Endocrine System

Endocrine System

Your endocrine system works with your nervous system to control important bodily functions. The endocrine systems responsibilities include regulating growth, sexual development and function, metabolism and mood. The endocrine system also helps give your body the energy it needs to function properly. Endocrine glands secrete hormones into the bloodstream. Hormones are considered chemical messengers, coordinating your body by transferring information from one set of cells to another. Your endocrine system health can be affected by hormone imbalances resulting from impaired glands. A hormone imbalance can cause problems with bodily growth, sexual development, metabolism and other bodily functions. Endocrine system diseases or conditions include diabetes, growth disorders and osteoporosis.

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    Pheochromocytomas can recur (come back) at the original site, in the opposite adrenal gland, in extra-adrenal sites (paragangliomas), and at sites distant from the original tumor (metastatic disease to bone, lung, liver). This can take place even more than 20 years after the original operation. Patients should undergo life-long yearly blood tests (plasma metanephrines).  
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    Patients with hyperparathyroidism have been shown to have more neuropsychological symptoms, including fatigue, when compared with the general population. However, it is difficult to ascertain if hyperparathyroidism is the actual cause of fatigue, as there are many other reasons that could be contributing.
    For more information go the endocrinediseases.org:
    Signs and symptoms of parathyroid disease: Non-classical symptoms 
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    The natural history of benign goiter is usually slow growth of the nodules. Therefore, observation can be safe. MNG (multinodular goiter) is treated if there is a suspicion of the nodules harboring cancer, the goiter is growing quickly, or if the goiter's large size is causing compressive symptoms, such as hoarseness, difficulty swallowing, or difficulty breathing. Use of thyroid hormone to attempt to suppress and shrink MNG is not indicated and puts patients at risk for hyperthyroidism. 
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    Inositol is a naturally occurring nutrient found in various forms, the most common being myo-inositol. Even though it is sometimes referred to as a vitamin, it is not. This nutrient is not essential in humans as we can make it in the body from glucose. Inositol is a direct precursor of phospholipids which are a major component of cellular membranes. It helps to maintain proper electrical energy and nutrient transfer across the cell membrane. It also acts as a lipotropic which converts fats into other useful products. It helps establish healthy cell membranes, which facilitate nerve impulses. It is sometimes used therapeutically in the treatment of OCD/Panic disorder.
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    You need to have precautions for the following cases:

    Surgery
    Because cortisol is "stress hormone," people with chronic adrenal insufficiency who need any type of surgery requiring general anesthesia must be treated with intravenous glucocorticoids and saline. Intravenous treatment begins before surgery and continues until the patient is fully awake after surgery and able to take medication by mouth. The "stress" dosage is adjusted as the patient recovers until the presurgery maintenance dose is reached.

    In addition, people who are not currently taking glucocorticoids but who have taken long-term glucocorticoids in the past year should inform their doctor before surgery. These people may have sufficient adrenocorticotropic hormone (ACTH) for normal events, but they may need intravenous treatment for the stress of surgery.

    Illness
    During an illness, oral dosing of glucocorticoid may be adjusted to mimic the normal response of the adrenal glands to stress on the body. Significant fever or injury may require triple oral dosing. Once recovery from the stress event is achieved, dosing is then returned to maintenance levels. People with adrenal insufficiency should know how to increase medication during such periods of stress. Immediate medical attention is needed if severe infections, vomiting, or diarrhea occur. These conditions can precipitate an Addisonian crisis.

    Pregnancy
    Women with adrenal insufficiency who become pregnant are treated with standard replacement therapy. If nausea and vomiting in early pregnancy interfere with taking medication by mouth, hormone injections may be necessary. During delivery, treatment is similar to that of people needing surgery. Following delivery, the dose is gradually tapered and the usual maintenance doses of oral hydrocortisone and fludrocortisone acetate are reached about 10 days after childbirth.

    This answer is based on source information from the National Institute of Diabetes and Digestive and Kidney Diseases.

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    There are no proven ways to prevent pheochromocytoma. However, the earlier you identify a pheochromocytoma, the less amount of damage it will cause. If you have a genetic history of pheochromocytoma or are experiencing any of the symptoms like stomach pain or irregular blood pressure, speak to your doctor immediately. The best preventative measure is an awareness of the symptoms and risk factors.

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    In its early stages, adrenal insufficiency can be difficult to diagnose. A review of a patient's medical history and symptoms may lead a doctor to suspect Addison's disease.

    A diagnosis of adrenal insufficiency is confirmed through laboratory tests. The aim of these tests is first to determine whether levels of cortisol are insufficient and then to establish the cause. Radiologic exams of the adrenal and pituitary glands are also useful in helping to establish the cause.

    Adrenocorticotropic hormone (ACTH) stimulation test
    The ACTH stimulation test is the most commonly used test for diagnosing adrenal insufficiency. In this test, blood cortisol or urine cortisol or both are measured before and after a synthetic form of ACTH is given through an injection. The normal response after an ACTH injection is a rise in blood and urine cortisol levels. People with Addison's disease or long-standing secondary adrenal insufficiency have a little or no increase in cortisol levels.

    Both low- and high-dose ACTH stimulation tests may be used depending on the suspected cause of adrenal insufficiency. For example, if secondary adrenal insufficiency is mild or of recent onset, the adrenal glands may still respond to ACTH because they have not yet atrophied. Some studies suggest that a low dose-1 microgram-may be more effective in detecting secondary adrenal insufficiency because a low dose is still enough to raise cortisol levels in healthy people but not in people with mild or recent secondary adrenal insufficiency.

    Corticotropin-releasing hormone (CRH) stimulation test
    When the response to the ACTH test is abnormal, the CRH stimulation test can help determine the cause of adrenal insufficiency. In the CRH stimulation test, synthetic CRH is injected intravenously and blood cortisol is measured before after the injection and 30, 60, 90, and 120 minutes after the injection. People with Addison's disease respond by producing high levels of ACTH but no cortisol. People with secondary adrenal insufficiency have absent or delayed ACTH responses. CRH will not stimulate ACTH secretion if the pituitary is damaged. So, an absent ACTH response points to the pituitary as the cause. A delayed ACTH response points to the hypothalamus as the cause.

    This information is based on source information from the National Institute of Diabetes and Digestive and Kidney Diseases.

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    Adrenal insufficiency is an endocrine-or hormonal-disorder that occurs when the adrenal glands do not produce enough of certain hormones. The adrenal glands are located just above the kidneys. Adrenal insufficiency can be primary or secondary.

    Primary adrenal insufficiency, also called Addison's disease, occurs when the adrenal glands are damaged and cannot produce enough of the hormone cortisol and often the hormone aldosterone. Addison's disease affects one to four of every 100,000 people, of all age groups and both sexes.

    Secondary adrenal insufficiency occurs when the pituitary gland-a bean-sized organ in the brain-fails to produce enough adrenocorticotropic hormone (ACTH), hormone that stimulates the adrenal glands to produce cortisol. If ACTH output is too low, cortisol production drops. Eventually, the adrenal glands can shrink due to lack of ACTH stimulation. Secondary adrenal insufficiency is much more common than Addison's disease.

    This answer is based on source information from the National Endocrine and Metabolic Diseases Information Service.

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    Secondary adrenal insufficiency can be traced to a lack of adrenocorticotropic hormone (ACTH). Without ACTH to stimulate the adrenal glands, the adrenals' production of cortisol drops. Aldosterone production is not usually affected.

    A temporary form of secondary adrenal insufficiency may occur when a person who has been taking synthetic glucocorticoid hormone such as prednisone for a long time stops taking the medication, either abruptly or gradually. Glucocorticoid hormones, which are often used to treat inflammatory illnesses such as rheumatoid arthritis (RA), asthma, and ulcerative colitis, block the release of both corticotropin-releasing hormone (CRH) and ACTH. As a result, the adrenals may begin to atrophy-or shrink-from lack of ACTH stimulation and then fail to secrete sufficient levels of cortisol.

    A person who stops taking synthetic glucocorticoid hormone may have enough ACTH to function when healthy. However, when a person is under the stress of an illness, an accident, or surgery, his or her body may not have enough ACTH to stimulate the adrenal glands to produce cortisol.

    Another cause of secondary adrenal insufficiency is surgical removal of the noncancerous, ACTH-producing tumors of the pituitary gland that cause Cushing's disease. Cushing's disease is another disorder that leads to excess cortisol in the body. In this case, the source of ACTH is suddenly removed and replacement hormone must be taken until normal ACTH and cortisol production resumes.

    Less commonly, adrenal insufficiency occurs when the pituitary gland either decreases in size or stops producing ACTH. These events can result from:

    Tumors or infections of the area Loss of blood flow to the pituitary Radiation for the treatment of pituitary tumors Surgical removal of parts of the hypothalamus Surgical removal of the pituitary gland This answer is based on source  information from the National Institute of Diabetes and Digestive and Kidney Diseases.

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    Treatment of adrenal insufficiency involves replacing, or substituting, hormones that the adrenal glands are not making. Cortisol is replaced with a synthetic glucocorticoid such as hydrocortisone, prednisone, or dexamethasone, which are taken orally one to three times each day, depending on which medication is chosen. If aldosterone is also deficient, it is replaced with oral doses of a mineralocorticoid, called fludrocortisone, which is taken once or twice a day. Because adrenal hormones help the body retain sodium, those with adrenal insufficiency may have to increase their salt intake. The doses of each medication are adjusted to meet the needs of an individual.

    During an Addisonian crisis, low blood pressure (BP), low blood glucose, and high levels of potassium can be life threatening. Standard therapy involves intravenous injections of glucocorticoids and large volumes of intravenous saline solution with dextrose, a type of sugar. This therapy usually brings rapid improvement. When the patient can take fluids and medications by mouth, the amount of glucocorticoids is decreased until a maintenance dose is reached. If aldosterone is deficient, maintenance therapy also includes oral doses of fludrocortisone acetate.

    This answer is based on source information from the National Institute of Diabetes and Digestive and Kidney Diseases.