Stress and the interaction of the hypothalamic-pituitary-adrenal axis with other pituitary axes and its consequences on muscle mass.

In this manuscript, the relation of the hypothalamic-pituitary-adrenal axis to energy handling, thyroid function, gonadal and growth hormones are discussed against the background of stress. Clinical data from the SHIP-PAGE (steroid hormones in patients with pituitary, adrenal and gonadal endocrinopathies) study are provided to show that the HPA axis is sensitive to glucose and interferes with the activities of other pituitary axes. While chronic stress leads to central hypogonadism and a loss in muscle mass, high glucose loads hamper the plasticities of the HPA, the hypothalamic-pituitary-gonadal as well as the hypothalamic-pituitary-growth hormone axes but elevate insulin concentrations. Therefore, prevention programs ideally include strategies to reduce stress and promote muscle activity.