The endocrine system in critical illness

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The circulating levels of ACTH-cortisol, thyroid-stimulating hormone-thyroxine, epinephrine (adrenaline), norepinephrine (noradrenaline), vasopressin, growth hormone, prolactin, insulin, and glucagon all increase in severe illness. These changes represent an exaggeration of normal host responses. There then develops a reduced thyroxine response to thyroid-stimulating hormone and a reduced synthesis of insulin-like growth factors in response to growth hormone. It is not clear at present of the significance of this tissue resistance or of the benefit of treating these derangements.

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