The clinical intervention aimed at re-establishing the physiological concentration differences, or gradients, of hormones across tissue compartments necessary for directional signaling and receptor responsiveness. This moves beyond simple total hormone levels to address the critical free fractions and tissue-specific concentrations. Restoring these gradients ensures proper feedback and signaling directionality.
Origin
The concept draws from transport physiology and endocrinology, recognizing that hormones must move from production sites (e.g., gonads, adrenals) to target tissues along a concentration gradient. Restoration implies correcting imbalances where peripheral tissue levels are inappropriately high or low relative to the circulation or target site. It emphasizes spatial and temporal concentration differences.
Mechanism
Restoration often involves optimizing binding protein concentrations, such as SHBG or CBG, which modulate the free hormone fraction available for diffusion. Furthermore, modulating tissue-specific metabolism, such as 5-alpha reductase activity in target cells, directly affects the local concentration of active metabolites. Effective restoration relies on synchronized pulsatile release patterns from endocrine glands, which establish dynamic gradients.
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