Endocrinology is a branch of medicine dedicated to diagnosing and treating diseases related to the endocrine glands and hormonal system. Human endocrine system comprises different glands (e.g. thyroid gland, pancreas and adrenal glands) that produce and secrete hormones. Depending on their target, the hormones have several different effects and tasks.
It is often thought that hormonal turmoil affects only teenagers, but actually people at all ages may have hormone-related disorders. Below we describe some diseases related to the endocrine glands and hormones.
It is estimated that in the general population the endocrine disorders are most frequently related to the thyroid gland (manifesting mainly as hyper- and hypothyroidism). Thyroid-related problems may affect up to 10% of people. The second most common is diabetes, which affects 8.5% of the population. Although diabetes is at present less common than thyroid-related diseases, during the last decades there has been a staggering increase in its frequency in the Western world, so that according to the “black” scenario, in the 21st century diabetes will become one of the most important causes of death. Less frequent endocrine disorders include the Cushing’s syndrome, affecting about 2–3% of people, and Addison’s disease, which is very rare, affecting less than 0.5% of the population.
Endocrinological diseases are usually diagnosed based on blood analysis. In that case the presence of certain complaints and symptoms has usually already raised the suspicion of a hormonal disorder. Depending on the diagnosis, additional tests are performed, such as the ultrasound or stimulation tests (e.g. glucagon stimulation test and insulin tolerance test to study the secretion of growth hormone). There are also several rare diseases (like the MEN syndrome, caused by a known gene mutation), which can be diagnosed by means of genetic tests.
- Diabetes is a metabolic disorder, whereby the blood sugar is above normal during a longer period of time. There are two main types of this disease: type 1 is insulin-dependent and type 2 non-insulin-dependent. Type 1 diabetes is caused by the inability of the pancreas to produce enough insulin. Type 2 diabetes is characterized by insulin resistence or, in other words, inability of the organism to respond to insulin in a normal way. Type 2 diabetes may lead to insulin deficiency as well. Another separate type of diabetes is pregnancy diabetes or gestation diabetes, which develops during pregnancy and usually disappears after giving birth. The symptoms of diabetes include frequent urination, and increased thirst and appetite. If left untreated, diabetes may lead to severe complications. For treatment, both oral and injectable medications are used. Healthy lifestyle and nutrition are also very important in the prevention and treatment of this disease.
- Hypothyroidism, also called underactive thyroid, is a frequent endocrine disorder. Hypothyroidism means that the thyroid gland does not produce enough thyroid hormone. This leads to symptoms like constant feeling of cold, fatigue, depression, constipation, slow metabolism, weight gain, and even obesity. Hypothyroidism can be diagnosed based on blood analysis. For treatment, oral thyroid hormone replacement therapy is applied.
- Hyperthyroidism is caused by a thyroid gland that is too active and produces too much thyroid hormone. The symptoms are very individual: some patients have no symptoms at all, but others experience irritability, sleep problems, tachycardia, diarrhoea and weight loss. Hyperthyroidism can also be diagnosed based on simple blood analysis.
- Disorders related to sex hormones: sex hormones include androgens, estrogens and progestagens. Androgens are considered to be male sex hormones and estrogens and progestagens are considered to be female sex hormones. The level of sex hormones in the organism depends on the gender, age and individual differences. With aging, the level of sex hormones decreases to a certain extent, but this in itself is not harmful or dangerous. However, the production of sex hormones may decrease as a result of certain diseases as well. On the other hand, in some people the level of sex hormones is too high. The best known such condition is hyperandrogenism, also known as androgen excess. In women, the most common hyperandrogenism-related condition is polycystic ovary syndrome. Hair loss, also known as alopecia or baldness, has also been associated with hyperandogenism, however, according to the present knowledge, it is rather caused by the combined effect of genetic background and a certain male sex hormone.
- Growth hormone-related disorders: growth hormone is a hormone that stimulates growth and the multiplication and renewal of cells. In certain diseases and conditions the organism may produce too much or too little growth hormone. Excessive growth hormone may lead to gigantism (if overproduction ot this hormone happens in childhood) or acromegaly (if excessive production happens in adulthood).
- Cushing’s syndrome is a cluster of symptoms caused by excessive cortisol. The main reasons for developing the Cushing’s syndrome include prolonged use of certain medications (e.g. prednisolone) and tumors. If this condition is caused by an adenoma of hypophysis, then it is called the Cushing’s disease. The symptoms of the Cushing’s syndrome include high blood pressure, gaining fat in the trunk and lower belly, stretch marks, „moon face“, and acne.
- Addison’s disease, also known as primary adrenal insufficiency, is a chronic endocrine disorder the symptoms of which generally appear slowly. The reason for the Addison’s disease is the inability of the adrenal glands to produce enough steroid hormones (cortisol and aldosterone). The symptoms of the Addison’s disease include darkening of the skin (which actually looks like a sun tan), stomach-ache, weakness, and weight loss. Without treatment this condition may lead to death. Although this disease cannot be cured, its symptoms can be alleviated or even eliminated with hormone replacement therapy.
- Sleep disorders: melatonin is a so-called sleep hormone, produced by the body itself. Melatonin regulates the sleep/wake cycle and the circadian rhythm. Quite often melatonin is used for treating sleep disorders and correcting the circadian rhythm.
Endocrinologist’s consultation18 clinics
An endocrinologist is a specialized physician who treats the diseases and abnormalities of the hormonal system, including the pathologies of the hypothalamus and the pituitary, adrenal, pancreatic and thyroid glands. The most common hormonal diseases are diabetes, hypothyroidism (underactive thyroid gland) and hyperthyroidism (overactive thyroid gland). During the first appointment, the endocrinologist examines the patient and prescribes necessary tests and analyses.