Hypothermia and Adrenocortical Function

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To the editor: In his review of hypothermia in the October 1978 issue, Reuler (1) includes a diagram that suggests cold exposure stimulates the pituitary gland, which in turn stimulates secretion by the thyroid and adrenal glands. Although increased thyroid-stimulating hormone output in response to cold has been demonstrated in other species and in the human neonate, several investigators have been unable to document this phenomenon in the adult human (2).

Acute cold exposure does stimulate cortisol secretion. In hypothermic patients, however, we have found (3) that adrenal responsiveness to ACTH is lost and cortisol levels may be in the

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