Metabolic/Endocrine Disorders

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The Endocrine System.

Endocrine and metabolic diseases span a vast range of conditions. The endocrine system works via chemical messages (hormones) secreted from glands directly into the circulatory system to regulate the function of distant target organ. Feedback loops works to maintain the release of these hormones and so maintain homeostasis ie the state of steady conditions vital for life.[1]

Glands of the Endocrine system

Each gland of the endocrine system releases specific hormones into your bloodstream. These hormones travel through your blood to other cells and help control or coordinate many body processes.

They include:

  • Adrenal glands: Two glands that sit on top of the kidneys that release the hormone cortisol.
  • Hypothalamus: A part of the lower middle brain that tells the pituitary gland when to release hormones.
  • Ovaries: The female reproductive organs that release eggs and produce sex hormones.
  • Islet cells in the pancreas: Cells in the pancreas control the release of the hormones insulin and glucagon.
  • Parathyroid: Four tiny glands in the neck that play a role in bone development.
  • Pineal gland: A gland found near the center of the brain that may be linked to sleep patterns.
  • Pituitary gland: A gland found at the base of brain behind the sinuses. It is often called the "master gland" because it influences many other glands, especially the thyroid. Problems with the pituitary gland can affect bone growth, a woman's menstrual cycles, and the release of breast milk.
  • Testes: The male reproductive glands that produce sperm and sex hormones.
  • Thymus: A gland in the upper chest that helps develop the body's immune system early in life.
  • Thyroid: A butterfly-shaped gland in the front of the neck that controls metabolism.[2]

The diagram on the right shows the glands of the endocrine system ( Pineal gland, Thalamus, Pituitary gland,Thyroid, Adrenal glands, Pancreas, Uterus,Ovaries, Testes).

[3]

The endocrine system involves many organ systems and hormones, many of which are still being investigated.[4]

Endocrine Disorders- pathological process

A malfunction in the endocrine systems (either the glands, hormones, receptors or organs impacted by hormones) can cause an endocrine disorder. The various dysfunctions can cause wide-ranging effects on the body.The disorders arise from the multitude of effects caused by too little or too much secretion of a hormone, too little or too much action of a hormone, or problems with receiving the hormone.[1] A metabolic disorders occurs when an improper level of a hormones alters the body’s metabolism and affect its function (diabetes is an example).[5]

[6]

Causes of Endocrine Disorders

Endocrine disorders are typically grouped into two categories:

  • Endocrine disease that results when a gland produces too much or too little of an endocrine hormone, called a hormone imbalance.
  • Endocrine disease due to the development of lesions (such as nodules or tumors) in the endocrine system, which may or may not affect hormone levels.

The endocrine's feedback system helps control the balance of hormones in the bloodstream. If your body has too much or too little of a certain hormone, the feedback system signals the proper gland or glands to correct the problem. A hormone imbalance may occur if this feedback system has trouble keeping the right level of hormones in the bloodstream, or if your body doesn't clear them out of the bloodstream properly.

Increased or decreased levels of endocrine hormone may be caused by:

  • A problem with the endocrine feedback system
  • Disease
  • Failure of a gland to stimulate another gland to release hormones (for example, a problem with the hypothalamus can disrupt hormone production in the pituitary gland)
  • A genetic disorder, such as multiple endocrine neoplasia (MEN) or congenital hypothyroidism
  • Infection
  • Injury to an endocrine gland
  • Tumor of an endocrine gland

Most endocrine tumors and nodules (lumps) are noncancerous. They usually do not spread to other parts of the body. However, a tumor or nodule on the gland may interfere with the gland's hormone production.[2]

Epidemiology

Endocrine disorders with U.S. prevalence estimates of at least 5% in adults included diabetes mellitus, impaired fasting glucose, impaired glucose tolerance, obesity, metabolic syndrome, osteoporosis, osteopenia, mild-moderate hypovitaminosis D, erectile dysfunction, dyslipidemia, and thyroiditis. Erectile dysfunction and osteopenia/osteoporosis had the highest incidence in males and females, respectively. The least prevalent conditions, affecting less than 1% of the U.S. population, were diabetes mellitus in children and pituitary adenoma. Conditions with the lowest incidence were adrenocortical carcinoma, pheochromocytoma, and pituitary adenomas. Certain disorders, such as hyperparathyroidism and thyroid disorders, were more common in females. As expected, the prevalence of diabetes mellitus was highest among ethnic minorities.[7]

Clinical Presentation

Due to the complex and interconnected nature of the endocrine system, a wide range of conditions with distinct clinical presentations, can result in endocrine disorders.

including:


Testing for Endocrine Disorders

If you have an endocrine disorder, your doctor may refer you to a specialist called an endocrinologist. An endocrinologist is specially trained in problems with the endocrine system. The symptoms of an endocrine disorder vary widely and depend on the specific gland involved. However, most people with endocrine disease complain of fatigue and weakness. Blood and urine tests to check your hormone levels can help your doctors determine if you have an endocrine disorder. Imaging tests may be done to help locate or pinpoint a nodule or tumor.treatment of endocrine disorders can be complicated, as a change in one hormone level can throw off another. Your doctor or specialist may order routine blood work to check for problems or to determine if your medication or treatment plan needs to be adjusted.[2]
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Management / Interventions

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see individual disorders above and the managements and physiotherapy involved.

References

  1. 1.0 1.1 Wikipedia. Endocrine system. Available from: https://en.wikipedia.org/wiki/Endocrine_system (last accessed 6.4.2019)
  2. 2.0 2.1 2.2 WebMD. Endocrine Disorders. Available from:https://www.webmd.com/diabetes/endocrine-system-disorders#1 (accessed 10/4/2019)
  3. Cool facts. How does endocrine system works. Available from: https://www.youtube.com/watch?v=IAXv8Kxt4QU&app=desktop (last accessed 6.4.2019)
  4. Better Health. Endocrine system. Available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hormonal-endocrine-system (last accessed 6.4.2019)
  5. Tampa general hospital. Endocrine disorders. Available from: https://www.tgh.org/services/diabetes-endocrinology/endocrine-disorder-causes (last accessed 7.4.2019)
  6. Krislynn314. Diseases and conditions of the endocrine system. Available from: https://www.youtube.com/watch?v=sz8_OGqu0sM (last accessed 7.4.2019)
  7. Golden SH, Robinson KA, Saldanha I, Anton B, Ladenson PW. Prevalence and incidence of endocrine and metabolic disorders in the United States: a comprehensive review. The Journal of Clinical Endocrinology & Metabolism. 2009 Jun 1;94(6):1853-78.