ascorbic-acid and Adrenal-Insufficiency

Topics: Adrenal Cortex Hormones; Adrenal Insufficiency; Aged; Ascorbic Acid; Diagnosis, Differential; Female; Humans; Male; Vitamin B Complex; Water-Electrolyte Balance

Etomidate-induced suppression of cortisol biosynthesis is a result of a blockade of 11-beta-hydroxylation in the adrenal gland, mediated by the imidazol radical of etomidate. Since the generation of steroids requires reductive and energy rich equivalents, the present study examined whether supplementation with ascorbic acid or xylitol, a major source of NADPH, could attenuate adrenal suppression by etomidate in human subjects by promoting the turnover rate of 11-beta-hydroxylase. During continuous etomidate/alfentanil anaesthesia for pelviscopic surgery 30 female patients received either Ringer's lactate, xylitol (0.25 g kg-1 h-1) or ascorbic acid (0.5 g h-1) intravenously (i.v.). The plasma concentrations of cortisol, aldosterone and dehydroepiandrosterone (DHEA) were recorded for 5 h after end of surgery and a stimulation with synthetic ACTH was performed. The results showed no evidence of a clinically relevant attenuating effect of ascorbic acid or xylitol on etomidate-induced adrenocortical suppression. However, the observed suppression of cortisol levels was not enough to allow an attenuating affect to be measured.

Topics: Adolescent; Adrenal Cortex; Adrenal Insufficiency; Adrenocorticotropic Hormone; Adult; Aldosterone; Alfentanil; Anesthetics, Intravenous; Ascorbic Acid; Dehydroepiandrosterone; Endoscopy; Etomidate; Female; Humans; Hydrocortisone; Hydroxylation; Injections, Intravenous; Isotonic Solutions; Middle Aged; Mixed Function Oxygenases; NADP; Oxidation-Reduction; Pelvis; Ringer's Lactate; Xylitol

This study was carried out to assess whether the adrenal inhibition induced by etomidate could be prevented by associating ascorbic acid with etomidate, as a protective effect of ascorbic acid administered three hours after etomidate has been described. Sixteen ASA 1 or 2 patients, less than 65 years old, free of endocrine disease, were included. At induction of anaesthesia, eight of them (group B) were given an infusion of ascorbic acid 1 g, in 500 ml of 5% glucose. Group A patients (n = 8) were given 500 ml of 5% glucose. Anaesthesia was induced with etomidate 0.3 mg.kg-1, fentanyl 0.005 mg.kg-1 and vecuronium 0.1 mg.kg-1. Maintenance was carried out using a continuous infusion of etomidate (0.1 mg.kg-1.h-1 for 10 min, followed by 0.01 to 0.02 mg.kg-1.h-1). Additional boluses of fentanyl or diazepam (10 mg) were administered when arterial blood pressure or heart rate were 20% greater than preanaesthetic values. The number of injections required was the same in both groups. Plasma cortisol concentrations were measured by radioimmunoassay (RIA) before anaesthesia (T0), 4 h (T4) and 24 h (T24) after the end of surgery. Blood ACTH levels were also assessed by RIA at T0 and T4. The adrenal insufficiency at T4 had completely ended at T24. In fact, the relative decrease in cortisol levels was greater in patients treated with ascorbic acid (T4/T0: 47.6 +/- 9% in group A vs 76.5 +/- 33% in group B, p less than 0.05); this was suggestive of a higher degree of adrenal inhibition in patients receiving ascorbic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adrenal Cortex; Adrenal Cortex Function Tests; Adrenal Insufficiency; Adrenocorticotropic Hormone; Adult; Aged; Ascorbic Acid; Etomidate; Humans; Hydrocortisone; Middle Aged

We describe a case of scurvy in a 32-year-old woman. The disease was associated with bilateral tumours of the quadriceps muscles and malignancy was considered. Adrenal insufficiency was also diagnosed. All abnormalities subsided in response to vitamin C therapy. It is unknown whether there is a causal link between the two diseases, but evaluation of adrenal function seems justified in future cases of scurvy.

Topics: Adrenal Insufficiency; Adult; Ascorbic Acid; Diagnosis, Differential; Female; Humans; Muscle Neoplasms; Scurvy

Topics: Adrenal Insufficiency; Adult; Ascorbic Acid; Capillary Permeability; Chronic Disease; Female; Humans; Male; Middle Aged

Tetracosactrin (Synacthen) tests were performed on 19 elderly women who had leucocyte ascorbic acid (LAA) levels of less than 15 microgram/108 WBC. 9 were then given a daily dose of 200 mg ascorbic acid orally for 2 weeks while the other 10 were left untreated. Following this, tetracosactrin tests were repeated in both groups. All initial plasm cortisol responses to tetracosactrin were within normal limits. Treatment with ascorbic acid produced no changes in these. This suggests that the low LAA levels often found in old people do not result in adrenal insufficiency.

Topics: Adrenal Glands; Adrenal Insufficiency; Aging; Ascorbic Acid; Ascorbic Acid Deficiency; Cosyntropin; Female; Humans; Hydrocortisone

Topics: 17-Ketosteroids; Adolescent; Adrenal Glands; Adrenal Insufficiency; Adrenocorticotropic Hormone; Adult; Ascorbic Acid; Female; Humans; Methods; Middle Aged; Mitral Valve Stenosis; Pituitary-Adrenal Function Tests

Topics: Adrenal Cortex Hormones; Adrenal Insufficiency; Ascorbic Acid; Child, Preschool; Humans; Infant; Infant, Newborn; Pantothenic Acid; Pyridoxine

Topics: Adrenal Insufficiency; Ascorbic Acid; Autonomic Nervous System Diseases; Blood Circulation; Communicable Diseases; Cortisone; Desoxycorticosterone; Encephalitis; Flavonoids; Humans; Liver; Pathology; Pulmonary Edema; Rutin; Water-Electrolyte Balance

Topics: Addison Disease; Adrenal Insufficiency; Ascorbic Acid; Cortisone; Desoxycorticosterone; Dexamethasone; Drug Therapy; Geriatrics; Hypertension; Hypoadrenocorticism, Familial; Menopause; Nephritis; Prednisone; Triamcinolone

Topics: Adolescent; Adrenal Insufficiency; Ascorbic Acid; Blood Chemical Analysis; Child; Geriatrics; Silicosis

Topics: 17-Ketosteroids; Addison Disease; Adrenal Cortex Hormones; Adrenal Glands; Adrenal Insufficiency; Adrenocorticotropic Hormone; Ascorbic Acid; Blood Chemical Analysis; Eosinophils; Hypoadrenocorticism, Familial; Injections, Intramuscular; Nephritis; Pharmacology; Prednisolone; Psychotic Disorders; Urine

Topics: Adrenal Glands; Adrenal Insufficiency; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Animals; Ascorbic Acid; Corticosterone; Dogs; Humans; Hydrocortisone; Hypophysectomy; Rats; Steroids

Topics: Adrenal Cortex; Adrenal Cortex Diseases; Adrenal Insufficiency; Ascorbic Acid; Desoxycorticosterone; Sodium Chloride; Vitamins

Topics: Adrenal Insufficiency; Animals; Ascorbic Acid; Carbohydrate Metabolism; Pituitary Diseases; Pituitary Gland; Rats

Topics: Adrenal Glands; Adrenal Insufficiency; Ascorbic Acid; Humans; Muscle Fatigue; Tissue Extracts

Topics: Addison Disease; Adrenal Insufficiency; Ascorbic Acid; Humans; Hypoadrenocorticism, Familial

Topics: Addison Disease; Adrenal Insufficiency; Ascorbic Acid; Family Characteristics; Humans; Hypoadrenocorticism, Familial; Lipid Metabolism; Lipids; Metabolic Diseases; Minerals; Nitrogen; Vitamins