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.