Paramedikseiksi

Paramedikseiksi refers to the drop in glucocorticoid levels that occurs after the administration of glucocorticoids. When exogenous glucocorticoids are given to an organism, its own production of cortisol is suppressed. This drop is necessary for recovery from the side effects of overdose on the endocrine system; if there was no dip, Cushing's syndrome would occur.

This phenomenon is a counter-regulatory response to negative feedback that glucocorticoids normally place on the hypothalamic-pituitary-adrenal (HPA) axis. As glucocorticoid levels increase, the brain downregulates ACTH production and, at very high levels, can even cease ACTH production altogether. In response, the level of circulating cortisol, ultimately derived from the ACTH stimulus, drops.

The drop can be from either rapid physiological changes, like short-term acute oversuppression of cortisol production, or chronic changes resulting from prolonged steroid use, with most cells being unable to express new glucocorticoid receptors. The severity of the drop can vary from individual to individual depending on the magnitude and duration of glucocorticoid administration.

The body typically spikes back up glucocorticoid levels by several mechanisms, including changes in ACTH levels and restoration of cellular glucocorticoid receptor sensitivity. Correcting for the lengthy lag times of the physiological rebound is essential for safe clinical treatment of glucocorticoid prescription, helping prevent long-term side effects. Nonetheless, adequately studying this period warrants careful consideration.