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Human Endocrine System
Endocrinology
Endocrine disease
Assessment of a patient by a physician.
Blood Sugar Level Ranges
Diabetes
Endocrine emergencies
Endocrine Emergencies / Symptoms
Endocrine System / All human symptoms and signs. Endocrine System
Endocrine Glands
Endocrine Function
Endocrine Controls
Endocrine Disorders
Effects of Aging on the Endocrine System
Endocrinology
Hormones from Endocrine Glands
What is HbA1c?
List of Endocrine Disorders / Most common and least common
List of endocrine diseases

Endocrine emergencies
  1. Alcoholic Ketoacidosis

  2. Diabetic ketoacidosis

  3. Type 1 diabetes mellitus with ketoacidosis without coma

  4. Diabetic Coma and Type 2 Diabetes

  5. Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS) / Hyperosmolar hyperglycemic

  6. Hypoglycemic Coma

  7. Myxedema coma

  8. Thyroid storm

  9. Acute adrenal insufficiency

  10. Pituitary apoplexy

  11. Pheochromocytoma crisis

  12. Acute hypercalcemia

  13. Acute hypocalcaemia

Endocrine Emergencies















Hormones from Endocrine Glands
The glands of the endocrine system are:
  1. Hypothalamus.

  2. Pineal Gland.

  3. Pituitary Gland.

  4. Thyroid.

  5. Parathyroid.

  6. Thymus.

  7. Adrenal.

  8. Pancreas.

Hypothalamus

  • Thyrotropin-releasing hormone (TRH)
    • Stimulates secretion of TSH and prolactin.
  • Corticotropin-releasing hormone (CRH)
    • Triggers the release of ACTH.
  • Growth hormone-releasing hormone (GHRH)
    • Triggers the release of growth hormone.
  • Growth hormone inhibitory hormone (GHIH) (somatostatin)
    • Inhibits growth hormone secretion.
  • Gonadotropin-releasing hormone (GnRH)
    • Triggers the release of LH and FSH.
  • Dopamine or prolactin-inhibiting factor (PIF)
    • Inhibits prolactin secretion.

Pituitary Gland

The pituitary can be divided into the anterior and posterior gland. The hormones below are secreted by the anterior pituitary gland, except for ADH and oxytocin, which is secreted by the posterior pituitary gland.

  • Adrenocorticotropic hormone (ACTH)
    • Stimulates the synthesis and secretion of adrenocortical hormones (cortisol, androgens, and aldosterone).
  • Antidiuretic hormone (ADH) / Vasopressin
    • Stimulates the reabsorption of water from urine in the kidneys.
    • It also triggers vasoconstriction.
    • Both the retention of water and vasoconstriction increases blood pressure.
  • Follicle-stimulating hormone (FSH)
    • In women, it stimulates the growth of the ovarian follicle.
    • In men, it stimulates the maturation of sperm in the testes.
  • Growth hormone
    • Stimulates the synthesis of proteins and growth of cells and tissues.
  • Luteinizing hormone (LH)
    • In women, it stimulates ovulation, formation of the corpus luteum and production of estrogen and progesterone.
    • In men, it stimulates the testes to produce testosterone.
  • Oxytocin
    • Stimulates the secretion of milk from the breasts.
    • Triggers and enhances of uterine contractions.
  • Prolactin
    • Promotes the development of breasts in women and milk production and secretion.
  • Thyroid-stimulating hormone (TSH)
    • Stimulates the synthesis and secretion of thyroid hormones (thyroxine and triiodothyronine).

Pineal Gland

The pineal gland was believed to play no significant role in the body an was thought of as a vestigial remnant. It is now known that the pineal gland secretes melatonin and related hormones which may play a role in sleep and possibly affect the secretion of luteinizing hormone and follicle-stimulating hormone.

Thyroid

  • Thyroxine (T4) and Triiodothyronine (T3)
    • Increases the body’s metabolic rate by acting on most cells.
  • Calcitonin
    • Promotes calcium deposition in the bones.
    • Also reduces the calcium levels present in the blood and tissue fluid.

Parathyroid

  • Parathyroid hormone (PTH)
    • Increases calcium absorption from the gastrointestinal tract.
    • Triggers the release of calcium from the bones.
    • These two effects increases the calcium concentration in the blood.

Adrenal cortex

  • Cortisol
    • It is a glucocorticoid that has a wide range of metabolic and anti-inflammatory effects as described under natural corticosteroids.
  • Aldosterone
    • It is a mineralocorticoid that regulates the concentration of essential electrolytes in the body as discussed under natural corticosteroids.

Adrenal medulla

  • Norepinephrine and epinephrine
    • Has the same effects on target organs as stimulation by the sympathetic nerves but is longer lasting.

Pancreas

  • Insulin
    • Acts on cells to increase glucose uptake from the blood.
  • Glucagon
    • Promotes the release of stored glucose from the liver and production of glucose if necessary.

Testes

  • Testosterone
    • Promotes the development and maturation of the testes, as well as the sexual characteristics of men.

Ovaries

  • Estrogen
    • Promotes tissue development in the female reproductive system, including the ovaries, fallopian tubes, uterus and genitalia.
    • Increases the growth and development of the and breasts, as well as the sexual characteristics of women.
  • Progesterone
    • Promotes secretory changes in the uterus and fallopian tubes in preparation of pregnancy.
    • Stimulates the development of milk-producing tissue in the breast but does not stimulate actual breast milk secretion.

Thymus Gland

The thymus gland in adults seems to have little functionality compared to early life but plays a role in the maturation of immune cells. It is not an endocrine gland.

The following tissues and organs in the body also produce and secrete hormones but are not endocrine glands.

Adipocytes (Fat Cells)

  • Leptin

Heart

  • Atrial natriuretic peptide (ANP)

Kidney

  • Renin
  • 1,25-Dihydroxycholecalciferol
  • Erythropoietin

Placenta

  • Human chorionic gonadotropin (HCG)
  • Human somatomammotropin
  • Estrogen
  • Progesterone

Stomach

  • Gastrin
  • Ghrelin

Discussed under Digestive Hormones.

Small intestine

  • Secretin
  • Cholecystokinin (CCK)

Discussed under Digestive Hormones.


What are Digestion Hormones?
Digestive hormones (gut hormones) are chemical ‘messengers’ which signal the gastrointestinal tract and accessory organs to perform different actions in order to coordinate the digestive process.

Gastrin

  • Source
    • G cells in the stomach.
  • Trigger
    • Protein and amino acids stimulate gastrin secretion but somatostatin and acid suppresses gastrin secretion.
  • Action
    • Increases gastric acid secretion.

Somastatin

  • Source
    • D cells which are located throughout the gastrointestinal tract (gut).
  • Trigger
    • Eating fatty foods.
  • Actions
    • Reduces gastrin and stomach acid secretion.
    • Inhibits insulin and pancreatic enzyme secretion.
    • Decreases nutrient absorption from the gut.

Grehlin

  • Source
    • Stomach
  • Trigger
    • Secretion stimulated by fasting or starvation and suppressed by eating food.
  • Action
    • Stimulates appetite.

Cholecystokinin (CCK)

  • Source
    • First two parts of the small intestine (duodenum, jejunum) – I cells.
    • Nerve endings in the last part of the small intestine (ileum) and colon.
  • Triggers
    • Protein and amino acids.
    • Fatty foods.
    • Trypsin which is a pancreatic enzyme that assists with the digestion of proteins suppresses the secretion of CCK.
  • Actions
    • Feeling of satiety which reduces appetite.
    • Reduces gastric acid secretion and gastric emptying (passing of food from the stomach into the duodenum)
    • Stimulates pancreatic enzyme secretion.
    • Stimulates gallbladder contraction and bile flow.
    • Opens the sphincter of Oddi which allows the pancreatic enzymes and bile to enter the small intestine.

Secretin

  • Source
    • First two parts of the small intestine (duodenum, jejunum) – S cells.
  • Triggers
    • Acid in the duodenum (small intestine) – increase in pH.
    • Fatty acids.
  • Actions
    • Stimulates pancreatic fluid and bicarbonate secretion for the dilution and neutralization of stomach acid in the small intestine.
    • Decreases gastric acid secretion.
    • Reduces gastric emptying (passing of food from the stomach into the duodenum).

Motilin

  • Source
    • Small intestine
    • Colon
  • Triggers
    • Fasting, starvation.
    • Fatty foods.
  • Actions
    • Controls peristalsis by stimulating smooth muscle contraction and relaxation to coordinate the movement of food through the gut.
    • Regulates movement of residual undigested material through the gut (migrating motor complexes or MMC) between meals.

Gastric Inihibitory Polypeptide (GIP)

  • Source
    • Duodenum and jejunum – K cells.
  • Triggers
    • Glucose.
    • Fatty foods.
  • Actions
    • Reduces gastric acid secretion.
    • Decreases gastric emptying.
    • Stimulates the release of insulin.

Vasoactive Intestinal Peptide (VIP)

  • Source
    • Nerve fibers supplying all parts of the gastrointestinal tract.
  • Triggers
    • Unknown at this point.
  • Actions
    • May have various effects on many parts of the body, not only the gastrointestinal tract.
    • Vasodilator – increases blood flow to the gut.
    • Empties water and electrolytes into pancreatic enzymes and bile.
    • May affect water and electrolyte transport between the bloodstream and gut lumen.
    • Relaxes smooth muscle, particularly that of the sphincters.
    • May play a role in blood glucose regulation.

Guanylin

  • Source
    • Small intestine.
    • Colon
  • Trigger
    • Unknown at this point.
    • Causes diarrhea which may be in response to certain stimuli (not as yet ascertained).
  • Actions
    • Secretion of chloride.
    • Decreases absorption of water from the gut.

Symptoms & Signs A-Z List
Diabetes Mellitus
  1. Frequent urination – polyuria (kidneys are trying to dilute the glucose in urine)

  2. Excessive thirst – polydipsia

  3. Excessive hunger – polyphagia (loss of calories through urination causes weight loss, and the body needs to compensate for it).

  4. Other symptoms include blurred vision, drowsiness, nausea, and decreased endurance during exercise

  5. Those with poorly controlled DM have greater susceptibility to infections

  6. Weight loss almost always occurs before treatment in Type I, but most ppl with type II don’t lose weight

  7. In type I, sx begin abruptly and may progress rapidly to diabetic ketoacidosis (DKA)

  8. Hyperthyroidism
  9. Heart palpitations, hypertension, person may feel warm even in a cool room, moist skin and diaphoresis, tremor, nervousness, fatigue and weakness, increased level of activity, increased appetite (but with weight loss), impaired sleep, frequent bowel movements, with occasionally with diarrhea

  10. Older adults may not show the above symptoms, but they may become weak, sleepy, confused, withdrawn, and depressed (sometimes called apathetic or masked hyperthyroidism)

  11. Heart problems, especially abnormal heart rhythms, are seen more often in older people

  12. Can cause changes in the eyes (puffiness, increased tear formation, irritation, unusual sensitivity to light, and the person appears to stare)

  13. Hypothyroidism
  14. Insufficient thyroid hormone causes bodily functions to slow down.

  15. In sharp contrast to hyperthyroidism, the symptoms of hypothyroidism are subtle and gradual and may be mistaken for depression.

  16. Symptoms include dulled facial expressions, hoarse voice, slow speech, eyelids droop, puffy and swollen face and eyes, weight gain, constipation, inability to tolerate cold, hair that is sparse, coarse, and dry, and the skin that is coarse, dry, scaly, and thick.

  17. Many people develop carpal tunnel syndrome, which makes the hands tingle or hurt.

  18. If untreated, hypothyroidism can eventually cause anemia, a low body temperature, and heart failure. 1.This may progress to confusion, stupor, or coma (myxedema coma)

  19. Treatment with thyroid hormone replacement therapy (oral medication) for life

  20. Neurocognitive effects 1.Cognitive deterioration

  21. Onset and development of the cognitive impairments are usually subtle and insidious

  22. The patient becomes sluggish, lethargic, and suffers concentration and memory disturbances (and effects on motor speed)

  23. Some people, especially older people, may appear confused, forgetful, or demented–signs that can easily be mistaken for Alzheimer’s disease or other forms of dementia.

  24. Replacement therapy improves performance, but it may not completely reverse the effects

  25. Affective Features (reversed or greatly improved by thyroid replacement therapy) 1.Hypothyroidism may be accompanied by symptoms of depression, emotional lability, mental sluggishness, indifference, self-accusatory ruminations, and suspiciousness

  26. Psychiatric presentation may be the first sign of hypothyroidism

  27. Myxedema
    Physical Findings
  28. Comatose or semi comatose

  29. Dry coarse skin

  30. Hoarse voice

  31. Thin dry hair

  32. Delayed reflex relaxation time

  33. Hypothermia

  34. Pericardial, pleural effusions, ascites

  35. Graves disease
  36. Patient with Graves disease who has discontinued antithyroid medication OR is previously undiagnosed

  37. Hyperpyrexia ( >40 0C )

  38. Sweating

  39. Tachycardia with or without AF

  40. Nausea, vomiting and diarrhea

  41. Tremulousness and delirium, occasionally apathetic

  42. Acute Adrenal Insufficiency
    Clinical Presentation
  43. Nausea and vomiting

  44. Hyperpyrexia

  45. Abdominal pain

  46. Dehydration

  47. Hypotension and shock

  48. Pituitary Apoplexy
    Symptoms and Signs
  49. Severe headache and visual disturbance

  50. Bitemporal hemianopia

  51. N III palsy

  52. Meningeal symptoms with neck stiffness

  53. Symptoms of acute secondary adrenal insufficiency

  54. Nausea vomiting , hypotension and collapse

  55. Pheochromocytoma Crisis
    Clinical Features
  56. History of poorly controlled Hypertension or accelerated Hypertension

  57. Hypertension, palpitations, sweating, pallor, pounding headache, anxiety,tremulousness, pulmonary edema, feeling of impending death, hyperhydrosis, nausea and vomiting, abdominal pain, paralytic ileus hyperglycaemia, hypertensive encephalopathy, myocardial infarction and stroke

  58. Attacks build up over a few minutes and fade gradually over 15 min or can be more sustained (60 min)

  59. Signs of end organ damage

  60. Acute Hypercalcaemia
    Clinical Features
  61. History of polyuria and polydipsia

  62. Dehydration

  63. Bone pain

  64. Confusion

  65. Anorexia

  66. Constipation

  67. Acute Hypocalcaemia
    Symptoms
  68. Perioral numbness

  69. Tingling parasthesias

  70. Muscle cramps

  71. Carpopedal spasm

  72. Seizures

  73. Signs
  74. Hyperreflexia

  75. Chvostek sign

  76. Trousseau sign

  77. Hypotension

  78. Bradicardia

  79. Prolonged QT interval

  80. Arrhythmias

  81. Hypopituitarism: Symptoms & Signs
    The symptoms of hypopituitarism result from decreased hormone production by the pituitary gland. When all the pituitary hormones are affected, the condition is known as panhypopituitarism. Isolated or partial hypopituitarism results when the production of one or more hormones is decreased. The symptoms are variable and depend on the severity of the condition and the number of hormones that are affected. Symptoms can include
  82. anemia,

  83. decreased appetite,

  84. weight loss or gain,

  85. sensitivity to cold,

  86. fatigue, and

  87. a decreased sex drive.

  88. Women
    Women may experience irregular menstrual cycles, loss of menstruation (amenorrhea), infertility, and the inability to produce milk. Infertility can affect males, as well as a reduction in hair on the face or body.

    Children

    Short stature
    Delayed growth

    Hypopituitarism in children can lead to short stature and delayed growth and development. Other symptoms and signs include

  89. weakness,

  90. headache,

  91. abdominal pain,

  92. low blood pressure,

  93. vision problems,

  94. facial swelling,

  95. hoarseness,

  96. joint stiffness, and

  97. loss of pubic or armpit hair.

Endocrine System
How many endocrine system organs are there in the human body?
6
Can you name the endocrine system organs in the human body?
1.Pituitary gland
2.Pineal gland
3.Thyroid gland
4.Parathyroid glands
5.Adrenal glands
6.Pancreas

The female ovaries and the male testes are a part of which body system? Can these organs be members of more than one organ system? Why or why not?
Testes are one of the main components in the male reproductive system as they are involved in the production of both androgens and sperm. These male gonads are located in the scrotum.

The female gonads are known as ovaries located in the pelvic cavity. These paired ovals are about two to three centimeter each in length. They are the site where production and released of egg cells takes place. Oocyte grows within this environment.

Female ovaries and male testes are the structural components of the reproductive system. These two organs are also part of the endocrine system.

Pituitary Gland Function
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What is the Pituitary Gland?
The pituitary is an endocrine (hormone-producing) gland that sits just beneath the base of the brain, behind the bridge of the nose. It is very small – only about the size of a pea. The pituitary gland is very important as it takes messages from the brain (via a gland called the hypothalamus) and uses these messages to produce hormones that affect many parts of the body, including stimulating all the other hormone-producing glands to produce their own hormones. For this reason it is often referred to as the ‘master gland’.

The pituitary gland has two parts. The anterior (or front) pituitary produces hormones that affect the breasts, adrenals, thyroid, ovaries and testes, as well as several other hormones. The main glands affected by the posterior (or rear) pituitary are the kidneys.

How Does the Normal Pituitary Work?
The pituitary gland produces a number of hormones. Hormones are essential for many aspects of life. Some send messages to other endocrine glands to tell them to increase or decrease production of their hormones. One such example is TSH, which stimulates the thyroid to grow and produce thyroid hormones.

The main hormones produced by the pituitary are:
ACTH adrenocorticotropic hormone
ADH anti-diuretic hormone, or vasopressin
FSH follicle-stimulating hormone
GH growth hormone
LH luteinizing hormone
PRL prolactin
TSH thyroid-stimulating hormone

The endocrine system is a network of glands that produce and release hormones that help control many important body functions, especially the body's ability to change calories into energy that powers cells and organs. The endocrine system influences how your heart beats, how your bones and tissues grow, even your ability to make a baby. It plays a vital role in whether or not you develop diabetes, thyroid disease, growth disorders, sexual dysfunction, and a host of other hormone-related disorders.

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.

Endocrine glands 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.
Even the slightest hiccup with the function of one or more of these glands can throw off the delicate balance of hormones in your body and lead to an endocrine disorder, or endocrine disease.

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 meoplasia (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.

Types of Endocrine Disorders

There are many different types of endocrine disorders. Diabetes is the most common endocrine disorder diagnosed in the ______.

Other endocrine disorders include:

Adrenal insufficiency. The adrenal gland releases too little of the hormone cortisol and sometimes, aldosterone. Symptoms include fatigue, stomach upset, dehydration, and skin changes. Addison's disease is a type of adrenal insufficiency.

Cushing's disease. Overproduction of a pituitary gland hormone leads to an overactive adrenal gland. A similar condition called Cushing's syndrome may occur in people, particularly children, who take high doses of corticosteroid medications.

Gigantism (acromegaly) and other growth hormone problems. If the pituitary gland produces too much growth hormone, a child's bones and body parts may grow abnormally fast. If growth hormone levels are too low, a child can stop growing in height.

Hyperthyroidism. The thyroid gland produces too much thyroid hormone, leading to weight loss, fast heart rate, sweating, and nervousness. The most common cause for an overactive thyroid is an autoimmune disorder called Grave's disease.

Hypothyroidism. The thyroid gland does not produce enough thyroid hormone, leading to fatigue, constipation, dry skin, and depression. The underactive gland can cause slowed development in children. Some types of hypothyroidism are present at birth.

Hypopituitarism. The pituitary gland releases little or no hormones. It may be caused by a number of different diseases. Women with this condition may stop getting their periods.

Multiple endocrine neoplasia I and II (MEN I and MEN II). These rare, genetic conditions are passed down through families. They cause tumors of the parathyroid, adrenal, and thyroid glands, leading to overproduction of hormones.

Polycystic ovary syndrome (PCOS). Overproduction of androgens interfere with the development of eggs and their release from the female ovaries. PCOS is a leading cause of infertility.

Precocious puberty. Abnormally early puberty that occurs when glands tell the body to release sex hormones too soon in life.

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.

Endocrinology
What is endocrinology?
Endocrinology is the study of hormones.

Endocrinology is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones.

What is endocrinology?
What is the endocrine system?
What do endocrinologists do?
What is an endocrinologist?

List of endocrine diseases
Adrenal disorders

Adrenal insufficiency
    Addison's disease
    Mineralocorticoid deficiency
    Diabetes
Adrenal hormone excess
    Conn's syndrome
    Cushing's syndrome
    Glucocorticoid remediable aldosteronism (GRA)
    Pheochromocytoma
Congenital adrenal hyperplasia (adrenogenital syndrome)
Adrenocortical carcinoma

Glucose homeostasis disorders

Diabetes mellitus
    Type 1 Diabetes
    Type 2 Diabetes
    Gestational Diabetes
    Mature Onset Diabetes of the Young
Hypoglycemia
    Idiopathic hypoglycemia
    Insulinoma
Glucagonoma

Thyroid disorders

Goiter

Hyperthyroidism
    Graves-Basedow disease
    Toxic multinodular goitre
Hypothyroidism
Thyroiditis
    Hashimoto's thyroiditis
Thyroid cancer
Thyroid hormone resistance

Calcium homeostasis disorders and Metabolic bone disease

Parathyroid gland disorders
    Primary hyperparathyroidism
    Secondary hyperparathyroidism
    Tertiary hyperparathyroidism
    Hypoparathyroidism
      Pseudohypoparathyroidism

Osteoporosis
Osteitis deformans (Paget's disease of bone)
Rickets and osteomalacia
Pituitary gland disorders

Posterior pituitary

Diabetes insipidus
Anterior pituitary
Hypopituitarism (or Panhypopituitarism)

Pituitary tumors
    Pituitary adenomas
    Prolactinoma (or Hyperprolactinemia)
    Acromegaly, gigantism
    Cushing's disease


Sex hormone disorders

Disorders of sex development or intersex disorders
    Hermaphroditism
    Gonadal dysgenesis
    Androgen insensitivity syndromes


Hypogonadism (Gonadotropin deficiency)

Inherited (genetic and chromosomal) disorders
    Kallmann syndrome
    Klinefelter syndrome
    Turner syndrome
Acquired disorders
    Ovarian failure (also known as Premature Menopause)
    Testicular failure
Disorders of Puberty
    Delayed puberty
    Precocious puberty
Menstrual function or fertility disorders
Amenorrhea
Polycystic ovary syndrome
Tumours of the endocrine glands not mentioned elsewhere

Multiple endocrine neoplasia

MEN type 1
MEN type 2a
MEN type 2b
Carcinoid syndrome

See also separate organs

Autoimmune polyendocrine syndromes
Incidentaloma - an unexpected finding on diagnostic imaging, often of endocrine glands
Principles of endocrinology
The endocrine pancreas
    Diabetes
    Gestational diabetes
    Diabetic Children

Diabetes
1. Definition
2. Causes
3. Types
4. Relevant anatomy, physiology, biochemistry
5. Symptoms and signs
6. Medical emergencies associated with this medical condition
7. Risk factors
8. Normal values
9. Various diagnostic tests
10. Diagnosis
11. Complications
12. Treatment or management
13. Epidemiology
14. History of this medical condition
15. Prevention
Diabetes mellitus
    What are the symptoms of diabetes?
    Type 1 Diabetes
    Type 2 Diabetes
    Gestational Diabetes
    Mature Onset Diabetes of the Young
What is diabetes?
What is pre-diabetes? If a person is diagnosed with this, does it mean it will develop into diabetes?
What is the difference between pre-diabetes and diabetes?
What is the difference between type 1 and type 2 diabetes and their causes?
What warning signs should a patient with a risk of diabetes look for?
What are some tips for maintaining proper diet and exercise through the holidays?
What foods or super foods should people with diabetes focus on during holiday gatherings?
What is a healthy glucose level, and why is it important to maintain?
Does eating a lot of sugar cause diabetes?
Are artificial sweeteners safe?
What’s the difference between carbohydrates and sugar?
Is diabetes reversible?
How is diabetes diagnosed?
When is medication required?
How long should medication last?
What type of medication is available?
Is diabetes reversible?
How could this be prevented?
Here are further guidelines.

Insulin
The thyroid gland
The adrenal gland
The parathyroid glands and vitamin D
The gonad
The pituitary gland
Cardiovascular and renal
Public Alert
Stay away from public affairs.
This is in reference to a seminar on November 11, 2010, at SKIMS, Srinagar, Kashmir. The topic for discussion is Diabetes. I have written a book on diabetes. The state department of health can procure this book and circulate it to all relevant hospitals and departments.


Women’s Health Signs & Symptoms

Adolescence

During adolescence, teenagers are always concerned about breast development, beginning menstrual cycles, and even shaving their legs. These may or may not be signs of endocrine disorders.

What happens if a girl doesn't develop breasts or hair or have periods when expected?

There is a wide variation in the time of expected puberty. If a girl has not developed breasts and axillary and pubic hair by the age of 14 and has not by age 16, she should undergo medical evaluation. Although in some cases, this may simply reflect either a family trait or a harmless deviation from "normal," this may be the first sign of a number of medical conditions, including thyroid, adrenal, pituitary or ovarian disorders. At times, undernutrition or excessive exercise may delay the onset of puberty (see below).

Also, adrenal disease may be a consideration for girls who fail to begin menstruating or have irregular periods, excess facial and body hair, and acne. An early rapid growth spurt followed by a premature end to the growing period can cause short stature. Sometimes these symptoms can seem to have the same presentation as PCOS.

Middle Age

Type 2 diabetes

Type 2 diabetes, hypertension and hypercholesterolemia are the most important and common risk factors for heart attacks in women. Women who have insulin resistance are at particular risk. Women with type 2 diabetes have an extremely high risk of heart disease and the symptoms of heart disease may be different from the typical symptoms. They may not have chest pain but merely fatigue, weakness during exercise, or other vague symptoms. Women with diabetes should be regularly tested for silent heart disease and should follow strict guidelines to control blood sugars, cholesterol, and blood pressure. Certain medications may be prescribed to reduce the risk of heart disease or reduce the risk of a second heart attack in a woman who has already had one. These may include statin drugs, aspirin, ACE inhibitors or Angiotensin blockers, and beta blockers. It is very important for women with diabetes to let their physicians know about any symptoms they might be having.

Blood Sugar Level Ranges
Between 4.0 to 5.4 mmol/L (72 to 99 mg/dL) when fasting
•Up to 7.8 mmol/L (140 mg/dL) 2 hours after eating
Target Levels
by Type
Upon waking Before meals
(pre prandial)
At least 90 minutes after meals
(post prandial)
Non-diabetic*   4.0 to 5.9 mmol/L under 7.8 mmol/L
Type 2 diabetes   4 to 7 mmol/L under 8.5 mmol/L
Type 1 diabetes 5 to 7 mmol/L 4 to 7 mmol/L 5 to 9 mmol/L
Children w/ type 1 diabetes 4 to 7 mmol/L 4 to 7 mmol/L 5 to 9 mmol/L

*The non-diabetic figures are provided for information but are not part of NICE guidelines.

Normal and diabetic blood sugar ranges

For the majority of healthy individuals, normal blood sugar levels are as follows:

  • Between 4.0 to 5.4 mmol/L (72 to 99 mg/dL) when fasting [361]
  • Up to 7.8 mmol/L (140 mg/dL) 2 hours after eating

For people with diabetes, blood sugar level targets are as follows:

  • Before meals: 4 to 7 mmol/L for people with type 1 or type 2 diabetes
  • After meals: under 9 mmol/L for people with type 1 diabetes and under 8.5mmol/L for people with type 2 diabetes

Blood sugar levels in diagnosing diabetes

The following table lays out criteria for diagnoses of diabetes and prediabetes.

Blood sugar levels in diagnosing diabetes
Plasma glucose test Normal Prediabetes Diabetes
Random Below 11.1 mmol/l
Below 200 mg/dl
N/A 11.1 mmol/l or more
200 mg/dl or more
Fasting Below 5.5 mmol/l
Below 100 mg/dl
5.5 to 6.9 mmol/l
100 to 125 mg/dl
7.0 mmol/l or more
126 mg/dl or more
2 hour post-prandial Below 7.8 mmol/l
Below 140 mg/dl
7.8 to 11.0 mmol/l
140 to 199 mg/dl
11.1 mmol/l or more
200 mg/dl or more

Random plasma glucose test

A blood sample for a random plasma glucose test can be taken at any time. This doesn’t require as much planning and is therefore used in the diagnosis of type 1 diabetes when time is of the essence.

Fasting plasma glucose test

A fasting plasma glucose test is taken after at least eight hours of fasting and is therefore usually taken in the morning.

The _____ guidelines regard a fasting plasma glucose result of 5.5 to 6.9 mmol/l as putting someone at higher risk of developing type 2 diabetes, particularly when accompanied by other risk factors for type 2 diabetes.

Oral Glucose Tolerance Test (OGTT)

An oral glucose tolerance test involves taking a first taking a fasting sample of blood and then taking a very sweet drink containing 75g of glucose.

After having this drink you need to stay at rest until a further blood sample is taken after 2 hours.

HbA1c test for diabetes diagnosis

An HbA1c test does not directly measure the level of blood glucose, however, the result of the test is influenced by how high or low your blood glucose levels have tended to be over a period of 2 to 3 months.

Indications of diabetes or prediabetes are given under the following conditions:

  • Normal: Below 42 mmol/mol (6.0%)
  • Prediabetes: 42 to 47 mmol/mol (6.0 to 6.4%)
  • Diabetes: 48 mmol/mol (6.5% or over)

List of Endocrine Disorders / Most common and least common
  1. Diabetes mellitus

  2. Type 2 diabetes

  3. Type 1 diabetes

  4. Growth Disorders

  5. Osteoporosis

  6. Polycystic ovary syndrome

  7. Adrenal insufficiency

  8. Addison's disease

  9. Conn's Syndrome

  10. Cushing's syndrome

  11. Glucocorticoid remediable aldosteronism

  12. Pheochromocytoma

  13. Congenital adrenal hyperplasia

  14. Adrenocortical Tumor/carcinoma

  15. Gestational diabetes

  16. Hypoglycemia

  17. Idiopathic Hypoglycemia

  18. Insulinoma

  19. Glucagonoma

  20. Goiter, specified as simple

  21. Hyperthyroidism

  22. Hypothyroidism

  23. Thyroiditis

  24. Thyroid Tumor

  25. Thyroid hormone resistance

  26. Osteitis deformans without mention of bone tumor

  27. Osteomalacia

  28. Rickets

  29. Diabetes insipidus

  30. Hypopituitarism

  31. Pituitary Tumors

  32. True hermaphroditism

  33. Gonadal dysgenesis

  34. Hypogonadism

  35. Kallmann syndrome

  36. Klinefelter syndrome

  37. Turner syndrome

  38. Ovarian failure

  39. Amenorrhoea

  40. Delayed puberty

  41. Precocious puberty

  42. Multiple endocrine neoplasia type 1

  43. Multiple endocrine neoplasia

  44. Multiple endocrine neoplasia type 2
Last Updated: June 15, 2018