Understanding Hormones
In its simplest form, a hormone is a chemical messenger from one cell (or group of cells) to another. Hormones are secreted by endocrine glands. The effect is to communicate with distant parts of the body. For example, the adrenal gland secretes adrenalin which has an affect on several different organs including heart, muscles, brain, skin, and so on. While every organ system secretes and responds to hormones (including the brain, lungs, heart, intestine, skin and the kidneys), the clinical specialty of endocrinology focuses primarily on the endocrine organs, that is the organs whose primary function is hormone secretion. These organs include the pituitary, thyroid, adrenals, ovaries, testes and pancreas.
In most cases, hormones reach their destinations by being secreted directly into the blood stream rather than into a duct system.
Different Hormones and Their Functions
Hormones have many different functions and types of action; one hormone may have several effects on different target organs, whilst, conversely, one organ may be affected by more than one hormone type. The human body secretes, literally, thousands of different types of hormones, including:
- Amines, such as epinephrine (also known as adrenaline) and norepinephrine secreted by the adrenal glands, and dopamine
- Thyroid hormones such as T3 and thyroxine (or T4)
- Peptide hormones secreted by the pituitary gland, such as thyrotropin-releasing hormone (TRH), growth hormone (GH), luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
- Insulin secreted by the pancreas
- Steroid hormones including estrogen and progesterone from the ovaries, testosterone from the testes, and cortisol and aldosterone from the adrenal glands.
Diagnosis
The medical specialty of Endocrinology involves the diagnostic evaluation of a wide variety of symptoms and variations and the long-term management of disorders due to the deficiency or the excess of one or more hormones. The diagnosis and treatment of endocrine diseases are guided by laboratory tests to a greater extent than most other specialties. Many diseases are investigated through “excitation/stimulation” or “inhibition/suppression” testing. These procedures can involve injection with a stimulating agent (or suppression agent, as the case maybe) to test the function of an endocrine organ. Blood is then sampled to assess the changes of the relevant hormones or metabolites. Your FVH Endocrinologist, therefore, has an extensive knowledge of clinical chemistry and biochemistry, essential to understand the uses and limitations of the investigations.
A second important aspect of the practice of Endocrinology is distinguishing human variations from disease. Atypical patterns of physical development and abnormal test results must be assessed as indicative of disease or not. Diagnostic imaging of endocrine organs is sometimes required to help achieve a diagnosis.
Endocrinology involves caring for the person as well as treating the disease. Most endocrine disorders are chronic diseases that need life-long care. The most common of these is diabetes mellitus. Care of diabetes and other chronic diseases necessitates understanding the patient at the personal and social level, as well as, the molecular, and the physician-patient relationship is a very important component of the treatment.
Most Common Endocrine Diseases and Conditions
Thyroid disorders:
- Hyperthyroidism and Graves-Basedow disease
- Hypothyroidism
- Thyroiditis
- Thyroid cancer
Glucose homeostasis disorders:
- Diabetes mellitus
- Hypoglycemia
Parathyroid gland disorders:
- Hyperparathyrodism
- Hypoparathyroidism
- Pseudohypoparathyroidism
Metabolic bone disease:
- Osteoporosis
- Osteitis deformans (Paget’s disease of bone)
- Rickets and Osteomalacia
Pituitary gland disorders:
- Diabetes insipidus
- Hypopituitarism
- Pituitary tumours
- Pituitary adenomas
- Prolactinoma (or Hyperprolactinemia)
- Acromegaly, Gigantism
- Cushing’s disease
Sex hormone disorders:
- Disorders of sex development
- Hermaphroditism
- Gonadal dysgenesis
- Androgen insensitivity syndromes
- Hypogonadism
- Gonadotropin deficiency
- Kallmann syndrome
- Klinefelter syndrome
- Ovarian failure
- Testicular failure
- Turner syndrome
- Disorders of puberty
- Delayed puberty
- Precocious puberty
- Menstrual function or fertility disorders
- Amenorrhea
- Polycystic ovary syndrome
Adrenal disorders:
- Adrenal insufficiency
- Addison’s disease
- Congenital adrenal hyperplasia
- Mineralo-corticoid deficiency
- Conn’s syndrome
- Cushing’s syndrome
- Pheochromocytoma
- Adrenocortical carcinoma
Treatments
Treatment for diabetes includes:
- Medications particularly insulin or specific drugs depending on the type of Diabetes
- Educating the patient of the illness, its complications. In general, the advice given to diabetic patients is how to lead a more normal life including correct nutrition / exercises/ lifestyle etc and how to self-administer Insulin injections
- Depending on each case, patients will be treated according to the latest available information about this disease.
Treatment for Thyroid conditions, depending on the type and stage of the illness:
- Nuclear Medicine - diagnosis to determine the type of thyroid and best treatment
- Medication
- Surgery
