Endocrinology

  • study of endocrine glands and the hormones they secrete

HORMONES

  • are chemical signals that are secreted by cells into the blood stream that
    travels to its target tissues

POSITIVE FEEDBACK

An increase in the hormone
product results to an
elevated activity (another
hormone production) of the
system

NEGATIVE FEEDBACK

A decrease in the hormone
product results to a
decreased activity (another
hormone production) of the
system

CLASSIFICATION EXAMPLE

PEPTIDES/POLYPEPTIDES

  • Water soluble
 
A. GLYCOPROTEIN HCG, TSH, EPO, FSH
B. POLYPEPTIDES ADH, GH, ACTH, Prolactin
STEROIDS
  • Synthesized from
    cholesterol
  • Insoluble
Aldosterone, Estrogen, Cortisol, Progesterone,
Testosterone, Vitamin D
AMINES Epinephrine, norepinephrine, T3, T4, melatonin
HormonesInformations
Glands – Hypothalamus
Releasing Hormones
  • TRH – regulates production of TSH and prolactin
  • GnRH – regulates production of LH and FSH
  • GHRH – regulates production of GH
  • CRH – regulates production of ACTH

Somatostatin

  • Inhibitor of GH and TSH production

Dopamine

  • Prolactin release inhibitor
Anterior pituitary Glands

Growth Hormone

  • Most abundant pituitary hormone
  • Gigantism: increase (excess) in GH before the closure of epiphyseal plate
  • Acromegaly: increase (excess) in GH after the closure of epiphyseal plate
  • Dwarfism: a deficiency of GH

Prolactin

    • Initiates and maintains lactation
    • Highest levels at 4am, 8am, 8pm and 10pm
    • Prolactinoma: most common type of functional pituitary tumor

TSH

  • Stimulation for the production of T3 and T4

LH

  • For secretion of progesterone; for ovulation

ACTH

  • Stimulation for the production of adrenocortical steroid formation and secretion

FSH

  • For secretion of estrogen
  • For development of seminiferous tubules; spermatogenesis
Posterior pituitary ~ only releases hormones (doesn’t produce)

Oxytocin

  • Stimulates contraction of the uterine “Fergusson reflex”
  • Also acts in parturition and in transport of sperm
  • Also for milk ejection (suckling as stimulator)

ADH

  • Aka vasopressin
  • For water balance and blood pressure elevation
  • Deficiency: diabetes insipid
Thyroid gland

T3 and T4:

  • produced by follicular cells
  • For metabolism
  • There are more T4 than T3
  • T3 is more biologically active

Primary hyperthyroidism (Graves’ disease)

  • increased T3 and T4 but decreased TSH
  • presence of anti-TSH receptor antibody

Secondary hyperthyroidism

  • both FT4 and TSH are increased

Primary hypothyroidism (Hashimoto’s thyroiditis)

  • increased TSH but decreased T3 and T4
  • presence of anti-TPO antibody

Myxedema: manifestation of Hashimoto’s disease

Parathyroid gland: smallest gland in the body

Calcitonin:

  • produced by parafollicular cells
  • produced by parafollicular cells

PTH

  • Produced and secreted by chief cells of parathyroid gland
  • For bone resorption
  • Primary hyperparathyroidism: increased ionized calcium
  • Secondary hyperparathyroidism: decreased ionized calcium
Adrenal gland

Cortisol

  • Secreted by zona fasciculate
  • Highest levels in: 6am-9am
  • Lowest levels: 11pm-3am
  • Cushing’s syndrome:
    • increased levels of cortisol and ACTH but decreased levels of aldosterone and renin are notable 
    • screening test: 24hr urine free cortisol test 
    • Confirmatory: low dose dexamethasone suppression test and CRH stimulation test
  • Cushing’s disease:
    • increased levels of ACTH due to tumor on the pituitary gland
    • Methods:
      • Porter-Silber reaction (corticosteroids); + reaction = yellow pigment
      • Zimmerman reaction (ketosteroids) + reaction = reddish purple color

Aldosterone

  • Secreted by zona glomerulosa
  • Most important mineralocorticoid
  • Responsible to Na+ and K+ retention
  • Barterr’s syndrome: there is a defect in the kidney’s ability to reabsorb sodium
  • Conn’s syndrome (1’ hyperaldosteronism): there is hypokalemia and hypernatremia
  • Liddle’s syndrome: there is an excess sodium reabsorption and excretion of potassium due to defect in the DCT

Catecholamine

  • Secreted in medulla
  • 80% epinephrine, 20% norepinephrine
  • Pheochromocytoma: tumor that results to overproduction of catecholaminess
Reproductive glands

Testosterone

  • Principal androgen in the blood
  • Most potent male androgen
  • Synthesized by the Leydig cells

Estrogen

  • Estrone: most abundant in menopausal women
  • Estradiol: most potent; most abundant in pre-menopausal women
  • Estriol: major estrogen detected during pregnancy; produced by placenta; marker for down syndrome
  • Kober reaction: used to analyze estrogens

Progesterone

  • Single best hormone to evaluate if ovulation has occurred
Pancreas

Insulin

  • Hypoglycemic agent

Glucagon

  • Hyperglycemic agent

METABOLITES OF HORMONES!

  • Dopamine: Homovanilic acid
  • Serotonin: 5-HIAA
  • Epinephrine: Vanillyl mandelic acid and metanephrine
  • Norepinephrine:
    • Urine: 3-methoxy-4-hydroxyphenylglycol
    • Blood: vanillyl mandelic acid