Which organs produce hormones in the human body. How does the endocrine system regulate bodily functions. What are the key hormones and their roles in maintaining homeostasis. Can lifestyle factors influence hormone production and balance.

The Endocrine System: A Complex Network of Hormone-Producing Organs

The endocrine system is a intricate network of glands and organs that produce and secrete hormones, chemical messengers that regulate various bodily functions. These hormones play crucial roles in metabolism, growth, development, reproduction, and homeostasis. Understanding which organs produce hormones and how they function is essential for comprehending the complexities of human physiology.

Major Hormone-Producing Organs

Several organs in the human body are responsible for hormone production:

• Pituitary gland
• Thyroid gland
• Parathyroid glands
• Adrenal glands
• Pancreas
• Ovaries (in females)
• Testes (in males)

Each of these organs produces specific hormones that regulate different aspects of bodily function. For instance, the pituitary gland, often referred to as the “master gland,” produces hormones that control the function of other endocrine glands.

Organs That Do Not Produce Hormones

While many organs contribute to hormone production, some do not. These include:

• Liver
• Kidneys
• Lungs
• Heart
• Spleen

Although these organs do not produce hormones, they play essential roles in other bodily functions and may be influenced by hormones produced elsewhere in the body.

Hormonal Regulation of Bodily Functions: A Delicate Balance

Hormones act as chemical messengers, traveling through the bloodstream to target specific cells or organs. They influence numerous physiological processes, including:

1. Metabolism
2. Growth and development
3. Reproductive functions
4. Mood and behavior
5. Stress response
6. Blood sugar regulation
7. Calcium homeostasis

The precise regulation of hormone production and secretion is crucial for maintaining overall health and well-being. Imbalances in hormone levels can lead to various disorders and health conditions.

Feedback Mechanisms in Hormone Regulation

How does the body maintain proper hormone levels? The endocrine system employs feedback mechanisms to regulate hormone production and secretion. These mechanisms can be either negative or positive feedback loops:

• Negative feedback: The most common type, where an increase in hormone levels signals the body to decrease production.
• Positive feedback: Less common, where an increase in hormone levels triggers further production, often seen in processes like childbirth.

These feedback mechanisms help ensure that hormone levels remain within optimal ranges for proper bodily function.

Key Hormones and Their Functions: Understanding the Body’s Chemical Messengers

The human body produces a wide array of hormones, each with specific functions. Some of the most important hormones include:

Insulin: The Blood Sugar Regulator

Produced by the pancreas, insulin plays a crucial role in regulating blood sugar levels. It allows cells to uptake glucose from the bloodstream, providing energy for cellular functions. When insulin production or function is impaired, it can lead to conditions like diabetes.

Thyroid Hormones: Metabolic Maestros

The thyroid gland produces hormones such as thyroxine (T4) and triiodothyronine (T3). These hormones regulate metabolism, influencing energy production, body temperature, and growth. Imbalances in thyroid hormones can result in conditions like hypothyroidism or hyperthyroidism.

Growth Hormone: The Body’s Builder

Secreted by the pituitary gland, growth hormone stimulates growth and cell reproduction. It plays a crucial role in childhood development and continues to influence metabolism and body composition throughout adulthood.

Cortisol: The Stress Hormone

Produced by the adrenal glands, cortisol is often referred to as the “stress hormone.” It helps regulate metabolism, immune response, and the body’s reaction to stress. Chronic elevation of cortisol levels can have detrimental effects on health.

Endocrine Disorders: When Hormone Production Goes Awry

Disruptions in hormone production or function can lead to various endocrine disorders. These conditions can arise from overproduction, underproduction, or impaired receptor sensitivity to specific hormones.

Common Endocrine Disorders

Some frequently encountered endocrine disorders include:

• Diabetes mellitus (Types 1 and 2)
• Thyroid disorders (hypothyroidism and hyperthyroidism)
• Adrenal insufficiency
• Cushing’s syndrome
• Polycystic ovary syndrome (PCOS)
• Growth hormone deficiency

Each of these disorders results from specific imbalances in hormone production or function, leading to a range of symptoms and health complications.

Diagnosing Endocrine Disorders

How are endocrine disorders diagnosed? Healthcare providers employ various methods to assess hormone levels and endocrine function:

1. Blood tests to measure hormone levels
2. Urine tests to assess hormone excretion
3. Imaging studies (e.g., CT scans, MRI) to visualize endocrine glands
4. Genetic testing for hereditary endocrine disorders
5. Stimulation or suppression tests to evaluate gland function

Early diagnosis and appropriate treatment are crucial for managing endocrine disorders and preventing potential complications.

The Impact of Lifestyle on Hormone Production and Balance

While genetic factors play a significant role in endocrine function, lifestyle choices can also influence hormone production and balance. Various aspects of daily life can impact the endocrine system:

Nutrition and Hormone Health

Diet plays a crucial role in maintaining hormonal balance. Certain nutrients are essential for hormone production and function:

• Healthy fats for steroid hormone production
• Protein for peptide hormone synthesis
• Vitamins and minerals as cofactors in hormone production
• Fiber for regulating hormone excretion

A balanced diet that includes a variety of whole foods can support optimal endocrine function.

Exercise and Hormonal Regulation

Physical activity has a profound impact on hormone levels and function. Regular exercise can:

• Improve insulin sensitivity
• Increase growth hormone production
• Regulate stress hormones like cortisol
• Enhance thyroid function

Both aerobic exercise and strength training can contribute to hormonal balance and overall health.

Stress Management and Endocrine Health

Chronic stress can disrupt hormone production and balance, particularly affecting cortisol levels. Implementing stress-reduction techniques such as meditation, yoga, or deep breathing exercises can help maintain endocrine health.

Sleep and Circadian Rhythms

Quality sleep is essential for proper hormone production and regulation. Many hormones follow circadian rhythms, with levels fluctuating throughout the day and night. Maintaining a consistent sleep schedule and practicing good sleep hygiene can support optimal endocrine function.

Emerging Research in Endocrinology: New Frontiers in Hormone Science

The field of endocrinology continues to evolve, with ongoing research shedding light on new aspects of hormone function and regulation. Some exciting areas of current research include:

Gut Microbiome and Hormone Interactions

Recent studies have revealed intricate connections between the gut microbiome and the endocrine system. The microorganisms in our digestive tract can influence hormone production, metabolism, and even mood regulation. This emerging field of research may lead to novel approaches for managing endocrine disorders.

Endocrine Disruptors in the Environment

Environmental pollutants known as endocrine disruptors can interfere with hormone production and function. Ongoing research aims to identify these compounds, understand their mechanisms of action, and develop strategies to mitigate their effects on human health.

Chronobiology and Hormone Rhythms

The study of biological rhythms, or chronobiology, is providing new insights into the temporal patterns of hormone secretion. Understanding these rhythms may lead to more effective treatments for endocrine disorders and improved strategies for optimizing hormone function.

Personalized Endocrine Medicine

Advances in genetic testing and biomarker analysis are paving the way for personalized approaches to endocrine health. Tailoring treatments to an individual’s unique genetic and hormonal profile may improve outcomes for patients with endocrine disorders.

Maintaining Endocrine Health: Practical Tips for Hormone Balance

While some aspects of endocrine function are beyond our control, there are several steps individuals can take to support hormone health:

Dietary Considerations for Hormone Balance

Adopting a balanced diet rich in whole foods can support endocrine health. Consider incorporating the following:

• Lean proteins for hormone production
• Healthy fats, including omega-3 fatty acids
• Complex carbohydrates for sustained energy
• Plenty of fruits and vegetables for essential nutrients
• Adequate fiber to support hormone metabolism

Limiting processed foods, excessive sugar, and alcohol can also contribute to hormonal balance.

Exercise Routines for Endocrine Support

Regular physical activity is crucial for maintaining hormone health. Aim for a combination of:

• Aerobic exercise (e.g., walking, jogging, cycling) for cardiovascular health
• Strength training to support muscle mass and bone density
• Flexibility exercises like yoga or stretching for stress reduction

Consistency is key – aim for at least 150 minutes of moderate-intensity exercise per week.

Stress Management Techniques

Chronic stress can wreak havoc on the endocrine system. Incorporate stress-reduction practices into your daily routine:

• Meditation or mindfulness exercises
• Deep breathing techniques
• Regular relaxation time
• Engaging in hobbies or enjoyable activities

Finding effective ways to manage stress can have a significant positive impact on hormone balance.

Sleep Hygiene for Hormonal Health

Prioritizing quality sleep is essential for maintaining endocrine function. Practice good sleep hygiene by:

• Establishing a consistent sleep schedule
• Creating a relaxing bedtime routine
• Limiting screen time before bed
• Ensuring a comfortable sleep environment

Aim for 7-9 hours of quality sleep per night to support optimal hormone production and regulation.

The Future of Endocrinology: Advancements in Hormone Research and Treatment

As our understanding of the endocrine system continues to grow, new possibilities for diagnosis, treatment, and prevention of hormone-related disorders are emerging. Some promising areas of development include:

Bioengineered Hormone Therapies

Advancements in biotechnology are leading to the development of more precise and effective hormone replacement therapies. These may include:

• Long-acting hormone formulations for improved patient compliance
• Targeted delivery systems for reduced side effects
• Bioidentical hormones that closely mimic natural hormone structures

These innovations may offer more personalized and effective treatments for individuals with endocrine disorders.

Gene Therapy for Endocrine Disorders

Gene therapy holds promise for treating certain endocrine disorders at their genetic roots. Researchers are exploring ways to:

• Correct genetic mutations that cause hormone deficiencies
• Enhance the function of hormone-producing cells
• Regulate gene expression to optimize hormone production

While still in early stages, gene therapy could revolutionize the treatment of some endocrine conditions in the future.

Artificial Intelligence in Endocrinology

The integration of artificial intelligence (AI) and machine learning in endocrinology is opening new avenues for diagnosis and treatment. AI applications may include:

• Analyzing complex hormone patterns to improve diagnosis
• Predicting treatment outcomes based on individual patient data
• Optimizing hormone replacement therapies
• Identifying new biomarkers for endocrine disorders

These technological advancements could lead to more accurate diagnoses and personalized treatment plans for patients with endocrine disorders.

Wearable Technology for Hormone Monitoring

The development of wearable devices for continuous hormone monitoring is an exciting frontier in endocrinology. These devices may offer:

• Real-time tracking of hormone levels
• Early detection of hormonal imbalances
• Improved management of conditions like diabetes
• Personalized feedback for lifestyle modifications

As this technology advances, it could empower individuals to take a more active role in managing their endocrine health.

In conclusion, the endocrine system is a complex and vital component of human physiology, with hormone-producing organs playing crucial roles in maintaining health and well-being. While some organs do not produce hormones, they are still influenced by and interact with the endocrine system. Understanding the functions of various hormones, recognizing the signs of endocrine disorders, and adopting lifestyle habits that support hormonal balance are essential for overall health. As research in endocrinology continues to advance, we can look forward to more effective treatments and a deeper understanding of this intricate system that regulates so many aspects of our lives.

Diabetes and Endocrine Function | Endocrine Society

An estimated 30 million Americans have diabetes, a disease in which there is too much sugar in the bloodstream. About 7 million of them, however, have not yet been diagnosed with the disease.

Endocrine Connection

Diabetes occurs when the pancreas, a gland behind the stomach, does not produce enough of the hormone insulin, or the body cannot use insulin properly. Insulin helps carry sugar from the bloodstream into the cells. Once inside the cells, sugar is converted into energy for immediate use or stored for the future. That energy fuels many of our bodily functions.

The body produces glucose from the foods you eat. The liver also releases sugar when you are not eating. The pancreas produces the hormone insulin, which allows glucose from the bloodstream to enter the body’s cells where it is used for energy. In type 2 diabetes, too little insulin is produced, or the body cannot use insulin properly, or both. This results in a build-up of glucose in the blood. 

People with diabetes are at risk of developing serious health problems (complications). If your blood glucose level stays too high for too long, complications can include:

• Blindness
• Kidney disease and failure
• Nerve damage which can result in nerve pain or injury to the feet or other extremities without feeling pain
• Heart attacks (with or without symptoms)
• Stroke 

There are three blood tests that can be used to check the levels of glucose in your blood and diagnose prediabetes or diabetes:

• Fasting Blood Glucose Test (FBG): Blood is drawn in the morning after you go without food overnight or for at least 8 hours.
• Oral Glucose Tolerance Test (OGTT): This test is also done in the morning after going without food overnight or for at least 8 hours. Blood is drawn before you drink 8 ounces of a sugar solution and 2 hours after. This test is more precise but less convenient than the FBG test.
• Hemoglobin A1C Test (A1C): This test shows what your average blood glucose levels have been over the past 3 months. You can eat and drink normally before the test.

If you are living with diabetes, lifestyle is an important part of your care. It is very important that you eat a good balance of real foods every day and exercise regularly. Managing your diabetes also means taking medicine, if needed, and testing your blood sugar levels each day. 

Prediabetes occurs when blood glucose levels are higher than normal, but not high enough for a diabetes diagnosis. Over time, this can increase your risk of heart disease and stroke, as well as your risk of developing type 2 diabetes. Unfortunately, prediabetes symptoms are hard to spot, so many people have the condition and do not know it.

The U.S. Centers for Disease Control indicates that about 79 million American adults over the age of 20 have prediabetes. As the population ages, becomes increasingly overweight and increasingly inactive, the number of adults with prediabetes continues to grow. The number of young people with this condition is also increasing. Common risk factors include:

• Being obese or overweight
• Not getting enough exercise
• A family history of type 2 diabetes
• Being 45 or older
• African American, Latino/Hispanic or American Indian family background
• Having had gestational diabetes
• Giving birth to a baby weighing more than 9 pounds

Preventing prediabetes is done with lifestyle changes, including a healthy diet that is high in vegetables and fruits and low in fat and processed foods. Regular physical activity, averaging 30 minutes five days per week, is also important. Maintaining a healthy weight or losing 5–10% of your weight if you are overweight, can also help.

In addition to lifestyle changes, a few drugs have been proven to lower the risk of developing diabetes if you have prediabetes. These drugs do have side effects, and their benefits wear off when you stop taking the drug, making lifestyle change the best option for tackling this problem.

Type 1 diabetes, sometimes called insulin-dependent diabetes or juvenile diabetes, can develop at any age but most often occurs in children, teens, and young adults. In type 1 diabetes, a person’s pancreas produces little or no insulin, so insulin treatment is needed for a lifetime.

The causes of type 1 diabetes are not fully known. In most cases, the body’s immune system attacks and destroys the part of the pancreas that produces insulin. This occurs over a period of time. So early on in type 1 diabetes, people may not have any symptoms. It is only when enough of the insulin producing cells are affected and insulin levels are low that the blood sugar rises and symptoms of diabetes start to occur. Because type 1 is an autoimmune disease, people with other autoimmune, conditions, such as Hashimoto’s disease or primary adrenal insufficiency (also known as Addison’s Disease), are more likely to develop type 1 diabetes. Overall, cases of type 1 diabetes seem to be increasing.

The symptoms of type 1 diabetes can look like other conditions or medical problems. If you (or your child) have these symptoms, talk with your doctor as soon as possible.

• Increased thirst
• Increased urination
• Constant hunger
• Weight loss
• Blurred vision
• Constantly feeling tired

People with type 1 diabetes must have daily injections of insulin to keep a normal level of glucose in the blood. Blood glucose is kept under the best control with three or more injections per day using long and short acting insulin, or when insulin is delivered throughout the day with an insulin pump. A healthy diet, exercise, and regular monitoring of blood glucose levels are also important to manage diabetes.

Type 2 diabetes is the most common form of the disease, affecting 90–95% of people with diabetes. In type 2 diabetes, the body is resistant to the action of insulin, meaning it cannot use insulin properly, so it cannot carry sugar into the cells. Although the body makes some insulin, it is not enough to overcome this resistance. You are more likely to develop type 2 diabetes if you are overweight, have a family history of diabetes, or have a history of diabetes during pregnancy. Other groups more likely to have the disease are people over age 45 and non-Caucasians. A simple blood test can tell you if you have diabetes.

Individuals with this condition have a pancreas that is able to produce insulin, but their bodies are unable to use or process the insulin that is made. Over time, the pancreas may stop creating insulin altogether, but type 2 diabetes starts with the inability to process the insulin that is made.

Being older (over 45) and overweight are the greatest risk factors for developing diabetes. Other factors that increase your chances of developing high blood glucose include:

• Having a parent or sibling with diabetes
• Having an African American, Latino/Hispanic, or American Indian family background
• Having had gestational diabetes (diabetes during pregnancy) or giving birth to a baby weighing more than 9 pounds
• Having high blood pressure (140/90 mm Hg or higher)
• Having low levels of HDL (good) cholesterol (below 35 mg/dL in men or 45 mg/dL in women) or high levels of triglycerides (above 250 mg/dL)
• Having polycystic ovary syndrome (PCOS)
• Being physically inactive

People with both type 1 and type 2 have high blood glucose levels, but the reasons for those high levels differ. Differences between type 1 and type 2 diabetes include:

Age of diagnosis: Type 1 is typically diagnosed in children or young people (but it can be diagnosed in older individuals as well), while type 2 diabetes is generally diagnosed in adults and occasionally children.

Treatment options: For individuals with type 1 diabetes, the only effective treatment is insulin. For people with type 2 diabetes, oral medications (pills), insulin, or non-insulin injectables may be used.

Hypoglycemia: Blood sugar levels can drop to dangerously low levels in people with type I diabetes, but it can also occur in individuals with type 2 diabetes. Certain medications, such as insulin, may increase the risk of hypoglycemia.

Preventability: While certain experimental medications may postpone the development of type 1 diabetes, there are no means of preventing type 1 diabetes. Type 2 diabetes can sometimes be prevented with lifestyle changes.

Gestational Diabetes is a temporary form of diabetes that can occur when a woman is pregnant. During pregnancy, the placenta produces hormones that help the baby develop. These hormones also block the effects of insulin in the woman’s body, increasing her blood sugar levels. Most women who have gestational diabetes have no symptoms.

If a woman has high blood sugar in pregnanct, she will have to follow a special diet for the rest of the pregnancy. In some cases, she may also need to take insulin. High blood sugar in women with gestational diabetes can affect them and their baby. These risks include: 

• Premature delivery and preeclampsia (pregnancy-induced high blood pressure).
• The baby grows too large. Very large babies may get stuck in the birth canal and have birth injuries. Large size also increases the chances of needing a cesarean (surgical) delivery.
• May cause stillbirth. Uncontrolled gestational diabetes also increases the risk of jaundice and breathing problems in the newborn.
• After birth, the baby may develop low blood sugar (hypoglycemia), a potentially dangerous condition. While in the womb, the baby’s pancreas produces large amounts of insulin in response to the mother’s high blood sugar, and it continues to do so after delivery. Without the sugar supplied by the mother, excess insulin can cause the baby’s own glucose level to drop too low.

Gestational diabetes affects about 4–8 of every 100 pregnant women in the United States. Any pregnant woman can develop the condition, but some women are at greater risk than others. Among women with the below risk factors, as many as 14 in 100 develop gestational diabetes. Known risk factors include:

• Age (older than 25 years; the risk is even greater after age 35)
• Race (occurs more often in African Americans, Hispanics, American Indians, and Asian Americans)
• Overweight and obesity
• Personal history of gestational diabetes or prediabetes
• Having delivered a baby weighing more than 9 pounds
• Family history of type 2 diabetes (in parents or siblings)

Monogenic Diabetes (MODY) is the least common form of diabetes. It is developed as a result of single gene mutations. Monogenic diabetes appears in several forms and most often affects young people.

Type B Insulin Resistance is a very rare form of diabetes and a component of an autoimmune disorder. 

• Do I need to be checked for prediabetes?
• If I have prediabetes, should I be checked for type 2 diabetes? How often?
• Should I take medicine to treat my prediabetes?
• What are the benefits and risks of prediabetes medicines?
• How can I lose weight if I need to?
• What can I (or my child) do to keep blood glucose level on target?
• What should I (or my child) eat?
• Which medicines do I (or my child) need?
• What type of exercise is best for me (or my child)?
• How often should I (or my child) check blood glucose levels?
• Should I (or my child) see a diabetes educator?
• Should I (or my child) see an endocrinologist?
• Should I have my blood glucose level tested?
• What are the results of my testing and what do they mean?
• What can I do to bring my glucose levels back to normal?
• What can I do to prevent gestational diabetes?
• I have gestational diabetes. How often should I check my blood glucose level?
• How often should I check my blood glucose after my baby is born?
• Can gestational diabetes lead to other health problems?

Endocrine Library >>

Editor(s):
Henry Anhalt, DO, Alicia Diaz-Thomas, M.D., MPH, Guillermo Umpierrez, M.D., Abbas Kitabchi, M.D., PHD, Puneet Arora, MBBS, FACE, Jorge Mestman, M.D., Jessica Abramowitz , M.D., Sasan Mifrakhraee, M.D.

Last Updated:
January 24, 2022

Hypopituitarism Information | Mount Sinai

Pituitary insufficiency; Panhypopituitarism

Hypopituitarism is a condition in which the pituitary gland does not produce normal amounts of some or all of its hormones.

Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

The pituitary is a gland attached to the base of the brain. The pituitary secretes hormones that regulate the body’s balance of many hormones controlling growth, development, and metabolism of the body.

The pituitary gland controls the release of several hormones, including the gonadotropins FSH (follicle-stimulating hormone) and LH (luteinizing hormone). FSH and LH in turn control the release of sex hormones (testosterone, estrogen, and progesterone). In children, these hormones govern the onset of puberty and sexual development. After puberty and during adulthood, they control reproductive function.

The pituitary secretes thyroid stimulating hormone (TSH), which stimulates the thyroid gland to secrete hormones that affect body metabolism.

Causes

The pituitary gland is a small structure that is located just below the brain. It is attached by a stalk to the hypothalamus. The hypothalamus is the area of the brain that controls the pituitary gland’s function.

The hormones released by the pituitary gland (and their functions) are:

• Adrenocorticotropic hormone (ACTH) — stimulates the adrenal gland to release cortisol; cortisol helps to maintain blood pressure and blood sugar
• Antidiuretic hormone (ADH) — controls water loss by the kidneys
• Follicle-stimulating hormone (FSH) — controls sexual function and fertility in males and females
• Growth hormone (GH) — stimulates growth of tissues and bone
• Luteinizing hormone (LH) — controls sexual function and fertility in males and females
• Oxytocin — stimulates the uterus to contract during labor and the breasts to release milk
• Prolactin — stimulates female breast development and milk production
• Thyroid-stimulating hormone (TSH) — stimulates the thyroid gland to release hormones that affect the body’s metabolism

In hypopituitarism, there is a lack of one or more pituitary hormones. Lack of a hormone leads to loss of function in the gland or organ the hormone controls. For example, lack of TSH leads to loss of normal function of the thyroid gland.

Hypopituitarism may be caused by:

• Brain surgery
• Brain tumor
• Head trauma (traumatic brain injury)
• Infections or inflammation of the brain and the tissues that support the brain
• Death of an area of tissue in the pituitary gland (pituitary apoplexy)
• Radiation therapy to the brain
• Stroke (rare)
• Subarachnoid hemorrhage (from a burst aneurysm)
• Tumors of the pituitary gland or hypothalamus

Sometimes, hypopituitarism is due to uncommon immune system or metabolic diseases, such as:

• Too much iron in the body (hemochromatosis)
• Abnormal increase in immune cells called histiocytes (histiocytoses )
• Autoimmune condition that causes inflammation of the pituitary (lymphocytic hypophysitis)
• Inflammation of various tissues and organs (sarcoidosis)
• Infections of the pituitary, such as primary pituitary tuberculosis

Hypopituitarism is also a rare complication caused by severe bleeding during pregnancy. The loss of blood leads to tissue death in the pituitary gland. This condition is called Sheehan syndrome.

Certain medicines can also suppress pituitary function. The most common drugs are glucocorticoids (such as prednisone and dexamethasone), which are taken for inflammatory and immune conditions. Drugs used to treat prostate cancer can also lead to low pituitary function.

Symptoms

Symptoms of hypopituitarism include any of the following (multiple symptoms are common):

• Abdominal pain
• Decreased appetite
• Lack of sex drive (in men or women)
• Dizziness or fainting
• Excessive urination and thirst (including frequent urination at night)
• Failure to release milk (in women)
• Fatigue, weakness
• Headache
• Infertility (in women) or stopping of menstrual periods
• Loss of armpit or pubic hair
• Loss of the body or facial hair (in men)
• Low blood pressure
• Low blood sugar
• Sensitivity to cold
• Short height (less than 5 feet or 1. 5 meters) if onset is during the childhood growth period
• Slowed growth and sexual development (in children)
• Vision problems
• Weight loss

Symptoms may develop slowly and may vary greatly, depending upon:

• The number of hormones that are missing and the organs they affect
• The severity of the disorder

Other symptoms that may occur with this disease:

• Face swelling
• Hair loss
• Hoarseness or changing voice
• Joint stiffness
• Weight gain

Exams and Tests

To diagnose hypopituitarism, there must be low hormone levels due to a problem with the pituitary gland. The diagnosis must also rule out diseases of the organ that is affected by this hormone.

Tests may include:

• Brain CT scan
• Pituitary MRI
• ACTH
• Cortisol
• Estradiol (estrogen)
• Follicle-stimulating hormone (FSH)
• Insulin-like growth factor 1 (IGF-1)
• Luteinizing hormone (LH)
• Osmolality tests for blood and urine
• Testosterone level
• Thyroid-stimulating hormone (TSH)
• Thyroid hormone (T4)
• Biopsy of the pituitary

Level of a pituitary hormone may be high in the bloodstream if you have a pituitary tumor that is producing too much of that hormone. The tumor may crush other cells of the pituitary, leading to low levels of other hormones.

Treatment

If hypopituitarism is caused by a tumor, you may need surgery to remove the tumor. Radiation therapy may also be needed.

You will need lifelong hormone medicines to replace hormones that are no longer made by organs under the control of the pituitary gland. These may include:

• Corticosteroids (cortisol)
• Growth hormone
• Sex hormones (testosterone for men and estrogen for women)
• Thyroid hormone
• Desmopressin

Drugs are also available to treat related infertility in men and women.

If you take glucocorticoid medicines for pituitary ACTH deficiency, be sure you know when to take a stress dose of your medicine. Discuss this with your health care provider.

Always carry a medical ID (card, bracelet, or necklace) that says you have adrenal insufficiency. The ID should also say the type of medicine and dosage you need in case of an emergency caused by adrenal insufficiency.

Outlook (Prognosis)

Hypopituitarism is usually permanent. It requires lifelong treatment with one or more medicines. But you can expect a normal life span.

In children, hypopituitarism may improve if the tumor is removed during surgery.

Possible Complications

Side effects of medicines to treat hypopituitarism can develop. However, do not stop any medicine on your own without talking with your provider first.

When to Contact a Medical Professional

Call your provider if you develop symptoms of hypopituitarism.

Prevention

In most cases, the disorder is not preventable. Awareness of risk, such as from taking certain medicines, may allow early diagnosis and treatment.

Burt MG, Ho KKY. Hypopituitarism and growth hormone deficiency. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 11.

Clemmons DR, Nieman LK. Approach to the patient with endocrine disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 208.

Fleseriu M, Hashim IA, Karavitaki N, et al. Hormonal replacement in hypopituitarism in adults: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101(11):3888-3921. PMID: 27736313 pubmed.ncbi.nlm.nih.gov/27736313/.

Last reviewed on: 5/13/2021

Reviewed by: Brent Wisse, MD, Board Certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Endocrine Prevention Week May 22-26, 2023

The thyroid gland is a familiar stranger. It is unlikely that there will be at least one person who has not heard about it or does not know where it is located. Almost every family has a person who has “something with the thyroid”. Sometimes thyroid diseases are detected by others who pay attention to the thickening of the neck.
There are many diseases of the thyroid gland. The role of the thyroid gland in the development of a child cannot be overestimated.

Let’s go in order?

The rudiment of the thyroid gland appears at 3-4 weeks of fetal development, and from the 12th week the fetal thyroid gland begins to perform its first function – iodine capture. From 14-16 weeks of fetal development, thyroid hormones begin to be produced. So, before reaching even half of its intrauterine development, the fetus begins to provide itself with thyroid hormones. Why and why?

Thyroid hormones perform several functions. First of all, it is the regulation of energy exchange. Even maintaining body temperature requires energy, which is also provided by thyroid hormones. The work of the cardiovascular system: heart rate, blood pressure also depend on thyroid hormones. And it is absolutely impossible to overestimate the role of the thyroid gland in the functioning of the nervous system. It is on her hormones that the child’s intelligence, memory, perception, and nervous excitability depend. In short, in the human body there is not a single function, not a single organ whose functional activity does not depend on thyroid hormones.

What does the thyroid gland look like and where is it located?

The thyroid gland is a small organ (only 25-40 grams) located on the front of the neck. Slightly above the gland is the thyroid cartilage, it is this anatomical proximity that gave the organ its name. The gland consists of two lobes (left and right) and an isthmus that connects them. The shape of the gland is often compared to the outline of a butterfly.

The thyroid gland produces two main hormones. Triiodothyronine (it can be remembered as T3) and thyroxine (aka T4). Triiodothyronine is the active hormone, while Thyroxine is the reserve hormone. The function of secretion of hormones by the superior gland regulates. This is the pituitary gland. It produces the hormone TSH (thyroid stimulating hormone) which controls the production of thyroid function. If there are enough hormones (T3 and T4), then TSH is produced in an average (physiological) amount. If the thyroid gland produces few hormones, then the pituitary gland gives an additional amount of TSH (in the analysis we can see its increase compared to the normative value). And vice versa, if the thyroid gland produces a lot of hormones, then the secretion of TSH decreases significantly.

How often do we encounter problems in the work of the thyroid gland?

Every newborn child for the first time in his life undergoes a thyroid function examination on the 4th-5th day of life. These days, blood is taken from him for neonatal screening. Neonatal screening allows you to identify a number of congenital diseases, which must be treated in the first days of a child’s life. In Moscow, neonatal screening allows you to examine a child for 36 diseases, one of which is hypothyroidism (deficiency of thyroid hormones). With congenital hypothyroidism, the nervous system and the child’s intellect suffer first of all. That is why it is extremely important to detect the disease in time and start treatment. This will save the rest of your baby’s life.

At an older age (school and adolescent), problems with hyperfunction of the thyroid gland (thyrotoxicosis), nodules, autoimmune damage to the gland come to the fore. Each of these conditions is well known to physicians and has proven methods of treatment. The main thing is to identify the problem in time by contacting a specialist.

A little more, I would like to talk about iodine and iodine deficiency. Remember that the thyroid gland begins to capture iodine as early as 3-4 weeks of fetal development? Thyroid hormones are formed with the participation of iodine. Triiodothyronine (T3) contains 3 iodine atoms, and thyroxine (T4) has four. Lack or excess of iodine in food will lead to disruption of hormone synthesis.

Basic food products (meat, vegetables, dairy products) do not contain iodine. Seafood can be a source of iodine. How often do children eat them? In what quantity? But it is for a child that iodine deficiency is especially dangerous. Iodine is necessary for the normal formation of the nervous system and adequate mental development of the child. On average, a child needs 100-200 micrograms of iodine per day (this depends on the age of the child).

The simplest and most effective way to combat iodine deficiency is to enrich table salt with iodine. Such salt does not have a special taste or smell and is used in its usual form. One gram of salt contains 40 micrograms of iodine. The daily intake of salt is 3-5 grams (that is, 120-200 micrograms of iodine).

Additional amount of iodine, the prescription of drugs containing iodine is carried out by a doctor if there are medical indications.

The functioning of the thyroid gland has a great influence on the growth, development and intelligence of both the baby and the teenager. It is important to remember the simplest ways to preserve the health of the child and his family!

For help in preparing the material, we thank the doctor, pediatric endocrinologist of the highest qualification category, head of the endocrinology department of the Moscow City Clinical Hospital DZM
Rybkina Irina Georgievna.

Endocrinology department

Thyroid gland – what it is, where it is located, diseases

Thyroid gland: general information

The thyroid gland (popularly “thyroid gland”) is a small organ located at the base of the neck. The thyroid gland is often compared to a butterfly because it also has “wings” (two lobes) and a “body” (an isthmus between the lobes). Each lobe is filled with follicles, special structures containing thyroid hormones.

The shape of the thyroid gland is an individual feature: sometimes one “wing” is larger than the other, and the “calf” may not be visible at all

Outside, the thyroid gland is covered with two layers: the first (outer) is in direct contact with the muscles of the larynx and the surrounding nerves, and the second creates a layer between the outer layer and the gland itself and allows it to move when a person swallows or talks.

The thyroid gland, along with the adrenal glands, hypothalamus, pituitary gland, ovaries and testicles, is part of the endocrine system. This system regulates the work of the body with the help of hormones.

The thyroid gland secretes thyroid hormones – T3 (triiodothyronine) and T4 (thyroxine) into the blood. They affect the metabolic rate, heart rate, digestive system, vitamin synthesis and even mood, as well as regulate body temperature and the menstrual cycle.

Iodine is needed for the synthesis of T3 and T4. This element is not produced in the body – it can be obtained from food or medicines. Most of all iodine is found in seaweed, seafood, fish, dairy products, egg yolks.

In addition to T3 and T4, thyroid cells produce another hormone – calcitonin. It regulates the exchange of calcium and phosphorus in the body.

The thyroid gland is controlled by the pituitary gland, a pea-sized gland located at the base of the brain that synthesizes thyroid-stimulating hormone (TSH). The interaction of the pituitary gland and the thyroid gland is arranged according to the principle of feedback. So, when the gland begins to produce less T4 than it needs, the level of TSH in the blood increases, and with an increase in the amount of T4, the level of TSH decreases.

If the work of the hypothalamus, pituitary gland or the thyroid gland itself is disturbed, the metabolism changes and the whole organism suffers.

Diseases of the thyroid gland

Malfunctions of the hypothalamus, pituitary gland or thyroid gland can occur for various reasons: due to certain medications, viral infections, iodine deficiency, chronic stress, autoimmune reactions, pregnancy and childbirth. In this case, both low activity of hormone production and high activity are considered a failure.

Without treatment, thyroid problems will only get worse and can lead to obesity, heart disease, inability to conceive or carry a child, and in some cases, coma.

The most common pathologies of the thyroid gland :

• hyperthyroidism is a condition in which the thyroid gland produces too much of the hormones T4 and T3;
• hypothyroidism – a condition in which the function of the thyroid gland is reduced, not enough hormones T4 and T3 are produced;
• thyroiditis – inflammation of the thyroid gland;
• Graves’ disease is an autoimmune disease that develops against the background of hyperproduction of the hormones T4 and T3;
• goiter – enlargement of the thyroid gland, often accompanied by hyperproduction of its hormones, which looks like a swelling on the neck;
• thyroid nodules – volumetric formations that can be both benign and malignant;
• Thyroid cancer is a malignant tumor formed from the cells of the gland.

Symptoms of thyroid disease

Symptoms of thyroid pathologies vary. However, there is something in common: they increase gradually, so people may not notice for a long time that something has gone wrong.

Symptoms of hyperthyroidism (thyrotoxicosis)

Due to the overactive thyroid gland, the body literally goes crazy: metabolic processes are accelerated, systems begin to work intermittently.

Common symptoms of hyperthyroidism :

• causeless weight loss against the background of a constant feeling of hunger;
• palpitations – the pulse can be over 100 beats per minute at rest;
• cardiac arrhythmias;
• bloating, flatulence, diarrhea;
• fatigue;
• heat intolerance, feeling hot for no reason;
• increased sweating;
• irritability;
• insomnia;
• hand trembling;
• menstrual disorders in women;
• dry skin;
• hair loss or brittleness.

Women are 10 times more likely to be diagnosed with hyperthyroidism than men. Usually pathology starts at 20–40 years old

Due to hyperthyroidism, bones can become brittle, vision is reduced, cardiovascular disorders can join, up to heart failure and heart attack.

Symptoms of hypothyroidism

Deficiency of thyroid hormones initially presents with mild weakness and weight gain. Over time, more noticeable symptoms occur.

Common symptoms of hypothyroidism :

• causeless weight gain;
• slow heart rate;
• lethargy, drowsiness;
• decrease in body temperature;
• hypersensitivity to cold;
• regular constipation;
• fatigue;
• swelling of the face, legs and arms;
• slow heartbeat;
• dry skin;
• brittle nails and hair;
• irregular menses;
• difficulty concentrating;
• depressed mood up to depression.

Most often, hypothyroidism is diagnosed in women over 40 years of age

Symptoms of thyroiditis

There are several types of thyroiditis – acute, subacute and chronic.

Acute and subacute thyroiditis are relatively rare. They occur due to a bacterial, fungal, or parasitic infection and are usually severe. A person’s temperature rises (up to 39-40 °C), he cannot turn his head, there is severe pain in the neck, which radiates to the ear or shoulder.

Chronic thyroiditis is much more common. It develops due to a malfunction in the immune system, as a result of which the body takes thyroid cells for pathogens and attacks them. Also, chronic inflammation of the thyroid gland can occur when taking certain medications, such as drugs for the treatment of arrhythmia and cancer, iodine-containing drugs, drugs with lithium.

People with chronic thyroiditis become depleted of thyroid hormones over time, symptoms of hypothyroidism develop: skin and hair become dry, and nails become brittle, hair begins to fall out, sensitivity to cold appears, general and muscle weakness, drowsiness, decreased concentration and deterioration memory, swelling, constipation, overweight, joint pain.

In addition, the thyroid gland gradually increases and over time begins to compress the surrounding organs and tissues and “solder” to them. Therefore, such thyroiditis causes symptoms from neighboring organs: shortness of breath, difficulty swallowing, hoarseness, wheezing.

The risk of developing autoimmune thyroiditis increases with age

Symptoms of Graves’ disease

Graves’ disease is an autoimmune disease that leads to an overactive thyroid gland and excessive production of hormones. As a result, the classic symptoms of hyperthyroidism occur: unreasonable weight loss, constant feeling of hunger, heart palpitations, flatulence and diarrhea, heat intolerance, excessive sweating, irritability.

A characteristic symptom of Graves’ disease is secondary exophthalmos, protrusion of the eyeball (bulging eyes)

In addition, in people with Graves’ disease, the skin condition changes, it becomes thickened, the microrelief is smoothed out, severe itching appears.

Signs of goitre

Goiter is an enlargement of the thyroid gland, a symptom of a number of diseases, and not an independent pathology. It can occur if the thyroid gland cannot cope with the production of hormones. In order to somehow compensate for their deficiency or excess, it begins to increase in volume.

Goiter looks like a round bump or swelling at the base of the neck

Signs of goiter :

• feeling of fullness in the neck,
• lump in throat,
• difficulty swallowing,
• cough,
• hoarseness of voice.

Symptoms of thyroid nodules

Thyroid nodules look like lumps, consisting of clusters of thyroid cells. They can be solid or filled with liquid. Usually these are benign formations, they are detected in most adults. In rare cases, such a node can be a malignant tumor.

Most people are unaware that they have thyroid nodules because the condition does not cause symptoms. You can notice them when they grow and begin to squeeze neighboring tissues, the trachea and nerve endings.

The appearance of thyroid nodules may be accompanied by the following symptoms :

• swallowing disorder,
• neck pain,
• shortness of breath,
• hoarseness of voice.

Symptoms of thyroid cancer

Thyroid cancer is a malignant tumor. Scientists still do not know exactly why it occurs. It is believed that genetic disorders are to blame.

Usually such tumors do not manifest themselves for a long time. Symptoms become noticeable as the tumor grows and include: swelling in the neck, difficulty swallowing, coughing, hoarseness.

In rare cases, thyroid cancer can affect hormone production and cause symptoms of hyper- or hypothyroidism.

Thyroid diagnostics

As a rule, thyroid diseases develop asymptomatically for a long time, so people do not go to the doctor in the early stages of pathologies. To understand that something is wrong with the organ, you will need to consult a specialist, as well as laboratory and instrumental examinations. In some cases, thyroid tissue is examined, for this a fine-needle biopsy is performed.

An endocrinologist deals with the diagnosis and treatment of thyroid diseases.

When to check the thyroid gland

Regular screening examinations help prevent severe pathologies. In addition, you should pay attention to your well-being. Sometimes even mild symptoms can signal a serious malfunction of the thyroid gland.

Early signs of thyroid dysfunction :

• sudden change in weight;
• swelling of the face;
• causeless irritability, tearfulness;
• discomfort in the neck;
• menstrual disorders;
• brittle nails and hair;
• stool problems;
• quickening or slowing of the heartbeat.

To check how the thyroid gland works, blood tests for hormones T4, T3, and TSH help.

Assessment of thyroid function

Discount 6%

1,190 ₽

Comprehensive study that helps diagnose thyroid diseases and monitor their treatment. It is recommended for people at risk for thyroid diseases, including residents of regions with a low natural iodine content in drinking water, and patients with a history of thyroid diseases.

1,130 ₽

113 bonuses to the account

1,130 ₽

Add to cart

If their blood level is elevated, the doctor diagnoses hyperthyroidism. And if lowered – hypothyroidism.

These tests can detect problems in the thyroid gland, but cannot determine their cause. This will require additional research.

For example, to detect autoimmune damage to the thyroid gland, the doctor prescribes blood tests for antibodies to thyroglobulin (AT-TG) and thyroid peroxidase (AT-TPO) – proteins that are found exclusively in the cells of the thyroid gland and are released when it is destroyed.

The cause of thyroid disease

Discount 5%

820 ₽

A comprehensive study determines the content of antibodies to thyroglobulin (AT-TG) and thyroid peroxidase (AT-TPO) in the blood – proteins that are found exclusively in thyroid cells . The analysis allows to identify autoimmune lesions of the thyroid gland. May be used as an adjunct to screening thyroid function assessment.

78 bonuses on account

780 ₽

Add to cart

If a neoplasm in the thyroid gland is suspected, the doctor prescribes an ultrasound examination (ultrasound) to assess the structure of the organ itself and the pathological element.

In addition, scintigraphy may be performed. This research method allows you to get an image of the organ, which shows changes in the tissue. To do this, a radioactive drug is injected into a vein, which enters the thyroid gland with the blood flow. A special device captures the radiation and converts it into a computer image.

At the same time, “hot” nodes may appear on the monitor – zones of more active accumulation of the radiopharmaceutical, and “cold” ones – not accumulating the radiopharmaceutical. “Hot” nodes most often correspond to areas with active synthesis of thyroid hormones, for example, with nodular thyrotoxic goiter. “Cold” zones of reduced activity usually correspond to cysts, fibrosis, thyroiditis, malignant neoplasms of the thyroid gland.

Thyroid scintigraphy shows inflammatory lesions that stain blue

Treatment of thyroid disorders

Treatment will differ depending on the cause of the disease. So, some pathologies require surgical intervention, others are treated with the help of medications. In some cases, no therapy is used at all, but it is important for the patient to be under medical supervision.

Persistent hypo- or hyperthyroidism is treated with thyroid hormone preparations. As a rule, they need to be taken for a long time. They correct the work of the organ and usually quickly alleviate the condition of a person.

Prevention of thyroid disease

No specific prevention of thyroid disease has been developed. However, the health of an organ largely depends on the supply of iodine to the body, so doctors recommend paying attention to the prevention of its deficiency. Especially often, pregnant and lactating women, newborns, as well as residents of regions remote from the sea face iodine deficiency.

It is usually sufficient for adults to receive 150 micrograms of iodine per day, for pregnant and lactating women – at least 250. For children, other norms are established: children under one year old need to receive at least 50 micrograms, from 1 year to 7 years – 90, from 7 to 12 years old – 120.

According to the WHO, more than 2 billion people live with iodine deficiency. There are no territories in Russia where its deficiency has not been registered.

The human body does not produce iodine on its own, but receives it only from food. There is a lot of this mineral in sea water, so seaweed, fish and seafood are especially rich in iodine. It is found in smaller quantities in dairy products and eggs.

Foods rich in iodine :

• seaweed,
• cod,
• cranberry,
• squid,
• milk,
• eggs.

Not everyone needs to take supplements or multivitamins with iodine, but only those who have been prescribed them by a doctor based on the results of blood tests.

Abuse of iodine is not worth it – an excess, like a deficiency, is dangerous to health

Due to the fact that it is not always possible to get enough iodine from food, salt, bread and other products have been iodized in Russia. Thanks to this, there are fewer people with iodine deficiency.

Sources

1. Diseases and conditions associated with iodine deficiency: clinical guidelines / Ministry of Health of the Russian Federation. 2020.
2. Prakash R.