CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David

2 Physiologic Regulatory Systems o contribute to the basic processes of

Endocrine system reproduction
Nervous system o help maintain homeostasis
o Neuroendocrine System Types of Hormones
_____________________________________________ Circulating hormones/Endocrines:
Types of Glands Local Hormones
Endocrine o Paracrines
Exocrine o Autocrines

Types of Endocrine Control Functional Types of Hormones

o Releasing Hormones:
Negative feedback promote secretion of Ant. Pituitary
A homeostatic mechanism that opposes or hormones
resists a change in the body's internal o Inhibitory Hormones:
conditions. suppress the secretion of a particular
Positive feedback hormone
A mechanism that increases or enlarges a o Tropic Hormones:
change in the body's internal conditions. stimulate growth & activity of other
_____________________________________________ endocrine glands
Endocrine System o Effector Hormones:
consists of ductless glands, which secrete targets non endocrine cells
hormone directly into the circulatory system
Major Glands of Endocrine System Types of Hormones according to
Pituitary Gland Structure
Thyroid Gland Steroids
Parathyroid Gland Biogenic Amines
Adrenal Gland Peptides and Proteins
Pancreas Glycoproteins
Reproductive Glands (ovaries & testes) Eicosanoids
Thymus Gland
Pineal Gland Steroids
lipids derived from cholesterol
Hormones
transported to blood stream through
from a Greek word hormon
attachment to transport protein
meaning to set in motion
Example: Aldosterone, cortisol, estrogen,
intercellular chemical signal
progesterone, testosterone, androgen
transported to act on tissues at
another site of the body to influence
Biogenic Amines (AA)
their activity o Tyrosine
Functions of Hormones: Thyroid hormones
o regulate the chemical composition and o T3-triiodothyronine
volume of the ECF o T4-thyroxine
o help regulate metabolism and energy Adrenal hormones
balance o Epinephrine
o help regulate contraction of smooth and o Norepinephrine/cathecholamine
cardiac muscles and secretion of glands s
o help maintain activities of immune system
o plays a role in the smooth sequential Peptides and Proteins
integration of growth and development synthesized by rough ER
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
hypothalamic releasing and inhibiting
hormone
Oxytocin, ADH, Insulin, Glucagon, GH,
calcitonin

Glycoproteins
AA derivatives with CHO groups
TSH, FSH, LH
1st target: Ant.Pituitary gland
Eicosanoids Thyrotropin
Fatty acids FSH
with 20 carbon atom fatty acid LH
nd
(arachidonic fatty acid) 2 target: A. Thyroid
prostaglandin T3
T4 to muscles and liver
Mechanism of Hormone action: B. ovaries and testes:
Estrogen
Progesterone
Testosterone to reproductive organs
Post Pituitary Gland
Responsible for blood glucose
Islet cells of pancreas
Insulin
Glucagon to liver and muscles
_____________________________________________

Hypothalamus
Nonsteroid Hormones collection of specialized cells located
Steroid Hormones at the central part of the brain
_____________________________________________ main link between the endocrine &
nervous system
General Mechanism of Hormone Action control the pituitary gland by
Hormone binds to cell surface or production of chemicals that stimulate
receptor inside target cell or suppress hormone secretion of
Cells may then pituitary
o Synthesize new molecules Hormones:
o Change permeability of TRH: Thyrotropin releasing hormones
membrane GnRH: Gonadotropin releasing
o Alter rates of reaction hormone
Each target cell responds to hormone GH-IH: Growth hormone inhibiting
differently hormone
o At liver cells insulin stimulates GH:RH: Growth hormone releasing
glycogen synthesis hormone
o At Adipocytes insulin CRH: Corticotropin releasing hormone
PIF: Prolactin inhibiting factor
stimulates Triglyceride synthesis
_____________________________________________
_____________________________________________
Pituitary Gland (hypophysis)
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
small egg shaped gland located at the
base of the brain beneath the
hypothalamus
master gland
divided into 2 lobes: anterior &
posterior
Anterior Pituitary Gland
regulates the activity of thyroid,
adrenals, and reproductive glands
GH, PRL, TSH, FSH, LH, ACTH
o Regulate activity of thyroid,
adrenals and reproductive
glands
also secretes ENDORPHINS
o
Hormones:
GH: growth of bone and soft tissues
PRL: for lactation
TSH: release of thyroid hormones
FSH: growth of the follicle and initial
wave of spermatogenesis
LH: ovulation and final follicular
growth and production of testosterone
ACTH: release of cortisol
Growth Hormone
stimulates AA transport and nucleic
acid & CHON synthesis
exerts major effects on cartilage and
growth of long bones
o AA transport and nucleic acid
and CHON Synthesis
o Increases hepatic glucose effect
w/ anti-insulin effect in muscles
o Increases lipolysis elevating
plasma free FA(ketogenesis in
diabetes)
increases hepatic glucose effect in
excess and exerts anti-insulin effect in
muscles
increases lipolysis elevating levels of
plasma free FA
Factors affecting GH secretion:
Stimulate GH:
Sleep
Exercise
Physiologic stress
Amino acids(arginine)
Hypoglycemia
Sex Steroids(estradiol)
Alpha antagonist(norepinephrine)
Beta blocker(Propanolol)
Inhibiting GH:
Glucose loading
Beta agonist(epinephrine)
Alpha blockes(phentalamine)
Emotional/psychogenic stress
Nutritional deficiency
Insulin deficiency
Throxine deficiency
Hormones that influences
secretion and metabolic effect of
GH: Thyroxine, cortisol, estrogen,
somatostatin, Somastatin releasing
factor
Test of GH insufficiency:
Stimulation test
o after exercise or during sleep,
GH normally increases
o Clonidine(potent GH stimulant)
Prolactin (PRL)
controls the initiation and
maintenance of lactation
o induces ductal growth
o development of breasts
o lobular alveolar system
o synthesis of specific milk
proteins
act directly on mammary glands
requires priming by estrogens,
progestins, corticosteroids, thyroid
hormones, and insulin
Thyroid Stimulating Hormone (TSH)
increases:
o size of thyroid follicular cells
o uptake of iodide by thyroid cells
from the ECF
o release of thyroxine from the
thyroid colloid follicles
o biosynthesis of thyroxine
differentiates pituitary (secondary)
hypothyroidism from primary
hypothyroidism
Follicle Stimulating Hormone (FSH)
gonadotropic hormones
growth and maturity of ovarian
follicles
estrogen secretion
promotes endometrial changes
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
(1st: proliferative phase of mens),
spermatogenesis
Luteinizing Hormone (LH)/(ICSH)
gonadotropic hormones
ovulation and secretion of androgens
and progesterone
initiates secretory phase of mens
(2nd)
formation of corpus luteum
development of testicular cells
Adrenocorticotropic Hormone (ACTH)
acts primarily on the adrenal cortex, to
stimulate growth and secretion of
corticosteroids
follows circadian rhythm
elevated during times of stress
_____________________________________________
Summary of Anterior pituitary Gland:
GH(growth hormone)
o Growth of bone and soft tissues
PRL(prolactin)
o For lactation
TSH(thyroid stimulating hormone)
o Release of thyroid hormones
FSH(follicle stimulating hormone)
o Growth of follicle(Female)
o Initial wave of
spermatogenesis(male)
LH(luteinizing hormone)
o Ovulation and final follicular
growth(female)
o Production of
testosterone(male)
ACTH(adrenocorticotropic
hormone)
o Release of cortisol
_____________________________________________
Types of cells
Acidophils: GH, PRL
Basophils: TSH, FSH, LH, ACTH
Chromophobes
_____________________________________________
Posterior Pituitary Gland
Hormones:
Oxytocin or pitocin:
o for contraction of uterus and
ejection of milk primed with
estrogen
ADH or arginine vasopressin or
pitressin:
o permeability of kidney tubules
DISEASES ASSOCIATED WITH
HORMONES OF THE PITUITARY
GLAND
Dwarfism
hyposecretion of GH during growth years
types:
o Achrondroplasia
o Hypoachondroplasia
o Spondyloepiphyseal Dysplasia
o Diastrophic dysplasia
Gigantism
hypersecretion of GH during childhood
Acromegaly
hypersecretion of GH during adulthood
Features:
o Course facial features
o Soft tissue thickening(lips)
o Spade like hands
o Protruding jaw(prognathism)
o Sweating
o Impaired glucose tolerance or
DM
Dx of Acromegaly
o OGTT and GH measurement
o Hyperglycemia should suppress
GH to <1ug/L
o After Treatment, failure to
suppress GH below 2ug/L may
cause higher prevalence of DM,
heart disease and hypertension
Galactorrhea
inappropriate production of breast milk
due to hypersecretion of PRL
symptoms:
o irregular menstruation
o menopausal symptoms
o milk discharges
o difficulty in getting erection
o breast tenderness and
enlargement
Amenorrhea
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
absence of menstrual cycle in females Infarction
due to hypersecretion of PRL Infection
Familial
Impotence Idiopathic
inability to attain penile erection in Monotropic hormone deficiency
males Laboratory Measurement of Some
due to hypersecretion of PRL
Hormones Secreted by the Pituitary
Gland
Infertility
Sandwich ELISA
lack of FSH and LH in both male and
o Capture Ab Assay diluent Std
female
and Samples Detection Ab
inability to conceive after 1 year of
Avidin HRP Substrate Stop
unprotected intercourse
solution
o Read at absorbance at 450nm
Cushings disease
o Explained by mam basta
hypersecretion of ACTH
mukang sandwich
leads to bilateral adrenal hyperplasia
Indirect ELISA
and cortisol overproduction
o Antigen coating Diluted
Obesity!!
Samples Detection Ab +
enzyme Substrate
o Read at Absorbance 405nm
Addisons disease
secondary (ACTH) or tertiary (CRH)
adrenal insufficiency Growth Hormone Immunoassay
hyposecretion of glucocorticoids and uses specific GH antibody
aldosterone draw specimens every 20-30 minutes
over a 1224 hours period
Polyuria Insulin tolerance test: to produce
deficient ADH production or action hypoglycemia and provoke GH release
o Hypothalamic DI Basal: 2-5 ng/mL or ug/L
o Nephrogenic DI Insulin tolerance: >10 ng/mL
o Psychogenic or primary Arginine/L-dopa: >7.5 ng/mL
polydipsia

Syndrome of Inappropriate ADH hGH-EASIA

Secretion (SIADH) solid phase Enzyme Amplified
autonomous sustained production of Sensitivity Immunoassay
AVP in the absence of known stimuli Mab 1-hGH-Mab-HRP
for its release absorbance is measured after
malignancy, CNS diseases, pulmonary colorimetric reaction
disorders drug therapies Day: <0.2-10 uIU/mL
Decreased: Night: 30 uIU/mL
Urine volume
Increased: Prolactin Immunoassay
Sodium concentration homologous competitive binding
Urine osmolality immunoassay/sandwich technique
uses two or more antibodies
Hypopituitarism directed at different parts of the
o Panhypopituitarism PRL molecule
Tumors hook effect
Trauma Adult male: 3-14.7 ng/mL or ug/L
Radiation therapy Adult female: 3.8-23 ng/mL or ug/L
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
Pregnancy, 3rd tri: 95-473 ng/mL Luteinizing Hormone ( LH) 2-18 mIU/ml
Follicle Stimulating Hormone ( FSH): 2-
ACTH Immunoassay 18 mIU/ml
measures the amount of Estradiol ( Day 3): <50 pg/ml
adrenocorticotropic hormone (ACTH) in
blood Fertility test (female)
like chemiluminescence and ELISA
Phase of Cycle
using ACTH antisera related test:
Hormone Follicular Day of LH Surge
cortisol
FSH < 10 mIU/ml> 15 mIU/ml
reacts with intact ACTH and ACTH
LH < 7 mIU/ml > 15 mIU/ml
fragments
PRL < 25 ng/ml
o Adults: 5-80 pg/mL (X 0.22=
pmol/L)
FSH: measures your ovarian
o Specimen: P, EDTA
reserve (ovarian function)
low levels of FSH & LH:
ACTH Stimulation Test
hypogonadotropic hypogonadism
cosyntropin test or tetracosactide test
high LH with a normal FSH level:
small amount of synthetic ACTH is injected,
PCOD (polycystic ovarian disease)
and the amount of cortisol or Aldosterone is
high prolactin: hyperprolactinemia
measured
distinguish whether the cause is adrenal
Hormone Follicular Day of LH Surge
(low cortisol and aldosterone production) or
Estradiol < 50 pg/ml > 100 pg/ml
pituitary (low ACTH production)
Progesterone < 1.5 ng/ml > 15 ng/ml
Fasting (8 hrs)
estradiol: rises as follicle matures
mature follicles: > 200-300 pg/ml of
estradiol; for monitoring superovulation
LH Ovulation Dipstrip Urine Test
P >15 ng/ml about 7 days after ovulation:
coloured bands will appear on the test
corpus luteum is functioning normally
card to indicate whether or not the LH
low Day 21 P suggests the cycles was
surge is occurring
anovulatory
presence of two purple bands of
similar color and intensity indicate an
Serum FSH Measurement (IRMA)
increase in LH is detected
measures the amount of follicle
- test approximately the same
stimulating hormone (FSH) in blood
time each day
Mab1-serum-Mab2125I
- reduce liquid intake two hours
used to assess and manage disorders
before testing
of the endocrine glands, including
suspected infertility
LH Immunoassay (EIA/IRMA)
related tests: LH, PRL, testosterone,
Mab1-LH-Mab2HRP
estradiol
o measured using chromogenic
Normal Values for serum FSH
reaction
Female, menstruating:
o Absorbance proportional to LH
o Follicular phase: 1.4-9.9
concentration
mIU/mL (IU/L)
Mab1-LH-Mab2125I
o Ovulatory phase: 0.2-17.2
mIU/mL (IU/L)
Fertility test (male)
o Luteal phase: 1.1-9.2
Semen analysis
mIU/mL (IU/L)
Testosterone 300-1100 ng/dl
Postmenopausal: 19.3-100.6 IU/L
Prolactin 7-18 ng/ml
Male: 1-15.4 mIU/mL (IU/L)
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
ADH Measurement
measures the amount of antidiuretic
hormone, or vasopressin, in blood
Related tests: sodium and osmolality
270-280 mOsm/kg: <1.5 pg/mL (<1.4 pmol/L)
280-285 mOsm/kg: <2.5 pg/mL (<2.3 pmol/L)
285-290 mOsm/kg: 1-5 pg/mL (0.9-4.6 pmol/L)
290-295 mOsm/kg: 2-7 pg/mL (1.9-6.5 pmol/L)
295-300 mOsm/kg: 4-12 pg/mL (3.7-11.1
pmol/L)
_____________________________________________
Thyroid Gland
located in front of the lower neck
bow tie or butterfly like
Follicles: structural units of thyroid
Colloid: homogenous viscous fluid
consisting mainly of a glycoprotein
iodine complex called thyroglobin
secretes T3 and T4 and calcitonin
Types of cells:
Follicular cells: T3 and T4
o calorigenesis & O2 consumption
o CNS activity and brain
development
o Cardiovascular stimulation,
bone and tissue growth and
development
o GI regulation and sexual
maturation
Perifollicular cells:
o calcitonin
o regulation of calcium
T3 and T4
Hormone Bound ( Alb,glb) Free
T3 99.8% 0.2%
T4 99.98% 0.02
T3: Globulin and albumin only
T4: albumin(10%) pre albumin(30%: TBPA)
Globulin(60%:TBG)
_____________________________________________
DISEASES ASSOCIATED WITH
HORMONES OF THE THYROID GLAND
Cretinism
hyposecretion of thyroid hormones during
fetal life or infancy
Iodine deficiency
Myxedema
hypothyroidism during the adult years
Hashimotos disease
*eyes popping out*
acquired hypothyroidism in later childhood
due to development of autoantibodies to
thyroid tissue components
Goiter
an enlarged thyroid gland which is a
symptom of many thyroid disorders
Graves Disease
hyperthyroidism which is an autoimmune
disorder
hypersecretion of thyroid stimulating
immunoglobulins (TSIs)
_____________________________________________
Laboratory Measurement of Some
Hormones Secreted by the Thyroid
Gland
Serum Free Triiodothyronine
measures the amount of free
triiodothyronine (T3) in blood
used to evaluate and manage
disorders of the thyroid gland
related tests: TSH, FT4
Adults: 1.4-4.4 pg/mL (0.22-6.78 pmol/L)
N>37 weeks (cord blood): 15-391 pg/dL (0.2-6
pmol/L)
Pregnancy, 1st: 211-383 pg/dL (3.2-5.9 pmol/L)
Pregnancy, 2nd: 196-338 pg/dL (3-5.2 pmol/L)
Pregnancy, 3rd: 196-338 pg/dL (3-5.2 pmol/L)
Direct Equilibrium Dialysis
uses undiluted serum dialyzed for
16-18 hours at 37C
dialysate is then analyzed directly
using RIA
2-128 ng/L (2.6 to 165 pmol/L)
Ultracentrifugation
serum is adjusted to pH of 7.4
incubated for 20 minutes at 37C
ultracentrifuge for 30 minutes at 37C
and 2000 rpm
ultrafiltrate is analyzed by
immunoassay
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
less time consuming than dialysis
Triiodothyronine Measurement
measures the level of total T3 in blood
used to evaluate and manage
thyroid dysfunction, including
hyperthyroidism
related tests: FT4, T3 uptake
Adults: 60-181 ng/dL (0.92-2.78 nmol/L)
Pregnancy (last 5 mos): 116-247 ng/dL
(1.79-3.8 nmol/L)
Serum Total T4 Competitive Immunoassay
measures the total amount of
thyroxine/T4 (both free and CHON
bound)in blood
uses barbital buffers (vs TBPA) and 8-
anilino-1naphthalene-sulfonic acid (vs
TBG)
Adults: 4.5-10.9 g/dL (58-140
nmol/L)
TSH Immunoassay
measures the amount of thyroid
stimulating hormone (TSH) in blood
using chemiluminescence w/ low detection
limit
related tests: T3 and T4
Adults: 0.5-4.7 units/L
Pregnancy (1st): 0.3-4.5 units/L
Pregnancy (2nd): 0.5-4.6 L
Pregnancy (3rd): 0.8-5.2 L
Anti-TSH Receptor Autoantibody
for diagnosis of Graves disease
detects autoantibodies that interfere
with the binding of TSH to TSH
receptor
serum + TSH receptor + I125 labelled
TSH tracer amount of free tracer is
measured
lower than 9 U/L
Thyrotropin Releasing Hormone (TRH)
Stimulation Test
injection of TRH and measurement of the
output of TSH
used in the diagnosis of combined
pituitarythyroid disorders
differentiates 2 hypothyroidism and 3
hypothyroidism
_____________________________________________
Other Laboratory Tests:
RAI uptake:
based on the ability of the
thyroid to concenrate, convert and
release I2
TBI:
based on the thyroid hormone
transport system indirectly
measuring the amount of TBG
PBI:
based on thyroid hormone
concentration representing the
organic fraction of blood iodine that
precipitates with serum proteins
BMR:
based on metabolic response
measuring the O2 consumption in
the resting fasting state
Parathyroid Gland
four tiny glands attached to the thyroid
releases PTH
o actions directed to bone, kidney
and intestines
o controls calcium and phosphate
metabolism with the help of
calcitonin
Types of cells:
Chief cells Synthesis and secrete
hormone PTH
Oxyphil cells non secretory cell
- Seen only after puberty
_____________________________________________
DISEASE ASSOCIATED WITH HORMONES
OF THE PARATHYROID GLAND
Clinical significance of PTH
Tetany:
hypoparathyroidism and deficiency of
calcium
abnormally high PTH values may indicate
primary, secondary, or tertiary
hyperparathyroidism, chronic renal failure,
malabsorption syndrome, and vitamin D
deficiency
Laboratory method for PTH:
PTH level measurement:
o overnight fasting
o Intact PTH: 10-65 pg/mL
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
o PTH N-terminal (includes intact PTH):
8-24 pg/mL
o PTH C-terminal (includes C-terminal,
intact PTH, and midmolecule): 50-330
pg/mL
related tests: Calcium, Phosphorus and
Creatinine
ADRENAL GLAND
a triangular gland on top of the
kidney
Adrenal cortex -
o regulates salt & water balance,
responds to stress, metabolism,
immune system, & sexual
development & function
Adrenal medulla
consists of Chromaffin cells
produces catecholamines from
tyrosine
Hormones:
Outer zone (zona glomerulosa):
o mineralocorticoids (aldosterone)
Middle zone (zona fasciculata):
o glucocorticoids (cortisol and
cortisone) regulate CHO, CHON,
and fat metabolism
Inner zone (zona reticularis):
o sex hormones
Mineralocorticoids (aldosterone)
responsible for fluid and electrolyte
balance
sodium reabsorption and water retention
maintain osmolality
Glucocorticoids (cortisol & cortisone)
enhances glucose production from
CHONs, acting as insulin antagonist
(cortisol) only hormone to inhibit the
anterior pituitary secretion of ACTH by
negative feedback
(cortisone): reacts with stress
stimulate lipolysis, provide resistance
to stress and depress immune
responses
urinary metabolite: 17-
hydroxycorticosteroids
Sex hormones/Androgenic steroids
Estrogen, progesterone,
dehydroepiandrosterone (DHEA),
androstenedione, and testosterone
Male: development of sexual
characteristics, usually insignificant
Female: influence female sex drive,
pubic hair, axillary hair growth
Hormones
Epinephrine (70%)
Norepinephrine (30%)
Dopamine
mobilize energy stores and prepare
the body for muscular activity and
stressful conditions (increase heart
rate and BP, and increase blood sugar)
Urinary metabolite: vanillyl mandelic acid
(VMA)
_____________________________________________
DISEASES ASSOCIATED WITH
HORMONES OF THE ADRENAL GLAND
Hyperaldosteronism
hypersecretion of aldosterone
1: due to an adenoma, hyperplasia,
adrenal carcinoma, glucocorticoid
suppressible aldosteronism
o greatly affects electrolyte
balance
2: stimulus outside the adrenal gland
Hypoaldosteronism
deficient aldosterone production
seen in Addisons disease, kidney disease-
2 (hyporeninemic hypoaldosteronism),
enzyme defects, acquired due to heparin
therapy or surgery
Cushings syndrome
hypersecretion of cortisol
due to primary adrenal disease like
adenoma features: truncal obesity, moon
face, hypertension, hirsutism
Addisons disease
primary adrenal insufficiency
due to progressive dysfunction or
destruction of the gland
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
symptoms: fatigue, weakness, weight
loss, GI disturbances, postprandial
hypoglycemia
hyposecretion of adrenal hormones
Congenital Adrenal Hyperplasia
(Adrenogenital Syndrome)
congenital absence or deficiency of
one or more of the biosynthetic
enzymes needed in cortisol
biosynthesis
hyperplasia: ACTH stimulation because
of low levels of cortisol
ambiguous genitalia for girls, and
precocious puberty for boys
Virilism or hirtuism
elevated plasma testosterone in
women as a result of ovarian or
adrenal tumor (virilizing adenoma)
Gynecomastia
excessive growth (benign) of the male
mammary glands due to an adrenal
tumor (feminizing adenoma) which
secretes feminizing hormone
(estrogen)
Pheochromocytoma
tumor of the adrenal medulla that is a
cause of hypertension
Neuroblastoma
fatal malignant condition in children in
which cancer of the nervous system
causes excess production of
norepinephrine
_____________________________________________
Laboratory Measurement of Some
Hormones Secreted by the Adrenal
Gland
measures the amount of aldosterone
in blood
related tests: sodium and potassium
test is done in the morning
position affects the result: seat upright
alcohol intake
o supine, normal-Na diet: 2-9
ng/dL (55-250 pmol/L)
o upright, normal-Na diet: 2 to 5x
supine value
o upine, low-Na diet: 2 to 5x
supine value
o
Urine Free Cortisol Measurement (UFC)
measures the amount of cortisol in
urine
24-hour urine collection
avoid drinking alcohol before and
during the urine collection
normal: <2% of cortisol is seen urine
>120 g/day is diagnostic
o RIA (adults): 20-70 g/day
(55-193 nmol/24 hrs)
o HPLC (adults): 50 g/day
(138 nmol/24 hrs)
Serum Cortisol Measurement
amount of cortisol in blood
used to help diagnose adrenal gland
dysfunction caused by conditions such
as Addison's disease and Cushing's
syndrome
related test: ACTH
pregnancy (FE)
8 AM to noon: 5-25 g/dL (138-
690 nmol/L)
8 PM to 8 AM: 0-10 g/dL (0-276
nmol/L)
Dexamethasone Suppression Test
1 mg at midnight
serum cortisol is measured the following
day (8:00 AM)
suppressed to <5 ug/dL or 140 nmol/L
ACTH Stimulation test
Cosyntropin test
evaluates the hyposecretion of
adrenal gland
exogenous ACTH is administered
cortisol should be increased by
twofold to threefold within 60
minutes
Adrenal antibody test
detects antiadrenal antibodies,
which attack the body's own
adrenal gland, in blood
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
used to diagnose and monitor o Adults: 0.5 - 2.0 ng/mL
patients suspected to have (0.17 - 0.66 nmol/L)
autoimmune adrenocortical
insufficiency
related test: ACTH Anti-Insulin Antibody Test (RIA)
o Adults: Negative at 1:10 measures the amount of antibodies to
dilution insulin
_____________________________________________ used when insulin resistance in diabetes is
Pancreas suspected
lying immediately beneath the determination of the binding of 125I-Tyr-
stomach Al4- insulin to the serum fraction precipitated
both an exocrine and an endocrine by PEG
gland related test: Insulin C-peptide
<8.2% binding
Types of tissues:
Acini Glucagon Immunoassay (RIA)
Islets of Langerhans glucagon competes with 125I
tracer for binding sites
Hormones amount of 125I is measured and is
Glucagon: glycogenolysis and inversely proportional to the
gluconeogenesis concentration of glucagon
Insulin: glycogenesis, glycolysis, Fasting: 60-200 pg/mL
lipogenesis
Somatostatin Gonads
main source of sex hormones
Diabetes mellitus Testes: androgens (testosterone)
deficiency of insulin or defects in insulin sexual development (muscle
receptors enlargement, growth of body hair,
voice changes, male sexual drive)
Hyperinsulinism
hypersecretion of insulin Ovaries: located in the pelvis
may be due to a tumor, insulinoma secrete estrogen and progesterone and
relaxin
Glucagonoma for sexual development (breast
hypersecretion of glucagon by a enlargement, distribution of
tumor fats), menstruation, pregnancy
_____________________________________________
Somatostatinoma Diseases associated with Hormones
hypersecretion of somatostatin by a secreted by Gonads
tumor
_____________________________________________ Female Pseudohermaphroditism
Laboratory Measurement of some genetically female but whose
hormones secreted by the Pancreas phenotypic characteristics are,
to varying degrees, male
Insulin C-peptide Measurement exposure to androgens before
measures the level of a by-product the 12th week of gestation
of the hormone insulin called C-
peptide in blood Precocious Puberty
used to know how much insulin is development of secondary
being produced in the body sexual characteristics in girls <
fasting specimen 8 yrs old and boys < 9 years old
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
premature hair and breast _____________________________________________
development

Kallmann Syndrome
most common form of
hypogonadotropic
hypogonadism due to deficiency
of GnRH
both seen in males and females

Testicular Feminization Syndrome Thymus Gland

Androgen insensitivity
syndrome
defect in androgen action
males w/ female habitus &
develop breast tissue
blind vagina with rudimentary
testes
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Laboratory Measurement of some
hormones secreted by the Gonads
Estrone Measurement
measures the amount of estrone in blood
note pregnancy and menstruation
Pregnant: increases 10-fold
from 24th to 41st wk
Progesterone RIA
Mab1-Progesterone-Mab2125I
Serum Estradiol Measurement
used for conditions such as amenorrhea,
early puberty or hypogonadism
related tests: FSH, LH, testosterone, PRL
lies in the upper part of the thoracic cavity
important in the immune system,
especially early in life
secretes thymosin
helps in the development of WBCs (T
cells)
Pineal Gland/Body
small pinecone shaped located in the
middle of the brain
secretes melatonin
decreases the secretion of LH and
FSH by decreasing the release of
hypothalamic releasing hormone
(inhibits functions of reproductive
system)
plays an important role in the onset
of puberty
regulates sleep and wake cycle

Total Testosterone EIA

measure the total amount of testosterone
uses salicylates or sulfactants, pH
alterations, temperature changes, and
competing steroids
related tests: FSH, LH, PRL, free
testosterone
RIA (125I)