Hormone deficiency and Excess��Dr Tamseela Mumtaz

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Contents:

• Introduction to Endocrine system
• Diseases caused by hormonal excess(Hyperpitiarism) and deficiency (Hypopituitarism)
• Disorders of pituitary gland
• Disorders of thyroid gland
• Disorders of adrenal gland
• Disorders of islets of langerhans
• Disorders of ovaries
• Disorders of testes
• Conclusion
• References

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Endocrine System:

• The endocrine system is the collection of glands that produce hormones that regulate:

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• Metabolism,
• Growth and development,
• Tissue function,
• Sexual function,
• Reproduction,
• Sleep & mood and many other things

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Male and Female Endocrine System

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Hypophysis:

• The pituitary gland (hypophysis cerebri), together with its connections to the hypothalamus
• Acts as the main endocrine interface between the central nervous system and the rest of the body.

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What are Hormones?

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• Are chemical messengers that are secreted directly into the blood, which carries them to organs and tissues of the body to exert their functions
• There are many types of hormones that act on different aspects of bodily functions and processes

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Some of these include: �

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• Development and growth
• Metabolism of food items
• Sexual function and reproductive growth and health
• Cognitive function and mood
• Maintenance of body temperature and thirst

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Where are they secreted from?

• Hormones are secreted from the endocrine glands in the body. The glands are ductless, so hormones are secreted directly into the blood stream rather than by way of ducts.

• Some of the major endocrine glands in the body include:
• Pituitary gland
• Pineal gland
• Thymus
• Thyroid
• Adrenal glands
• Pancreas
• Testes
• Ovaries

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Disorders of pituitary gland:

• Major disorders of pituitary are:
• Hypopituitarism
• Diabetes inspidus
• Acromegaly
• Pituitary tumor(Hyperpituitarism)

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Hypopituitarism:

• Hypopituitarism is a rare disorder in which your pituitary gland fails to produce one or more hormones, or doesn't produce enough hormones.

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Hypopituitarism:

• Causes:
• Pituitary tumors
• Poor blood supply to the pituitary gland
• Infections or inflammatory diseases of the brain.
• Radiation treatment
• Surgery to remove pituitary tissue
• Autoimmune diseases
• Brain injury
• Genetic diseases and syndromes

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• Symptoms:
• Stomach pain, decreased appetite, nausea and vomiting, constipation.
• Excessive thirst and urination.
• Fatigue and/or weakness.
• Anemia (not having enough red blood cells)
• Headache and dizziness.
• Sensitivity to cold.
• Weight loss or weight gain.
• Muscles aches.

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Diabetes inspidus:

• Causes:
• Diabetes insipidus is caused by a lack of antidiuretic hormone (ADH), also called vasopressin
• Which prevents dehydration, or the kidney's inability to respond to ADH.
• ADH enables the kidneys to retain water in the body.
• The hormone is produced in a region of the brain called the hypothalamus.

• Symptoms:
• Extreme thirst that can't be quenched (polydipsia)
• Excessive amounts of urine (polyuria)
• Colourless urine instead of pale yellow
• Waking frequently through the night to urinate
• Dry skin
• Constipation
• Weak muscles
• Bedwetting

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Hyperpituitarism:

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• Hyperpituitarism is defined as an excessive secretion or production of 1 or more of the hormones produced by the pituitary gland. 

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Acromegaly:

• Causes:
• Excessive secretion of growth hormone
• Characterized by excessive growth in the form of swelling of hands, legs and soft tissues

• Symptoms:
• Swollen hands and feet
• tiredness and difficulty in sleeping and sometimes sleep apnoea.
• your brow, lower jaw and nose getting larger,
• your teeth becoming more widely spaced.

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Pituitary tumor:�(two most common pituitary tumors)

1. Pituitary adenomas:
1. Pituitary adenomas are benign tumors of the pituitary gland.
2. Most are located in the anterior lobe (front portion) of the gland.
3. About 1 in 10 people will develop a pituitary adenoma in their lifetime.

2. Prolactinomas:

• A prolactinoma is a type of tumor that develops in the pituitary gland at the base of your brain. 
• Prolactinoma is a noncancerous tumor of the pituitary gland.
• This tumor causes the pituitary to make too much of a hormone called prolactin.

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Thyroid gland:

• The thyroid, or thyroid gland, is an endocrine gland in the neck consisting of two connected lobes.
• The lower two thirds of the lobes are connected by a thin band of tissue called the thyroid isthmus.
• The thyroid is located at the front of the neck, below the Adam's apple.

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Disorders of thyroid gland:

• Major disorders of thyroid gland are:

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• Goitre
• Cretinism
• Myxedema
• Hashimoto’s disease
• Grave’s disease

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Goitre:

• Causes:

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• An overactive thyroid gland (hyperthyroidism)
• An underactive thyroid gland (hypothyroidism)
• Hormone changes during puberty, pregnancy or the menopause.
• Not enough iodine in your diet.
• Taking some types of medicine, such as lithium, a medicine used to treat some mental health conditions.

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• Symptoms:
• Coughing.
• A tight feeling in your throat.
• changes to your voice, such as hoarseness.
• Difficulty swallowing (dysphagia)
• Difficulty breathing – there may be a high-pitched sound when you breathe.�

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Goitre Patients:

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Cretinism:

• Causes:
• Congenital hypothyroidism, is a severe deficiency of thyroid hormone in newborns.
• It causes impaired neurological function, stunted growth, and physical deformities.
• Symptoms:
• lack of weight gain.
• stunted growth.
• fatigue, lethargy.
• poor feeding.
• thickened facial features.
• abnormal bone growth.
• mental retardation.
• very little crying.

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Myxedema:

CAUSES:

• An autoimmune condition, including Hashimoto's thyroiditis.
• Surgical removal of your thyroid.
• Radiation therapy for cancer.
• Certain medications, such as lithium or amiodarone (Pacerone)
• Iodine deficiency or an excess of iodine.
• Pregnancy.
• Immune system medications, like those used in cancer treatment.

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SYMPTOMS:

• Weakness or lethargy
• Confusion or non-responsiveness
• Feeling cold
• Low body temperature
• Swelling of the body, especially the face, tongue, and lower legs
• Difficulty breathing

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Hashimoto’s thyroiditis:

• Causes:
• Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis and Hashimoto's disease
• Is an autoimmune disease in which the thyroid gland is gradually destroyed

• Symptoms:
• Fatigue and sluggishness
• Increased sensitivity to cold
• Constipation
• Pale, dry skin
• A puffy face
• Brittle nails
• Hair loss
• Enlargement of the tongue

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Grave’s disease:

• Causes:
• Graves, MD, circa 1830s, is an autoimmune disease characterized by hyperthyroidism due to circulating autoantibodies.
• Thyroid-stimulating immunoglobulins (TSIs) bind to and activate thyrotropin receptors, causing the thyroid gland to grow and the thyroid follicles to increase synthesis of thyroid hormone.

• Symptoms:

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• Anxiety and irritability.
• A fine tremor of the hands or fingers.
• Heat sensitivity and an increase in perspiration or warm, moist skin.
• Weight loss, despite normal eating habits.
• Enlargement of the thyroid gland (goiter)
• Change in menstrual cycles.

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Disorders of adrenal gland:

• Major disorders of adrenal gland are:
• Cushing disease
• Addison disease
• Primary aldesteronism

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Cushing disease:

• Causes:
• Cushing disease is a condition in which the pituitary gland releases too much adrenocorticotropic hormone (ACTH).
• The pituitary gland is an organ of the endocrine system. 
• Cushing disease is a form of Cushing syndrome

• Symptoms:
• Severe fatigue.
• Muscle weakness.
• Depression, anxiety and irritability.
• Loss of emotional control.
• Cognitive difficulties.
• New or worsened high blood pressure.
• Headache.
• Infections.

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Addison disease:

• Causes:
• In Addison's disease, your adrenal glands, located just above your kidneys
• Produce too little cortisol and, often, too little aldosterone.

• Symptoms:
• lack of energy or motivation (fatigue)
• muscle weakness.
• low mood.
• loss of appetite and unintentional weight loss.
• increased thirst.

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Primary aldosteronism:

• Causes:
• Primary aldosteronism, also known as primary hyper-aldosteronism or Conn's syndrome, refers to the excess production of the hormone aldosterone from the adrenal glands,
• Resulting in low renin levels.
• This abnormality is caused by hyperplasia or tumors

• Symptoms:
• The first clue that you may have primary aldosteronism is usually high blood pressure, especially hard to control blood pressure.
• Muscle cramps.
• Weakness.
• Fatigue.
• Headache.
• Excessive thirst.
• A frequent need to urinate.

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Pancrease:

• The pancreas is an organ located in the abdomen.
• It plays an essential role in converting the food we eat into fuel for the body's cells.
• The pancreas has two main functions: an exocrine function that helps in digestion and an endocrine function that regulates blood sugar.

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Disorders of islets of langerhans:

• Major disorders of pancrease are:

• Diabetes mellitus
• Hpoglycemia
• Pancreatitis
• Pancreatic cancer

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Diabetes mellitus:

• Causes:
• Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high.
• Urination and thirst are increased, and people may lose weight even if they are not trying to.

• Symptoms:
• Increased thirst.
• Frequent urination.
• Extreme hunger.
• Unexplained weight loss.
• Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough available insulin)
• Fatigue.
• Irritability.
• Blurred vision.

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Hypoglycemia:

• Causes:
• Hypoglycemia is a condition in which your blood sugar (glucose) level is lower than normal. Glucose is your body's main energy source. 
• Hypoglycemia is often related to diabetes treatment. 

• Symptoms:
• sweating.
• feeling tired.
• dizziness.
• feeling hungry.
• tingling lips.
• feeling shaky or trembling.
• a fast or pounding heartbeat (palpitations)
• becoming easily irritated, tearful, anxious or moody.

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Pancreatitis:

• Causes:
• Pancreatitis is inflammation of the pancreas.
• It happens when digestive enzymes start digesting the pancreas itself

• Symptoms:
• Upper abdominal pain.
• Abdominal pain that radiates to your back.
• Abdominal pain that feels worse after eating.
• Fever.
• Rapid pulse.
• Nausea.
• Vomiting.
• Tenderness when touching the abdomen.

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Pancreatic cancer:

• Causes:
• Smoking.
• Diabetes.
• Chronic inflammation of the pancreas (pancreatitis)
• Family history of genetic syndromes that can increase cancer risk, including a BRCA2 gene mutation, Lynch syndrome and familial atypical mole-malignant melanoma (FAMMM) syndrome.
• Family history of pancreatic cancer.
• Obesity.

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• Symptoms:
• Abdominal pain that radiates to your back.
• Loss of appetite or unintended weight loss.
• Yellowing of your skin and the whites of your eyes (jaundice)
• Light-colored stools.
• Dark-colored urine.
• Itchy skin.
• New diagnosis of diabetes or existing diabetes that's becoming more difficult to control.
• Blood clots.

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Disorders of ovary:

• The ovary is an organ found in the female reproductive system that produces an ovum.
• When released, this travels down the fallopian tube into the uterus, where it may become fertilized by a sperm.

• Major disorders of ovary are:

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• Amenorrhea
• Hypogonadism
• Polysystic ovary

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Amenorrhea:

• Causes:
• Hormonal issues stemming from problems with the hypothalamus or the pituitary gland.
• Structural problem with the reproductive organs, such as missing parts of the reproductive system.

• Symptoms:
• Milky nipple discharge.
• Hair loss.
• Headache.
• Vision changes.
• Excess facial hair.
• Pelvic pain.
• Acne.

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Hypogonadism:

• Causes:
• Hypogonadism means diminished functional activity of the gonads-the testes or the ovaries
• That may result in diminished production of sex hormones.
• Low androgen (e.g., testosterone) levels are referred to as hypoandrogenism and low estrogen (e.g., estradiol) as hypoestrogenism.

• Symptoms:
• Erectile dysfunction.
• low sperm count.
• depressed mood.
• decreased libido.
• lethargy.
• sleep disturbances.
• decreased muscle mass and strength.
• loss of body hair (pubic, axillary, facial)

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Polycystic ovary:

• Causes:
• Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age.
• Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels.
• The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs

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• Symptoms:
• Missed periods, irregular periods, or very light periods.
• Ovaries that are large or have many cysts.
• Excess body hair, including the chest, stomach, and back (hirsutism)
• Weight gain, especially around the belly (abdomen)
• Acne or oily skin.
• Male-pattern baldness or thinning hair.
• Infertility.

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Disorders of testes:

• The testes (or testicles) are a pair of sperm-producing organs that maintain the health of the male reproductive system.
• The testes are known as gonads.
• Their female counterpart are the ovaries

• Major disorders of testes are:

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• Hypogonadism
• Testicular cancer

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Hypogonadism:

• Causes:
• Either type of hypogonadism can be caused by an inherited (congenital) trait or something that happens later in life (acquired), such as an injury or an infection.
• At times, primary and secondary hypogonadism occur together.

• Symptoms:
• Erectile dysfunction.
• low sperm count.
• depressed mood.
• decreased libido.
• lethargy.
• sleep disturbances.
• decreased muscle mass and strength.
• loss of body hair (pubic, axillary, facial)

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Testicular cancer:

• Causes:
• It's not clear what causes testicular cancer in most cases.
• Doctors know that testicular cancer occurs when healthy cells in a testicle become altered.
• Healthy cells grow and divide in an orderly way to keep your body functioning normally.

• Symptoms:
• A painless lump or swelling on either testicle
• Pain, discomfort, or numbness in a testicle or the scrotum, with or without swelling
• Change in the way a testicle feels or a feeling of heaviness in the scrotum
• Dull ache in the lower abdomen or groin
• Sudden buildup of fluid in the scrotum
• Breast tenderness or growth

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Conclusion:

• Human body is made in such a way that it functions accurately, but still major or

minor alterations can lead to

disastrous life long

deformities.

• Many of the diseases are

genetically transmitted.

• So it’s important to know

about these diseases as it

will help us in future to find

better measures against them.

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References:

• https://www.slideshare.net/FIRDOUS88/endocrine-disorders-12818909
• https://www.hormone.org/what-is-endocrinology/the-endocrine-system
• https://www.researchgate.net/figure/Forty-nine-year-old-patient-with-severe-posttraumatic-hypopituitarism-Clinical_fig1_277918854
• Video link:
• https://www.youtube.com/watch?v=OSanyCNM0SY
• https://www.youtube.com/watch?v=rqFvilz_Ss0

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