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The clarification of discrepancies in cortisol secretion rate.

ABSTRACT It has been observed that discrepancies, and often pronounced ones, exist when apparent cortisol secretion rate is measured from each of 6 individual metabolites of cortisol. This study employed adrenalectomized patients maintained on dexamethasone. Unlabeled pure cortisol was infused episodically to simulate normal adrenal secretion. Cortisol-4-14C was infused at different times in relation to the measured plasma cortisol content. Urines were collected for 3 days and the specific activities were measured for cortol, cortolone, β-cortol, β-cortolone, tetrahydrocortisol and tetrahydrocortisone. The specific activities demonstrated that the tracer was not metabolized under any circumstance in precisely the same manner as the cumulative metabolism of the unlabeled cortisol. This is a sufficient reason for the discrepancies found in secretion rate measurements and no other mechanism need be invoked. Consideration is given to the validity of approximation of the true cortisol secretion rate. It was co...