Endocrine Disorders

Gigantism Hyperfunction of pituitary – too much growth hormone In preadolescent – overgrowth of long bones leads to excessive tallness.

Acromegaly Hyperfunction of pituitary –too much growth hormone in adulthood Overdevelopment of bones in face, hands and feet Attacks cartilage – so the chin protrudes, lips, nose and extremities enlarge RX- drugs to inhibit growth hormone, radiation

Dwarfism Hypofunction of pituitary in childhood Small size, but body proportions and intellect are normal Sexual immaturity RX- early diagnosis, injection of growth hormone.

Hyperthyroidism Overactive thyroid gland Too much thyroxine secreted leading to enlargement of gland, person has nervous irritability People with this disease consume large quantities of food but lose body fat and weight Most pronounced symptoms are enlargement of gland (GOITER) and bulging of eyeballs (EXOPHTHALMOS) Rx – total or partial removal of thyroid gland, drugs or reduce thyroxine, radiation

Hypothyroidism Not enough thyroxine secreted May be due to lack of iodine (simple goiter) Major cause of other types is inflammation of thyroid which destroys the ability of the gland to make thyroxine Symptoms – dry and itchy skin, dry and brittle hair, constipation, muscle cramps at night

Tetany In hypoparathyroidism decreased calcium levels affect function of nerves Convulsive twitching develops, person dies of spasms in the respiratory muscles RX – vitamin D, calcium and parathormone

Diabetes Mellitus Caused by ↓ secretion of insulin Can be insulin dependent (juvenile) or non insulin dependent Symps- polyuria, polyphagia, polydipsia, weight loss, blurred vision, and possible diabetic coma If not treated, excess glucose in blood (hyperglycemia) and glucose secreted in urine (glycosuria) Since glucose not available for cellular oxidation, body starts to burn up protein and fat If too much insulin is given, blood sugar may go too low (hypoglycemia→ insulin shock) If blood sugar gets too high-hyperglycemia→ diabetic coma Type II (non-insulin dependent) is most common, usually familial, occurs later in life, control with oral hypoglycemia drugs and diet Tests for Diabetes –blood sample measured in glucometer done by patient in home- normal blood sugar 80-100 mgms Urinalysis is a simple test used to diagnose diabetes

Disorders of the Endocrine System Before Cushing's Syndrome Cushing's syndrome is a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol. Sometimes called "hypercortisolism," it is relatively rare and most commonly affects adults aged 20 to 50. An estimated 10 to 15 of every million people are affected each year. After What are the symptoms of Cushing's syndrome? Symptoms vary, but most people have upper body obesity, rounded face, increased fat around the neck, and thinning arms and legs. Children tend to be obese with slowed growth rates.

Many people suffer the symptoms of Cushing's syndrome because they take glucocorticoid hormones such as prednisone for asthma, rheumatoid arthritis, lupus and other inflammatory diseases, or for immunosuppression after transplantation. Pituitary adenomas cause most cases of Cushing's syndrome. They are benign, or non-cancerous, tumors of the pituitary gland which secrete increased amounts of ACTH. Most patients have a single adenoma. This form of the syndrome, known as "Cushing's disease," affects women five times more frequently than men.

Addison's disease Addison's disease is an endocrine or hormonal disorder that occurs in all age groups and afflicts men and women equally. What is the cause of Addison’s disease? What are the most common symptoms of Addison’s disease? The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin in both exposed and nonexposed parts of the body. How is Addison’s disease treated? Treatment of Addison's disease involves replacing, or substituting, the hormones that the adrenal glands are not making. Cortisol is replaced orally with hydrocortisone tablets, a synthetic glucocorticoid, taken once or twice a day. If aldosterone is also deficient, it is replaced with oral doses of a mineralocorticoid called fludrocortisone acetate (Florinef), which is taken once a day.

Steroid Abuse in Sports What are the risks? Males These effects can cause any or all of the following problems in men: Temporary infertility or sterility (reversible) Altered sex drive Prostate enlargement, and increased prostate cancer risk Irreversible breast enlargement Painful erections Shrinkage of the testicles Reduced levels of testosterone Abnormal sperm production Increased levels of estrogen

Females Increased risk of cervical and endometrial cancer Increased risk of osteoporosis Temporary infertility or sterility (reversible) Altered sex drive Birth defects in future children Changes in fat distribution Growth of facial and body hair Deepening of the voice Shrinkage of the breasts and uterus Clitoral enlargement Menstrual irregularity Changes in the male reproductive system are often reversible, if anabolic steroids have not been abused for a long period of time. Unfortunately, some of the changes in women are NOT reversible. Prolonged abuse of anabolic steroids very often results in physical addiction. Abusers must undergo a strict, medically-supervised withdrawal program.