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. Author manuscript; available in PMC: 2010 Jun 1.
Published in final edited form as: J Psychiatr Res. 2009 Jan 21;43(9):877–883. doi: 10.1016/j.jpsychires.2008.12.003

Figure 1. Summary of Metabolic Pathway.

Figure 1

11β-HSD is 11β-hydroxysteroid dehydrogenase. 11ß-HSD type 1 (mainly located in liver, adipose tissue and brain) catalyses the reduction of inert cortisone to active cortisol; 11ß-HSD type 2 oxidizes active cortisol to inert cortisone in the kidney. 5α- and 5β -reductase are the rate limiting enzymes in the conversions of cortisol to 5α-tetrahydrocortisol (THF) and 5β-THF, respectively, largely occurring in liver, but also the brain. 5β-reductase is also rate limiting in the conversion of cortisone to tetrahydrocortisone (THE).