Alcohol and the endocrine system: A critical review of disruptions, potential mechanisms, and health implications.

The endocrine system coordinates and integrates cellular activity throughout the body by regulating cellular and organ function and maintaining homeostasis. Homeostasis, the dynamic maintenance of internal balance despite changing external or internal conditions, is essential for proper cellular function. The endocrine system achieves this through a complex regulatory network of hormone-mediated signaling among multiple endocrine organs, relying on precisely regulated synthesis and release of hormones and specific hormone-receptor interactions. Endocrine-mediated actions coordinate critical physiological processes, including growth, metabolism, reproduction, stress adaptation, and circadian rhythms throughout the lifespan. Endocrine glands-such as the hypothalamus, pituitary, thyroid, parathyroid glands, pancreas, adrenal glands, and gonads-secrete hormones that act via autocrine, paracrine, or endocrine mechanisms to influence target tissues. Hormonal actions are mediated by either cell surface receptors (e.g., G protein-coupled receptors for peptide hormones) or intracellular receptors (e.g., steroid and thyroid hormones). Hormone secretion is tightly regulated by feedback loops (e.g., cortisol inhibition of corticotropin releasing hormone [CRH] and adrenocorticotropin [ACTH] hormone) as well as by nutrient signals, neural inputs, and circadian cues. Alcohol, a commonly used substance, can impact the integrity of endocrine regulation of homeostasis at multiple sites and consequently contribute to risk for comorbid conditions. This review summarizes the physiological roles of key endocrine systems, delineates alcohol's effects as reported in both preclinical and clinical studies, discusses the clinical consequences and potential therapeutic implications of alcohol-related endocrine dysfunction, and identifies areas in need of further research.