secretion. The production of epinephrine and norepinephrine by the adrenal medulla is increased during alcohol intoxication and withdrawal. Plasma testosterone concentration is decreased during hangover and during alcohol withdrawal. The decrease is due to direct effects of alcohol on the testes, because plasma LH concentration is increased simultaneously. Alcohol has no significant effect on the LRH-induced secretion of LH. Plasma growth hormone concentration is decreased during alcohol intoxication and increased during hangover. TRH-induced secretion of prolactin is increased during alcohol intoxication and inhibited during hangover and withdrawal. The last finding suggests that there is dopaminergic overactivity in hypothalamus during alcohol withdrawal.