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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    A Urology, answered on behalf of
    All forms of testosterone replacement have risk associated. Side effects of testosterone replacement include:
    • Ankle swelling due to fluid retention
    • Worsening of sleep apnea (a potentially life-threatening problem, usually seen in overweight men with a snoring problem), also due to fluid retention
    • A thickening of the blood (polycythemia), which can increase the risk of blood clots
    • Quick prostate enlargement and problems emptying the bladder
    Testosterone does not cause prostate cancer, but can make it grow faster. Testosterone can also cause infertility. Careful monitoring by a doctor is required once on you start taking testosterone replacement to make sure that no significant side effects occur.

    On the upside, the return of your sex drive, energy, concentration and physical strength are enormous benefits.

    Always carefully weigh the risks and benefits to testosterone replacement.

    This content originally appeared on http://blog.mountainstar.com/
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    A answered
    Hormone therapy (HT) is the use of synthetic hormones to replace hormones made naturally in the body. Your doctor may prescribe hormone therapy either to replace hormones that your body is no longer producing or to counteract the effects of hormones that your body is producing.

    For example, during and after menopause the amount of the hormones estrogen and progesterone that a woman's body produces decreases dramatically, causing symptoms including hot flashes, decreased sexual desire, vaginal dryness, mood swings and problems sleeping. Taking synthetic versions of estrogen, progesterone (in women who have not had their uterus surgically removed) and/or testosterone, can help to minimize or eliminate these symptoms.

    People who have underactive thyroid glands (hypothyroidism) may be prescribed a synthetic version of thyroid hormone to compensate for the hormones not being produced by their thyroid gland.

    Hormone therapy can also be used to counteract the negative effects of hormones that are still being produced in the body. For example, in women who have been diagnosed with estrogen-receptive breast cancer, taking the medication tamoxifen can block the effects of estrogen on breast tissue, reducing risk of breast cancer recurrence. Similarly some men who are fighting prostate cancer are treated with hormones to block the effects of testosteroneand dihydrotestosterone.
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    Hypoparathyroidism is when the body does not make or respond to a hormone called PTH.

    PTH, or parathyroid hormone, helps your body control the levels of calcium and vitamin D in your blood. This hormone is made by the parathyroid glands in the neck.

    There are many reasons for hypoparathyroidism. If you have this condition, you can have decreased amounts of calcium in the blood. This can lead to a wide range of symptoms, including life-threatening seizures or heart problems. Some people don't have any symptoms.
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    A answered
    Natpara is a formulation of parathyroid hormone, used for the treatment of hypoparathyroidism, a rare condition in which the body secretes very low levels of parathyroid hormone naturally. This leads to low calcium levels and causes kidney damage, kidney stones, abnormal heartbeat, psychological symptoms (delirium, depression, etc.), seizures, and cataracts, among other problems. Natpara is administered by injection in the thigh. Natpara may raise the risk of bone cancer (osteosarcoma); patients who notice new tender lumps or pains that do not go away should tell their doctor. Natpara may also lead to an overabundance of calcium in the blood; patients who feel tired, weak, or have nausea, vomiting, or constipation should also tell their doctor. Safety for Natpara has not been established for children or pregnant women. Breastfeeding women may be advised to stop during treatment with Natpara.
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    A OBGYN (Obstetrics & Gynecology), answered on behalf of
    When might I need hormone replacement therapy?
    Hormone replacement therapy (HRT) may help some women who have had their overies removed. In this video Juliet Leman, DO, of Women's Care of Colorado talks about HRT to replace natural female hormones like estrogen.
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    A , Endocrinology Diabetes & Metabolism, answered
    Surgery is not necessary for everyone with hyperparathyroidism, though there is some disagreement about precisely who needs surgery. Generally accepted criteria for who needs surgery include anyone with calcium-based kidney stones, osteoporosis beyond that expected for age or specifically involving the long bone, and very high blood calcium levels, especially above 11.5 or 12.

    Subjective symptoms often result from hyperparathyroidism and may improve with surgery. The symptoms include muscle and joint aches and pains, which can be hard to distinguish from age-related arthritis. Difficulty with focus and concentration may improve following surgery, and depression or heightened anxiety may sometimes also improve or even resolve completely. 

    Although strictly speaking not an absolute criterion for surgery, most doctors tend to recommend surgery to those who are younger with the idea that the problems related to hyperparathyroidism are likely to get worse over many years and it is better to intervene early to prevent them. Therefore, one might elect to just monitor someone with hyperparathyroidism at age 80 if they have only a mild elevation in calcium and no symptoms, but to operate on someone who is 55 even if they too are asymptomatic and have only a slight calcium elevation. 
     
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    A , Endocrinology Diabetes & Metabolism, answered
    The best treatment for hyperparathyroidism is usually surgery. Most people will have a single benign tumor, referred to as an adenoma, involving one of their parathyroid glands. Nuclear medicine studies (a parathyroid Sestamibi scan) or a high-resolution ultrasound of the neck will disclose the location of the abnormal gland in about 70% to 80% of cases, and a surgeon with lots of experience with this condition can usually find and remove the abnormal gland even if the radiographic studies don’t define the location. 

    Problems with surgery arise in three situations: 
    1. The parathyroid adenoma is in an unusual location.
    2. The individual has a form of hyperparathyroidism involving more than one gland, referred to as parathyroid hyperplasia.
    3. The initial diagnosis was incorrect. 
    Usually the parathyroid glands are located in the neck, just adjacent to the thyroid. But during fetal development they start off in the chest and migrate upward. Occasionally they seem to get stuck, so parathyroid tumors are sometimes located in chest. Multiple glands are involved in conditions of hereditary hyperparathyroidism. This may occur as an isolated problem, but some people with hereditary forms of hyperparathyroidism have multiple endocrine neoplasia, a condition in which there are tumors involving various hormone-producing glands. Surgery for these patients is more difficult and involves removal of 3 or 3 and 1/2 of the parathyroid glands. The risk of removing too much tissue, causing hypoparathyroidism, or of re-growth of the parathyroid tissue are both high in this setting, so one needs to select a surgeon with alot of experience in this area. 

    Sometimes the diagnosis of hyperparathyroidism is not made correctly. A PTH level may be high because of a low vitamin D level, a condition called secondary hyperparathyroidism. Correcting the vitamin D deficiency is the correct treatment here, not surgery. One form of hyperparathyroidism, called hypocaliuric hypercalcemia, is the result of diminished sensitivity of the parathyroid glands to calcium. They respond as though the calcium levels are lower than they actually are. This condition is usually relatively benign and most people do not really need surgery. The condition is sometimes hereditary.  It is diagnosed by finding a very low urine calcium level. 
     
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    A , Endocrinology Diabetes & Metabolism, answered
    Hyperparathyroidism is often asymptomatic, but as the calcium rises many problems may develop. As the parathyroid hormone (PTH) stimulates the release of calcium from bone, osteoporosis may develop. This tends to be an unusual form of osteoporosis, affecting the shafts of the long bones more than age-related bone loss does. Usually when we do a bone density study on someone with hyperparathyroidism, we include images of the forearm which reveals osteoporosis of this type.

    Often in hyperparathyroidism there is a significant increase in urine calcium excretion. This places some at risk of kidney stones, and anyone who has had kidney stones should have their PTH level checked. 

    Hyperparathyroidism may lead to more subjective problems as well. Muscle aches and pains may develop. Neuro-psychiatric symptoms are common. These may include difficulty with focus and concentration. An increase in depression and/or anxiety may also occur. 
     
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    A , Endocrinology Diabetes & Metabolism, answered
    Secondary hyperparathyroidism is a situation in which the parathyroid glands are producing a large amount of parathyroid hormone (PTH) to compensate for another problem. One can easily measure parathyroid hormone levels, and there is a “normal” range, but the range is really meaningless unless one also knows the blood calcium level. PTH is designed to raise the blood calcium. If the calcium level is low, the PTH should be high, so a higher-than-normal level means that the parathyroid glands are doing their job properly. This is what’s called secondary hyperparathyroidism -- the PTH levels are high, but they should be high because there is something else causing the blood calcium level to be low and the PTH goes up to try to compensate. 

    There are many causes of secondary hyperparathyroidism, but by far the most common is some form of vitamin D deficiency. Severe deficiency of standard 25-hydroxy-vitamin D3 levels (lets call this 25-D), which is the form of vitamin D that is usually measured in the blood, will sometimes cause secondary hyperparathyroidism. Much more commonly, the problem results from an inability of the body to convert this form of vitamin D to the more active form, 1,25-dihydroxy-vitamin D3 (we’ll call this 1,25-D). Conversion of 25-D to 1,25-D takes place in the kidney and many people with kidney problems -- sometimes even with what appear to be mild kidney problems -- can’t properly convert vitamin D and will develop secondary hyperparathyroidism. This condition results in a low blood calcium, a low blood phosphorus, a form of bone disease called osteomalacia, which is similar to osteoporosis but is corrected by 1,25-D, and possibly muscle weakness. This problem is surprisingly common and is frequently not recognized. Treatment with an oral form of active 1,25-D is highly effective at correcting the problem. When the 1,25-D level rises, and when the blood calcium is restored to normal, the PTH levels will also fall back into the normal range. 
     
  • 1 Answer
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    A , Endocrinology Diabetes & Metabolism, answered
    Parathyroid hormone (PTH) is a key regulator of calcium and bone metabolism. PTH is made by the parathyroid glands which are located in the neck, just adjacent to the thyroid, though their function is completely separate from the thyroid. Most people have 4 glands, two on each side, one near the upper end of the thyroid gland on that side and one near the lower. Occasionally the glands may be found outside of their usual location, because they start out in one location during embryonic development and migrate or move as the fetus matures. Occasionally a parathyroid gland will seemingly get “stuck” somewhere along that migratory path. This is important only when a gland becomes overactive and needs to be removed surgically. It may be difficult to find a gland in an unexpected location unless you are a very skilled surgeon or do just the right radiographic tests to locate the gland. 

    The main role of PTH is to help keep the blood calcium level normal. This is critical because many physiologic processes require a precise calcium level in the blood. When the level of calcium in the blood starts to fall, the parathyroid glands release additional PTH.  PTH does three main things: 
    1. PTH increases the amount of active vitamin D in the body, which results in more calcium being absorbed from the food we eat.
    2. PTH causes the release of stored calcium from bone into the bloodstream.
    3. PTH causes calcium to be absorbed back into the body from urine that is being made. 
    These three actions together result in an increase in blood calcium levels. 

    Parathyroid hormone is used as a medication in two settings. First, one form of synthetic parathyroid hormone (drug name Forteo) is used to treat osteoporosis. Second, another form of parathyroid hormone (drug name NetPara) is used to treat hypoparathyroidism -- a condition of too little parathyroid hormone in the body. Hypoparathyroidism usually results from the accidental removal of all 4 parathyroid glands when one undergoes thyroid surgery, though there are other causes as well.