Alcohol and the hypothalamic-pituitary-adrenal axis

For more than two decades, endocrinologists have known that alcohol abuse a lters the dynamics of the hypothalamic-pituitary-adrenal (HPA) axis. Acutel y ethanol ingestion may stimulate a rise in plasma ACTH and cortisol levels . Chronic alcohol abuse is associated with activation of the HPA axis and r esistance to dexamethasone administration, especially during periods of acu te withdrawal from alcohol. However, on completion of withdrawal from alcoh ol, the HPA axis has a period of dampened responsiveness. In fact, some act ively drinking alcoholics meet the criteria for centrally mediated adrenal insufficiency.