Endocrine Disorders

The endocrine system consists of a group of glands that produce and release hormones which control many vital body functions. Some of the functions of endocrine system are to regulate tissue and bone growth, body metabolism, functioning of the heart and even the ability to have children. The hormone levels are crucial in deciding development of diabetes, thyroid disease, growth disorders, sexual dysfunction and a host of other hormone related disorders.

Types of endocrine disorders

Endocrine disorders are divided into three categories;

• Endocrine disease that results when a gland produces too much of a hormone (hormone hyper secretion)
• Endocrine disease that results when a gland produces too little of a hormone (Hormone deficiency)
• Endocrine disease that occurs due to development of nodules or tumours in the endocrine system which may or may not affect hormone levels.

The endocrine system has a feedback mechanism that controls the balance of hormones in the blood. If your body has too much or too little of a certain hormone, the feedback system signals the concerned gland to correct the hormone level. Increased or decreased levels of endocrine hormone may be due to a problem in the feedback system, disease, infection, genetic disorder, injury to the endocrine gland or tumor of the endocrine gland.Most endocrine tumours and nodules (lumps) are noncancerous. They usually do not spread to other parts of the body. However, a tumour or nodule in the gland may interfere with its hormone production.

Glands of the Endocrine system

Each gland releases specific hormones into the blood stream. These hormones are chemical messengers that travel through the blood to other cells and organs and help control various body functions.Endocrine glands include:

Disturbance in the function of one or more of these glands can alter the balance of hormones in the body and lead to endocrine disorders.

Common endocrine disorders

The symptoms of different endocrine disorders vary widely and depend on the specific gland involved. Most people with endocrine disease do complain of fatigue and weakness. Diabetes is the most common endocrine disorder. Other common endocrine disorders include:

• Adrenal insufficiency
  This occurs when the adrenal gland does not produce enough steroid hormone known as cortisol.This happens when adrenal glands do not work properly (primary adrenal insufficiency) or when the pituitary gland does not signal the adrenal glands to make cortisol (secondary adrenal insufficiency). Symptoms include fatigue, dizziness due to low blood pressure on standing, muscle pains and skin change (darkened skin on the face, neck and back of hands). Addisons disease is an autoimmue disease
  causing primary adrenal insufficiency.
• Cushing’s syndrome
  It is a condition that occurs when body is exposed to abnormally high levels of the hormone cortisol. Cushing’s syndrome may occur in people who take high doses of corticosteroid medications.Other causes include a pituitary gland tumour (known as Cushing’s disease) and adrenal gland abnormality or tumour. Symptoms of Cushing’s syndrome include weight gain, thin skin that bruises easily, reddish purple stretch marks on the thighs, arms and buttocks, round shaped face and muscle or bone weakness. If Cushing’s syndrome is not treated it can lead to high blood pressure, bone loss and diabetes
• Hyperthyroidism
  The thyroid gland produces too much of thyroid hormone leading to weight loss, fast heart beat, sweating and irritability. The most common cause for an overactive thyroid is an autoimmune disorder called Graves disease but other causes include nodules in the thyroid gland and thyroiditis (inflammation of the thyroid gland). Untreated hyperthyroidism can lead to atrial fibrillation (fast irregular heart beat),osteoporosis and a life threatening condition called thyroid storm. Eye problems can also be seen in this condition called Graves opthalmopathy where eyes are bulging and vision can be compromised.
• Hypothyroidism
  The thyroid gland does not produce enough thyroid hormone leading to weight gain, fatigue, constipation, dry skin, intolerance to cold, memory problems and depression. The underactive thyroid gland can cause slow development in children. Some types of hypothyroidism are present at birth. The common causes of hypothyroidism include iodine deficiency and autoimmune disease (Hashimotos thyroiditis), Untreated hypothyroidism can cause heart problems,infertility and mental health problems.
• Prolactinoma
  It is a benign tumour of the pituitary gland that secretes excess hormone prolactin. Prolactin is a hormone secreted by the pituitary that causes secretion of breast milk.Symptoms of prolactinoma include galactorrhoea (milky discharge from the breasts), irregular or absent periods in women, erectile dysfunction in men,infertility and headaches.
• Acromegaly and Gigantism
  If the pituitary gland produces too much growth hormone, it leads to a condition called gigantism in children and acromegaly in adults. Children grow abnormally tall whereas adults develop enlarged hands and feet,protruding jaw,thickened lips and a host of other features but don’t grow taller.This is usually caused by a benign tumour of the pituitary.
• Hypopituitarism
  The pituitary releases little or no hormones. Various diseases cause these conditions such as tumours and infections. Women with this condition may stop getting periods.
• Polycystic ovary syndrome (PCOS)
  Overproduction of androgens interferes with the development of eggs and their release from the female ovaries. PCOS is a leading cause of infertility.
• Precocious puberty
  Abnormally early puberty that occurs when glands tell the body to release sex hormones too soon in life.Puberty that begins before the age of 8 in girls and 9 in boys is considered precocious puberty. The cause can often not be found but infections, certain hormone disorders and tumours can cause this condition. Treatment involves giving medications to delay further development.

Growth hormone Deficiency in children

If the pituitary gland does not make enough growth hormone, a child can stop growing in height. The child will be much shorter than most children of the same age and gender.Growth hormone injections would have to be taken after investigating for the cause.

Pheochromocytoma

This is a tumour of the adrenal gland that causes excess release of catecholamines (hormones that regulate heart rate and blood pressure). High blood pressure is the most important symptom but fast pulse,excessive sweating and headaches are also seen.Some people who develop pheochromocytoma have a rare inherited condition called as multiple endocrine neoplasia which makes them prone to develop tumour in the parathyroid,adrenal and thyroid glands.

Osteoporosis

A condition in which bones are weak and brittle. There is a higher chance of fractures in osteoporotic bones. Low sex hormones or menopause are important predisposing risk factors.

Laboratory testing

Because symptoms of endocrine disorders can begin insidiously and maybe non specific, clinical recognition is often delayed for months or years. Blood and urine tests are done to measure the hormone levels which help to determine the endocrine disorder. Imaging tests maybe needed to locate a nodule or a tumour.

Treatment

In many cases endocrine disorders maybe symptomless or mild enough to not require treatment. Symptoms can arise from hormone deficiency or excess hormone production. Hypofunction disorders are treated by replacement of the hormone regardless of the cause. In case of hyperfunction disorders, radiation therapy, surgery and drugs that suppress hormone production can be used.

Risk factors for Endocrine disorders

A number of factors increase the risk of developing endocrine disorders.

Important risk factors include:

• Family history of endocrine disorder
• Personal history of autoimmune disorders such as diabetes
• Poor diet
• Inactivity
• Recent surgery,trauma,infection
• Pregnancy ( in hyperthyroidism)

The risk of certain endocrine disorders such as hypothyroidism can be lowered by eating a balanced healthy diet and regular physical activity.

Consult your doctor, If you have…

Fatigue, Weight Gain, Weight Loss, Palpitation, Menstrual Problem, Infertility in Women, Fractures, Early Puberty in Children, Short Stature in Children.