ENDOCRINOLOGY

Endocrine Glands
 Ductless glands
 Produce highly active chemical
regulators-hormones
 Hormones excreted into
bloodstream and carried to target
organs
 Functional Types of
Hormones
 Releasing Factors
 From hypothalmus
 Stimulate secretion of tropic hormones of
anterior pituitary
 Tropic Hormones: stimulate growth and
activity of other endocrine glands
 Nontropic (effector) hormones: exert
action on non-endocrine tissue
 Control and Regulation of
Hormones
 Primary control in hypothalmus
 Acted on by CNS or stress
 Secretes “releasing factors” which
stimulate anterior pituitary to secrete
tropic hormones
 Also secretes ADH and oxytocin (stored
and released by posterior pituitary)
 Anterior pituitary
 “master” gland- secretes tropic
hormones
 Also secretes Growth hormone, an
effector hormones
 Effector hormones exert feedback
inhibition on hypothalamus or the
anterior pituitary
 THYROID HORMONES
 Thyroid
 Small gland wrapped around trachea
 Secretes hormones that regulate
metabolic rate and oxygen consumption
 Also secretes calcitonin, a hormone that
aid in calcium metabolism
 Thryotropin releasing hormone (TRH)
made and released by hypothalmus
 TRH stimulating synthesis and
secretion of thyroid stimulating
hormone (TSH) by anterior pituitary.
 TSH stimulates synthesis and
secretion of T3 and T4 by thyroid.
 Circulating thyroid
hormones
 T3 (triiodothyronine) and T4
(thyroxine) – iodinated derivatives of
tyrosine
 Poorly soluble in plasma- transported
in blood by thyroid-binding globulins
(TBG) or albumin
 >99% is bound to these proteins,
<1% is “free”- free portion is active
Hyperthyroidism
 Symptoms: sweating, palpitations,
insomnia, tremors, anxiety, exophthalmos
 Most common cause-Grave’s disease
 Autoimmune disorder - antibodies to TSH
receptors
 Elevated T4 confirms diagnosis
 May need to measure “free T4” if abnormalities
in thyroid binding globulins.
 If T4 levels are normal, may need to
also measure T3 to rule out T3
thyrotoxicosis
Hypothyroidism
 Symptoms: dry skin, coarse/dry
hair, swelling of eyes, constipation,
lack of energy
 Decreased T4 in most cases

 Elevated TSH to confirm diagnosis

 Neonatal Hypothyroidism: cretinism
Parathyroid Hormone (PTH)
 Also called parathryin
 Synthesized by parathyroid gland
 Key hormone in regulating calcium ion
metabolism
 Acts on bone, kidney, GI tract to reabsorb or
conserve calcium ions
• Reduces urinary excretion of calcium
• Increases bone resorption (release of calcium from bone
• Increases synthesis of active form of Vitamin D- stimulates
intestinal reabsorption of calcium
 Hyperparathyroidism- causes
hypercalcemia (other cause of
hypercalcemia is malignancy)
 Symptoms:
 Bone pain, osteoporosis
 Kidney stones, flank pain, polyuria

 Anorexia, constipation, vomiting

 Anxiety, depression, fatigue

Anterior Pituitary Hormones
 Growth Hormone (GH) or Somatropin
 Release stimulated by growth hormone
releasing factor – suppressed by
somatostatin
 Promotes protein synthesis- stimulates
bone growth
 Decreased: dwarfism
 Increased: Giantism
 Diurnal variation: highest around
midnight
 Gonadotropins (FSH and LH)
 Induce growth of gonads
 Induce secretion of gonadal hormones

 Necessary for production of ova and

development of sperm
 Surge in LH is basis of home ovulation
kits
 Prolactin
 Initiates and maintains lactation
 Useful in diagnosis, management, and
follow-up of prolactinomas
• Galactorrhea
• Infertility
 Posterior Pituitary
Hormones
 ADH (vasopressin):
 Increases reabsorption of water by
renal tubules
 Decreased levels in diabetes insipidus

 Oxytocin
 Contraction of smooth muscle
 Used to induce labor
 No medical reason to measure blood
levels
Adrenal Cortex Hormones
 Corticosteroids (Cortisol)
 Metabolism of proteins, carbohydrates,
lipids
 Diurnal variation, highest in morning
 Diagnosis of adrenalcortical disorders,
such as Cushing’s (increase) and
Addison’s disease (decrease)
 Often measure cortisol metabolites in
urine (17-ketogenic steroids and 17-
hydroxysteroids)
 Testosterone
 Aldosterone: increases sodium
reabsorption in renal tubules
Female Sex Hormones
 Ovarian Hormones – Estrogens
 Most potent is estradiol
 Menstrual difficulties (with FSH and LH) to
differentiate ovarian from pituitary causes
 Estriol-no hormonal activity
• Produced in 3rd trimester of pregnancy
• Gives indication of fetal well-being
• Sudden drop indicates fetal-placental distress
 Placental hormones
 Human Chorionic Gonadotroping (HCG)
• Stimulates corpus luteum to produce
progesterone and prevent menstruation
• Produced by placenta shortly after
implantation of fertilized egg
• Pregnancy tests
• Greatly influenced in hydatidiform moles
• Increased in males with testicular cancer
Male Sex Hormones
 Testosterone
 Development of secondary sexual
characteristics
 Increased may indicated premature
puberty in males or masculinity in
females (virulism and hirsuitism)
 Decreased in hypogonadism and some
cases of infertility
Adrenal Medulla Hormones
 Epinephrine and Norepinephrine
 Called catecholamines
 Measured along with their metabolite
vanillymandelic acid (VMA) when
• Unexpected hypertension – rule out
pheochromocytoma
• Detect neuroblastoma in children