This anabolic/catabolic balance – or the balance of ‘growth and healing’ versus ‘wear and tear’ in the body – can be assessed by comparing total 17-hydroxycorticosteroids with total 17-ketosteroids in the urine.
Persistent catabolic effects of cortisol are most damaging when not balanced by anabolic hormones such as dehydroepiandrosterone (DHEA), important in functions such as immunity, reproduction (via its conversion to downstream sex steroids), cardiovascular health, bone density, and memory.
A low Anabolic/Catabolic balance may be associated with:
- A metabolic shift in which the production of stress hormone is favored over the production of androgens and downstream estrogens
- Deficient growth hormone
- Chronic stress or glucocorticoid therapy
- Excessive exercise
- Acute or chronic illness, reduced ability to recover from illness or injury
- Increased risk of developing disease, poorer prognosis in patients with illness27,28
TREATMENT OPTIONS to increase Anabolic/Catabolic Balance:
- Refer to appropriate Treatment Options for adrenal excess (high Total 17-hydroxy-corticosteroids) or low Total 17-ketosteroids, depending on which imbalance is contributing to the low ratio.
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A high Anabolic/Catabolic balance may be associated with:
- Excessive androgen therapy or a metabolic shift in which androgen production is favored over cortisol production
- Possible polycystic ovarian syndrome and/or hirsutism
- Congenital adrenal hyperplasia (enzyme deficiencies)
- Adrenal tumors
- Extreme athleticism
TREATMENT OPTIONS to decrease Anabolic/Catabolic Balance:
- Refer to appropriate Treatment Options for adrenal insufficiency (low Total 17-hydroxy-corticosteroids) or high Total 17-ketosteroids, depending on which imbalance is contributing to the high ratio.
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