Hypothalamic pituitary adrenal axis suppression and inhaled corticosteroid therapy

The hypothalamus senses low circulating levels of thyroid hormone (Triiodothyronine (T3) and Thyroxine (T4)) and responds by releasing thyrotropin-releasing hormone (TRH). The TRH stimulates the pituitary to produce thyroid-stimulating hormone (TSH). The TSH, in turn, stimulates the thyroid to produce thyroid hormone until levels in the blood return to normal. Thyroid hormone exerts negative feedback control over the hypothalamus as well as anterior pituitary, thus controlling the release of both TRH from hypothalamus and TSH from anterior pituitary gland. [2]

The secretion of cortisol is mainly controlled by three inter-communicating regions of the body, the hypothalamus in the brain, the pituitary gland and the adrenal gland . This is called the hypothalamic–pituitary–adrenal axis. When cortisol levels in the blood are low, a group of cells in a region of the brain called the hypothalamus releases corticotrophin-releasing hormone , which causes the pituitary gland to secrete another hormone, adrenocorticotropic hormone , into the bloodstream. High levels of adrenocorticotropic hormone are detected in the adrenal glands and stimulate the secretion of cortisol, causing blood levels of cortisol to rise. As the cortisol levels rise, they start to block the release of corticotrophin-releasing hormone from the hypothalamus and adrenocorticotropic hormone from the pituitary. As a result the adrenocorticotropic hormone levels start to drop, which then leads to a drop in cortisol levels. This is called a negative feedback loop.

Hypothalamic pituitary adrenal axis suppression and inhaled corticosteroid therapy

hypothalamic pituitary adrenal axis suppression and inhaled corticosteroid therapy

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hypothalamic pituitary adrenal axis suppression and inhaled corticosteroid therapyhypothalamic pituitary adrenal axis suppression and inhaled corticosteroid therapyhypothalamic pituitary adrenal axis suppression and inhaled corticosteroid therapyhypothalamic pituitary adrenal axis suppression and inhaled corticosteroid therapyhypothalamic pituitary adrenal axis suppression and inhaled corticosteroid therapy

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