Persistent disturbance of the hypothalamic-pituitary-gonadal axis in abstinent alcoholic men

Aims: Testosterone synthesis in chronic alcoholics is affected by a variety of mechanisms. Little is known about the reversibility of these changes upon abstinence and available data on circulating hormone levels are incomplete and inconsistent. Methods: Serum concentrations of free testosterone, total testosterone, and luteinizing hormone (LH) were determined in 18 male non-cirrhotic chronic alcoholics on days 2, 22, 82 and 127 of strictly controlled abstinence, as well as in a group of 20 healthy age-matched controls. Results: Higher total testosterone concentrations were found in alcoholics on the second day of abstinence, as compared to controls (7.1 ± 1.9 vs 5.6 ± 1.4 ng/ml) and throughout the whole observation period. Correspondingly, free testosterone concentrations were increased over control levels on day 2 (40.0 ± 12.1 vs 29.7 ± 8.1 pg/ml) and stayed elevated in the presence of augmented concentrations of LH [4.5 U/l (range 1.6–9.5 U/l) vs 2.0 U/l (range 0.8–8.1 U/l)] for up to 127 days of strictly controlled abstinence. Conclusions: Sustained increases in serum free and total testosterone levels in the presence of inadequately raised LH concentrations point towards persisting disturbances of the hypothalamic–pituitary–gonadal axis in male alcoholics upon cessation of drinking.