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Endocrine Hormones and Disorders Hyposecretion of Anti-Diuretic Hormone - Diabetes insipidus Due to decreased production of anti-diuretic hormone in the

supraoptic nucleus of the hypothalamus. Often associated with a head injury. Symptoms: Excessive diuresis and thirst (polyuria and polydipsia). Hyposecretion of Growth hormone - Pituitary dwarfism Due to decreased production of growth hormone from the somatotropic cells of the anterior pituitary. Generally due to a nonmalignant adenoma of the non-somatotropic tissue of the anterior pituitary. Symptoms: 1. Pronounced hypoglycemia. 2. In Lorain dwarfism: a. arrested sexual development b. stunted growth c. normal intelligence 3. In Frolich's dwarfism: a. arrested sexual development b. stunted growth c. mental retardation Hypersecretion of growth hormone - Giantism and Acromegaly Pituitary giantism is due to overproduction of growth hormone during childhood. Usually caused by an adenoma of the somatotropic cells. Symptoms: Excessive growth, hyperglycemia, diabetes mellitus, osteoporosis and high basal metabolic rate (BMR). Acromegaly excessive appositional growth of the skeleton resulting in thickening of the digits and facial features ("lantern jaw" and protruding brow ridges). Increase in height does not occur since at the time of the onset of acromegaly the epiphyseal plates have calcified. Except for growth in height, symptoms are the same as those for giantism. Hyposecretion of thymus or absence of gland

DiGeorge syndrome occurs in children born without a thymus gland. As a result, there is a lack of thymosin production. Thymosin is needed to stimulate the differentiation of T lymphocytes. Symptoms: 1. Little or no immune response. 2. Inability to resist bacterial, viral or fungal infections. 3. A lack of cancer cell surveillance. 4. Inability to reject foreign tissues. Hyposecretion of thyroid hormone Myxedema occurs in the adult due to low thyroxine production. This can be produced by an adenoma of non-thyrotropic cells in the anterior pituitary, low iodine in the diet or autoimmune destruction of the thyroid (Hashimoto's thyroiditis). Symptoms: 1. Low BMR and lower body temperature. 2. Increased fat deposition and lethargy 3. Low blood pressure, heart rate and respiratory rate 4. Goiter due to low levels of iodine in blood. Cretinism is due to hypothyroidism in infants or children. In addition to the symptoms seen in myxedema, the patient exhibits stunted growth, mental deficiency and immature sexual development. Hypersecretion of thyroid hormone Overproduction of thyroid hormone can be due to adenoma of the thyrotropic cells of the anterior pituitary, a thyroid tumor or an autoimmune reaction to TSH receptors on thyrotropic cells (Graves' disease). Symptoms: 1. 2. 3. 4. 5. 6. High BMR and high body temperature with profuse sweating. Increased appetite with weight loss. Increased heart rate, blood pressure and respiratory rate. Muscular tremor and nervousness Cardiac arrhythmias. Toxic goiter and exophthalmia (Graves' disease).

Hypersecretion of parathyroid hormone An excess of parathyroid hormone production is due to a tumor of the parathyroid gland.

Symptoms: 1. High blood calcium. 2. Decalcification of bone which leads to fractures (osteitis fibrosa cystica). 3. Cardiac arrhythmias. 4. Tetany in skeletal muscles. Hyposecretion of parathyroid hormone The non-function of the parathyroid glands produces below normal levels of calcium in the blood. Symptoms: 1. Spontaneous nerve depolarization causing muscular spasms, twitches and convulsions. 2. Trousseau sign - Cuffing the arm leads to irreversible flexion of fingers. 3. Chvostek sign - Tapping the facial nerve branches at the lower margin of the jaw produces contractions of facial muscles. Hyposecretion of insulin - Diabetes mellitus Due to a lack of insulin from nonfunctioning beta cells of the pancreatic islets. There are two primary forms of this disease: 1. Type I or juvenile onset diabetes mellitus generally occurs in people younger than 20 years (insulin dependent diabetes). This is the consequence of an autoimmune destruction of islet beta cells. 2. Type II or late onset diabetes mellitus usually occurs in people who are over the age of 40 and overweight. In many cases, diet and exercise can reverse symptoms. Symptoms: 1. Hyperglycemia 2. Polyuria, polydipsia and polyphagia. 3. Ketoacidosis which can lead to diabetic coma and death. Hypersecretion of insulin - hyperinsulinism A tumor of the islet beta cells will cause an overproduction of insulin. This will produce a pronounced hypoglycemia. There is a very low incidence of this condition. Symptoms:

1. 2. 3. 4. 4.

Anxiety and sweating. Body tremors Elevated body temperature Disorientation The patient can go into Insulin shock due to brain hypoglycemia.

Hyposecretion of glucagon - chronic hypoglycemia A decreased ability to secrete glucagon from pancreatic alpha cells has been associated with chronic hypoglycemia. Other contributing factors to this condition would be: 1. A beta cell tumor 2. Defect in the mechanism releasing glucose from the liver. 3. Addison's disease - low levels of corticosteroids which enhance glucose production. 4. Hyposecretion of growth hormone Hyposecretion of adrenal steroids - Addison's disease This is an uncommon disease since both adrenal glands must suffer a 90% loss of function before symptoms appear. In 25% of the cases, degeneration of the adrenal cortex is due to chronic TB. Autoimmune destruction of the cortical tissue is believed to be another cause. Symptoms: 1. Hypoglycemia, hyponatremia (low blood sodium) and hyperkalemia (high blood potassium). 2. Severe dehydration leads to hypovolemia. Low levels of body fluids, especially blood, will cause low blood pressure and can produce cardiac atrophy. 3. Gastrointestinal disorders 4. Low tolerance to stress or trauma 5. Hyperpigmentation due to elevated levels of ACTH in the blood. Hypersecretion of adrenal steroids - Cushing's syndrome Chief causes of Cushing's syndrome: 1. Hypersecretion of ACTH - Pituitary Cushing's syndrome is responsible for 60 to 70% of these cases. This condition is brought on by a pituitary adenoma. 2. Hypersecretion of adrenal steroids due to an adenoma of the adrenal cortex (20% of the cases) produces low levels of ACTH by negative feedback. This is called adrenal Cushing's syndrome.

3. Hypersecretion of ACTH by a non-endocrine cancer, e.g., lung carcinoma. This is called paraneoplastic Cushing's syndrome and is responsible for 10 to 15% of the cases. 4. Iatrogenic Cushing's syndrome is due to the long term use of glucocorticoids to control inflammation and edema or autoimmune diseases like rheumatoid arthritis. Symptoms: 1. Hyperglycemia due to enhanced gluconeogenesis. 2. Catabolism of body protein producing poor wound healing, easy bruising and muscular weakness. 3. Decreased immunity. 4. Hypernatremia leading to excessive water retention. 5. Hyperkalcemia and high blood pressure. 6. Shifting of fat deposits to the face ("moon face") and upper torso ("Buffalo hump"). 7. In a male child - Muscular hypertrophy ("pocket Hercules"). 8. In a female child or adult - Virilsm (bearded lady).

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Endocrine System The Endocrine System and Hormone Function Overview The Major Endocrine Organs Pituitary Gland Thyroid Gland Parathyroid Glands Adrenal Glands Pancreatic Islets Pineal Gland Thymus Gland Gonads Other Hormone-Producing Tissues and Organs

The Endocrine System and Hormone Function Overview

1. The endocrine system (Figure 9.1)is a major controlling system of the body. hormones, it stimulates such long-term processes as growth and developmen metabolism, reproduction, and body defense. 2. Endocrine organs are small and widely separated in the body. Some are mix (both endocrine and exocrine in function). Others are purely hormone prod 3. All hormones are fat-souble (steroid)or water-soluble (amino acid-based) ho 4. Endocrine organs are activated to release their hormones into the blood by humoral, or neural stimuli. Negative feedback is important in regulating ho levels in the blood. 5. Blood-borne hormones alter the metabolic activities of their target organs. T of a target organ to respond to a hormone depends on the presence of recept on its cells to which the hormone binds or attaches. 6. Fat-soluble (steroid) hormones directly influence the target cell's DNA by bi receptor sites in the nucleus (Figure 9.2). Water-soluble (amino acid-based) act through second messengers (Figure 9.3). Return to top The Major Endocrine Organs 1. Pituitary gland

The pituitary gland hangs from the base of the brain by a stalk and is enclos bone. It consists of a glandular (anterior) portion and a neural (posterior) p (Figure 9.4).

Except for growth hormone and prolactin, hormones of the anterior pituitar tropic hormones.

1. Growth hormone (GH): An anabolic and protein-conserving hormon promotes total body growth. Its most important effect is on skeletal m and bones. Hyposecretion during childhood results in pituitary dwar hypersecretion produces giantism (in childhood) and acromegaly (in adulthood). 2. Prolactin (PRL): Stimulates production of breast milk. 3. Adrenocorticotropic hormone (ACTH): Stimulates the adrenal corte release its hormones. 4. Thyroid-stimulating hormone (TSH): Stimulates the thyroid gland to thyroid hormone. 5. Gonadotropic hormones

a. Follicle-stimulating hormone (FSH): Beginning at puberty, stimulate development and estrogen production by the female ovaries; promot

production in the male. b. Luteinizing hormone (LH): Beginning at puberty, stimulates ovulatio converts the ruptured ovarian follicle to a corpus luteum, and causes corpus luteum to produce progesterone; stimulates the male's testes t testosterone. c. Releasing and inhibiting hormones made by the hypothalamus regula of hormones made by the anterior pituitary. The hypothalamus also hormones that are transported to the posterior pituitary for storage a release.

The posterior pituitary stores and releases hypothalamic hormones on comm

1. Oxytocin: Stimulates powerful uterine contractions and causes milk the nursing woman. 2. Antidiuretic hormone (ADH): Causes kidney tubule cells to reabsorb conserve body water and increases blood pressure by constricting blo vessels. Hyposecretion leads to diabetes insipidus. Return to top 2. Thyroid gland

a. The thyroid gland is located in the anterior throat. b. Thyroid hormone (thyroxine [T4] and triiodothyronine [T3]) is relea the thyroid follicles when blood levels of TSH rise (Figure 9.5). Thyro hormone is the body's metabolic hormone. It increases the rate at wh oxidize glucose and is necessary for normal growth and development iodine leads to goiter. Hyposecretion of thyroxine results in cretinism children and myxedema in adults. Hypersecretion results from Grav or other forms of hyperthyroidism. c. Calcitonin is released by C cells surrounding the thyroid follicles in r high blood levels of calcium (Figure 9.6). It causes calcium to be depo bones. 2. Parathyroid glands a. The parathyroid glands are four small glands located on the posterio the thyroid gland. b. Low blood levels of calcium stimulate the parathyroid glands to relea parathyroid hormone (PTH). It causes bone calcium to be liberated i blood. Hyposecretion of PTH results in tetany; hypersecretion leads bone wasting and fractures. Return to top

3. Adrenal glands a. The adrenal glands are paired glands perched on the kidneys. Each g two functional endocrine portions, cortex and medulla.

b. Three groups of steroid hormones are produced by the adrenal corte 1. Mineralocorticoids, primarily aldosterone, regulate sodium io and potassium ion (K+) reabsorption by the kidneys (Figure 9 release is stimulated primarily by low Na+ and/or high K+ lev blood. 2. Glucocorticoids enable the body to resist long-term stress by i blood glucose levels and depressing the inflammatory respons 3. Sex hormones (mainly male sex hormones) are produced in sm amounts throughout life. c. Generalized hypoactivity of the adrenal cortex results in Addison's d Hypersecretion can result in hyperaldosteronism, Cushing's disease, masculinization. d. The adrenal medulla produces catecholamines (epinephrine and norepinephrine) in response to sympathetic nervous system stimulati catecholamines enhance and prolong the effects of the fight-or-flight (Sympathetic nervous system) response to short-term stress. Hyperse leads to symptoms Typical of sympathetic nervous system overactivit Return to top

4. Pancreatic islets a. Located in the abdomen close to the stomach, the pancreas is both an and endocrine gland. The endocrine portion (islets) releases insulin a glucagon to blood (Figure 9.8). b. Insulin is released when blood levels of glucose are high. It increases glucose uptake and metabolism by body cells. Hyposecretion of insul in diabetes mellitus, which severely disturbs body metabolism. Cardi are polyuria, polydipsia, and polyphagia. c. Glucagon is released when blood levels of glucose are low. It stimulat liver to release glucose to blood by accelerating the conversion of glyc glucose, thus increasing blood glucose levels. 5. The pineal gland, located in the third ventricle of the brain, releases melaton affects biological rhythms and reproductive behavior. 6. The thymus gland, located in the upper thorax, functions during youth but a in old age. Its hormone, thymosin, promotes maturation of T lymphocytes, i in body defense. 7. Gonads a. The ovaries of the female, located in the pelvic cavity, release two hor 1. Estrogens: Release of estrogens by ovarian follicles begins at p under the influence of FSH. Estrogens stimulate maturation o female reproductive organs and development of secondary sex characteristics of the female. With progesterone, they cause th menstrual cycle. 2. Progesterone: Progesterone is released from the corpus luteum ovary in response to high blood levels of LH. It works with est establishing the menstrual cycle.

b. The testes of the male begin to produce testosterone at puberty in res LH stimulation. Testosterone promotes maturation of the male repro organs, male secondary sex characteristics, and production of sperm testes. c. Hyposecretion of gonadal hormones results in sterility in both female males. Return to top Other Hormone-Producing Tissues and Organs

1. The placenta is a temporary organ formed in the uterus of pregnant women primary endocrine role is to produce estrogen and progesterone, which mai pregnancy and ready breasts for lactation. 2. Several organs that are generally nonendocrine in overall function, such as t stomach, small intestine, kidneys, and heart, have cells that secrete hormone 3. Certain cancer cells secrete hormones. Return to top Last Modified: Wednesday, September 29, 2010 7:47 PM To receive additional information, contact Dr. Grass at jgrass@ccsf.org

hypersecretion of Growth Hormone:


gigantism in children and acromegaly in adults

hyposecretion of Growth Hormone:


pituitary dwarfism - if the condition occurs during childhood, slows long bone growth. Those with this condition are usually under 4 feet in height but are normally proportioned.

hyposecretion of ADH:
diabetes insipidus - polyuria, polydipsia, severe ionic imbalances

ADRENAL GLAND
hypersecretion of corticosteroids:
Cushing's syndrome - changes in carbohydrate and protein metabolism resulting in a puffy appearance. In extreme cases, changes such as "buffalo hump" and "moon face" occur.

hypersecretion of epinephrine and norepinephrine:


hypertension, hyperglycemia, nervousness, sweating. Complete exhaustion occurs.

hyposecretion of glucocorticoids and mineralocorticoids:


Addison's Disease - hypoglycemia, sodium and potassium imbalance, dehydration, hypotension, and rapid weight loss. Death occurs with lack of

The syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH) is a condition mostly found in patients diagnosed with small cell carcinoma of the lung, pneumonia, brain tumors, head trauma, strokes, meningitis, and encephalitis. This is a syndrome characterized by excessive release of antidiuretic hormone (ADH or vasopressin) from the posterior pituitary gland or another source. The result is hyponatremia, and sometimes fluid overload. Vasopressin has other important functions, addressed in the appropriate articles. of hormone
Hormones have the following effects on the body:

stimulation or inhibition of growth mood swings induction or suppression of apoptosis (programmed cell death) activation or inhibition of the immune system regulation of metabolism preparation of the body for mating, fighting, fleeing, and other activity preparation of the body for a new phase of life, such as puberty, parenting, and menopause control of the reproductive cycle hunger cravings

A hormone may also regulate the production and release of other hormones. Hormone signals control the internal environment of the body through homeostasis.