The endocrine response to severe physical strain including lack of sleep has been investigated in army personnel during a combat course of 5 days' duration. The thyroxine (T4) concentration in serum increased during the first 24 h, and then declined at a rate corresponding to a halflife of 7.6 days and on day 6 had reached the lowest level, 55 ng/ml. Triiodothyronine (T3) displayed a similar pattern, although an increase during the first 24 h could not be demonstrated. Within 48 h after the course T4 had returned to normal, whereas the serum level of T3 was significantly below the level before the course (p less than 0.05). The serum level of TSH was suppressed during the course. The serum level of prolactin was significantly suppressed and growth hormone was markedly elevated during the course with a significant negative correlation (r=-0.6) between the two. In agreement with a previous report, there was a rapid and sustained suppression of the serum level of testosterone to a mean level of 1.1 ng/ml on day 5. Short periods of sleep (3--6 h) were shown to be effective in reversing the changes described in this paper, especially for growth hormone, prolactin, and testosterone.