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adrenosterone reichstein's substance 11-ketoandrostenedione 11-ka4 hormone hormonal therapy replacement function action endocrine endocrinology level prohormone analogue 11-oxoandrostenedione 11-oxo steroid androgenic weak intermediate /prohormone 11-ketotestosterone adrenal cortex dietary supplement cortisol cortisone muscle breakdown metabolite metabolism biosynthesis cycle mechanism pathway path catabolism biosynthetic biogenesis substrate precursor synthesis derivative bioprecursor metabolic enzyme endogenous 3d