Hormones & Steroids

Endocrine Disorders

The endocrine system is a network of glands that produce and release hormones which regulate mood, growth and development, tissue function, metabolism, as well as sexual function and reproductive processes.

The eight major glands that make up the human endocrine system are the hypothalamus, pancreas, pituitary, thyroid, parathyroids, adrenals, pineal body, and the reproductive glands, (which include the ovaries and testes). The pancreas, which is mainly associated with the digestive system, is also part of this hormone- secreting system. Overall, although the endocrine glands are the body’s main hormone producers, some non-endocrine organs — such as the brain, heart, lungs, kidneys, liver, thymus, skin, and placenta — also produce and release hormones. Endocrine disorders are diseases that specifically relate to the endocrine glands and they are generally grouped into two categories: • Disease that results from producing too much or too little hormone, leading to a hormone imbalance • Disease that results from the development of a lesion (such as a nodule or tumor) in the endocrine system which may or may not affect hormone levels Common endocrine disorders include diabetes, 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), 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 from mild to very severe. Treatments depend on the specific disorder but often requires the use of synthetic hormones. Diagnosis for endocrine disorders is usually made using blood, urine or saliva tests that measure hormone levels. There is no single ideal method for assessment as each have their advantages and disadvantages. Serum-based assays provide a direct measurement of circulating hormones but are generally unable to distinguish the protein-bound, inactive form of the hormone from its free and biologically active form. Serum testing is ideal for peptide hormones such as FSH, LH, prolactin, fasting insulin, and thyroid hormones, including reverse T3, as well as thyroid antibodies. Serum tests can also be used to measure sex hormone binding globulin (SHBG) and, less commonly, cortisol binding globulin (CBG). In contrast, urine assays measure unbound hormone, reflecting the bioavailable levels. A 24-hour urine collection is the preferred method for assessing physiological hormone levels because it provides a comprehensive picture as opposed to a single time point analysis. Saliva testing has also gained in popularity and has the advantage of being noninvasive as well as being accessible to practitioners such as chiropractors, and acupuncturists who may be practicing in regions where they are not licensed to order blood tests or draw blood. Saliva collection also allows for multiple collections over a period of a day or month, which can help elucidate abnormal hormonal patterns, such as a shortened luteal phase. New diagnostic testing looks at the genetic basis for the endocrine disease. A variety of endocrine disorders are caused by gene variations which are now well understood in terms of their molecular basis and mode of inheritance. The recent advances in molecular testing and genomics have uncovered that genes play a far more important role in the pathogenesis of endocrine disease than previously appreciated. Overall, through the earlier detection of genetic carriers and/or through diagnosing the exact subtype of the disease, earlier and more targeted intervention and treatments are possible.

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Endocrine Disorders - Reagents for Assay Development

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