Endocrine Disorders

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Introduction

What are endocrine disorders?

Endocrine disorders are diseases related to the endocrine glands of the body. The endocrine system produces hormones, which are chemical signals sent out, or secreted, through the bloodstream. Hormones help the body regulate processes, such as appetite, breathing, growth, fluid balance, feminization and virilization, and weight control.

The endocrine system consists of several glands, including the pituitary gland and hypothalamus in the brain, adrenal glands in the kidneys, and thyroid in the neck, as well as the pancreas, ovaries and testes. The stomach, liver and intestines also secrete hormones related to digestion. Most common endocrine disorders are related to improper functioning of the pancreas and the pituitary, thyroid and adrenal glands.

Common endocrine disorders include diabetes mellitus, acromegaly (overproduction of growth hormone), Addison’s disease (decreased production of hormones by the adrenal glands), Cushing’s syndrome (high cortisol levels for extended periods of time), Graves’ disease (type of hyperthyroidism resulting in excessive thyroid hormone production), Hashimoto’s thyroiditis (autoimmune disease resulting in hypothyroidism and low production of thyroid hormone), hyperthyroidism (overactive thyroid), hypothyroidism (underactive thyroid), and prolactinoma (overproduction of prolactin by the pituitary gland). These disorders often have widespread symptoms, affect multiple parts of the body, and can range in severity from mild to very severe. Treatments depend on the specific disorder but often focus on adjusting hormone balance using synthetic hormones.

Modern treatment is generally quite effective for endocrine disorders, and severe consequences of endocrine dysfunction are rare. However, untreated endocrine disorders can have widespread complications throughout the body.

While endocrine disorders do not usually require hospitalization, in some cases they may lead to severe symptoms. Seek immediate medical care (call 911) for serious symptoms, such as difficulty breathing, chest pain, or difficulty thinking clearly.

Seek prompt medical care if you are being treated for endocrine disorders and have persistent bothersome symptoms, as they may indicate a more serious condition.

Symptoms

What are the symptoms of endocrine disorders?

The symptoms of endocrine disorders can range from mild or even nonexistent to serious and affecting your entire body and overall feeling of well-being. Specific symptoms depend on the specific part of the endocrine system affected.

Common symptoms of diabetes

Diabetes mellitus is the most common endocrine disorder and occurs when the pancreas either does not produce sufficient insulin or the body cannot use the available insulin. Symptoms of both type 1 and type 2 diabetes include:

Common symptoms of acromegaly

Acromegaly is a disorder in which the pituitary gland overproduces growth hormone. This leads to symptoms of overgrowth, especially of the hands and feet. Symptoms of acromegaly include:

  • Abnormally large lips, nose or tongue
  • Abnormally large or swollen hands or feet
  • Altered facial bone structure
  • Body and joint aches
  • Deep voice
  • Fatigue and weakness
  • Headaches
  • Overgrowth of bone and cartilage and thickening of the skin
  • Sexual dysfunction, including decreased libido
  • Sleep apnea
  • Vision impairment

Common symptoms of Addison’s disease

Addison’s disease is characterized by decreased production of cortisol and aldosterone due to adrenal gland damage. Common symptoms of Addison’s disease include:

Common symptoms of Cushing’s syndrome

Cushing’s syndrome arises from excess cortisol, produced by the adrenal glands. Symptoms of Cushing’s syndrome include:

  • Buffalo hump (fat between the shoulder blades)
  • Skin discoloration such as bruising
  • Fatigue
  • Feeling very thirsty
  • Thinning and weakening of the bones (osteoporosis)
  • Frequent urination
  • High blood sugar (hyperglycemia)
  • High blood pressure (hypertension)
  • Irritability and mood changes
  • Obesity of the upper body
  • Rounded “moon“ face
  • Weakness (loss of strength)

Common symptoms of Graves’ disease

Graves’ disease is a type of hyperthyroidism resulting in excessive thyroid hormone production. Common symptoms of Graves’ disease include:

  • Bulging eyes (Graves’ ophthalmopathy)
  • Diarrhea
  • Difficulty sleeping
  • Fatigue and weakness
  • Goiter (enlargement of the thyroid gland)
  • Heat intolerance
  • Irregular heart rate
  • Irritability and mood changes
  • Rapid heart rate (tachycardia)
  • Thick or red skin on the shins
  • Tremors
  • Unexplained weight loss

Common symptoms of Hashimoto’s thyroiditis

Hashimoto’s thyroiditis, or autoimmune thyroiditis, is a condition in which the thyroid is targeted by the immune system, leading to hypothyroidism and low production of thyroid hormone. Often, Hashimoto’s thyroiditis is symptomless, but symptoms can include:

Common symptoms of hyperthyroidism

Hyperthyroidism is a condition characterized by an overactive thyroid gland. Common symptoms of hyperthyroidism include:

  • Diarrhea
  • Difficulty sleeping
  • Fatigue
  • Goiter (enlargement of the thyroid gland)
  • Heat intolerance
  • Irritability and mood changes
  • Rapid heart rate (tachycardia)
  • Tremors
  • Unexplained weight loss
  • Weakness (loss of strength)

Common symptoms of hypothyroidism

Hypothyroidism is a condition in which the thyroid is underactive and produces too little thyroid hormone. Often, hypothyroidism can be symptomless or very mild. Common symptoms of hypothyroidism include:

  • Cold intolerance
  • Constipation
  • Decreased sweat production
  • Dry hair
  • Fatigue
  • Goiter (enlargement of the thyroid gland)
  • Joint and muscle pain
  • Missed menstrual periods
  • Slowed heart rate
  • Swollen face
  • Unexplained weight gain

Common symptoms of prolactinoma

Prolactinoma arises when a dysfunctional pituitary gland makes excess prolactin hormone, which functions in the production of breast milk. Excess prolactin can lead to symptoms such as:

  • Erectile dysfunction
  • Infertility
  • Loss of libido
  • Missed menstrual periods
  • Unexplained milk production

Serious symptoms that might indicate a life-threatening condition

In some cases, endocrine disorders can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms that might indicate a life-threatening condition including:

  • Confusion or loss of consciousness for even a brief moment
  • Dangerously low blood pressure (extreme hypotension)
  • Dangerously slow heart rate
  • Dehydration
  • Depression or anxiety
  • Difficulty breathing
  • Eye problems, including dryness, irritation, pressure, pain or bulging
  • Severe fatigue or weakness
  • Severe, unexplained headache
  • Severe vomiting and diarrhea
  • Sleep disturbances

Causes

What causes endocrine disorders?

Endocrine disorders arise because of problems with the glands of the endocrine system. Of the many potential endocrine disorders, some of the most common relate to problems with the pancreas or with the pituitary, thyroid, or adrenal glands.

Causes of endocrine disorders

A number of factors are believed to cause endocrine disorders. Types and causes of endocrine disorders include:

  • Acromegaly, an overproduction of growth hormone, and prolactinoma, an overproduction of prolactin hormone, resulting from damage to the pituitary gland

  • Addison’s disease and Cushing’s syndrome, disorders relating to changes in levels of hormones produced by the adrenal glands

  • Diabetes mellitus, which arises when the pancreas does not produce sufficient insulin or when the body cannot respond to the insulin that is present

  • Environmental or nutritional factors, such as a lack of iodine in hypothyroidism, which can affect hormone production

  • Genetic factors, which may play a role in endocrine disorders, especially with diabetes and other disorders, such as autoimmune thyroiditis, or Hashimoto’s thyroiditis

  • Hyperthyroidism (overactive thyroid), hypothyroidism (underactive thyroid), Graves’ disease (a type of hyperthyroidism resulting in excessive thyroid hormone production), and Hashimoto’s thyroiditis (autoimmune disease resulting in hypothyroidism), all resulting from problems with the thyroid gland

  • Tumors, since the underlying cause of the endocrine disorder can be linked to a growth or tumor of the gland

In many cases, the exact cause of a particular endocrine disorder is not known. Often, hormones interact with each other, so symptoms of a particular endocrine disorder may be nonspecific. It is important to seek medical evaluation if you believe you may have an endocrine disorder, as direct assessment of hormone levels may help find and fix the underlying cause of hormone imbalance.

What are the risk factors for endocrine disorders?

A number of factors increase the risk of developing endocrine disorders. Not all people with risk factors will develop endocrine disorders. Risk factors for endocrine disorders include:

  • Elevated cholesterol levels

  • Family history of endocrine disorder

  • Inactivity

  • Personal history of autoimmune disorders, such as diabetes

  • Poor diet

  • Pregnancy (in cases such as hyperthyroidism)

  • Recent surgery, trauma, infection, or serious injury

Reducing your risk of endocrine disorders

While many endocrine disorders are inherited or arise for unknown reasons, some may be related to modifiable lifestyle factors. You may be able to lower your risk of certain endocrine disorders, such as hypothyroidism, by:

  • Eating a balanced, healthy diet

  • Living a healthy lifestyle, including regular physical activity

Treatments

How are endocrine disorders treated?

In many cases, endocrine disorders may be symptomless or mild enough to not require treatment. Symptoms can arise from excess hormone production or a hormone deficiency. When symptoms of endocrine disorders are bothersome, they can generally be treated by correcting the hormone imbalance. This is often done by means of synthetic hormone administration. In cases such as prolactinoma, where a noncancerous tumor is responsible for symptoms, surgery or radiation therapy may be used. Often, diagnosis and treatment of the underlying cause of the endocrine disorder will resolve the symptoms.

What are the potential complications of endocrine disorders?

While most endocrine disorders are mild and slow to progress, certain endocrine disorders can lead to complications over time as unbalanced hormonal signaling affects normal body processes. In cases of Addison’s disease and hypothyroidism in particular, acute attacks or crises can have serious complications. Diabetes can also have potentially life-threatening complications. Complications of untreated or poorly controlled endocrine disorders can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of certain endocrine disorders include:

  • Anxiety or insomnia (in many thyroid conditions)
  • Coma (in hypothyroidism)
  • Depression (in many thyroid conditions)
  • Heart disease
  • Nerve damage
  • Organ damage or failure
  • Poor quality of life
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Nov 5
  1. Adrenal insufficiency and Addison’s disease. National Endocrine and Metabolic Diseases Information Service. http://endocrine.niddk.nih.gov/pubs/addison/addison.htm
  2. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy.Philadelphia: Saunders, 2013.
  3. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
  4. Cushing’s syndrome. National Endocrine and Metabolic Diseases Information Service. http://endocrine.niddk.nih.gov/pubs/cushings/cushings.htm
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