The Effect of Testosterone and Allied Compounds on the Mineral, Nitrogen, and Carbohydrate Metabolism of a Girl with Addison's Disease.

The evidence of the literature indicates that the adrenal cortex produces a variety of hormones, some of which, like desoxycorticosterone, act predominantly to maintain a normal water and electrolyte balance (1), while others, like corticosterone, are effective chiefly through preventing hypoglycemia, either by facilitating the formation of sugar from protein (gluconeogenesis) (2) or by inhibiting utilization of sugar by the tissues (3). Up to the present, most replacement therapy for patients with adrenal cortical insufficiency has been concerned with these two types of adrenal hormones. There is, however, clinical and experimental evidence that the adrenal cortex also secretes other types of hormones, some of which are androgenic (4, 5). Recent evidence has shown that such androgens not only prompt masculine secondary sexual development, but also an increase in muscular mass and endurance (6, 7). A striking example of this phenomenon is provided by the Herculean development of certain children with virilism due to hyperplasia or carcinoma of the adrenal cortex (8). These individuals usually excrete abnormally large quantities of neutral urinary 17-ketosteroids (9, 10) which are believed to be excretory transformation products of the adrenal cortical and, to a lesser extent, of the testicular androgens (9, 11). A striking example of the effect of adrenal cortical androgens upon a patient with adrenal cortical insufficiency is provided by a boy with congenital adrenal cortical hyperplasia, elevated