Model-Based Therapeutic Correction of Hypothalamic-Pituitary-Adrenal Axis Dysfunction
Figure 2
Migration of cortisol concentration from one stable point to another.
Concentration of circulating cortisol plotted as a function of the external stressor f. A first idealized trajectory (red - -) describes the displacement of the system from rest to a peak cortisol concentration followd by an eventual lapse into a chronic hypocortisolic state. A second idealized trajectory (green - -) illustrates the effects of treatment. Here removal of cortisol can be thought of as a negative stress f. An increase in ACTH concentration of ∼30% above baseline serves as a signal that the treatment may be discontinued.