Very low serum testosterone levels and severe impairment of spermatogenesis in burned male patients. Correlations with basal levels and levels of FSH, LH and PRL after LHRH + TRH.

The level of testosterone, FSH, LH and, in some cases, of PRL in serum was estimated in 39 burned male patients (mean burn index and S. E. was 31.5 +/- 2.5). The level of testosterone was found markedly decreased to a value as low as 0.19 ng ml-1, and such low level persisted for several weeks after the burn injury. At the same time the mean LH level was normal, while that of FSH decreased. However, in few patients high LH and PRL values were found. The dramatic drop of the level of testosterone and FSH began usually after the second postburn day. The administration of chorionic gonadotropin resulted in a marked elevation of testosterone level in less severely burned patients, while it was negligible in those severely burned. After LHRH plus TRH administration, the mean rise of LH level was almost normal, but FSH responded poorly. The lowest LH, FSH and PRL response was found during the 2nd and 3rd postburn week. The testes from 9 of the eleven patients that died were examined histologically, and no major histological alterations were found in those who died during the first 3 days after burn, while later a severe damage of germinal cells occurred. The pituitary-testicular axis does not operate properly after burn injuries. The main features of the endocrine (metabolic) response after burn are: 1. increased catabolism; 2. decreased anabolism; 3. changed endocrine priorities. To enable the survival an exaggerated response occurs very often with a possible resulting damage to some vital structures. Testosterone (anabolics) may be indicated in the treatment of burned patients.