CHAPTER II

DISCUSSION

2.1 Anatomy and Physiology of the Endocrine and Metabolism System

Endocrine glands lack the ducts that are present in exocrine glands. The endocrine glands secrete their product,
which are biologically active molecules called hormones, into the blood. Many endocrine glands are discreted organs
whose primary funtions are the production and secretion of hormones. The pancreas function as both an exocrine and as
an endocrine gland. The endocrine portion of the pancreas is composed of clusters of cells called the pancreas islets. the
concept of the endocrine system, however, must be extended beyond these organs. In recent years, it has been
discovered that many other organs in the body secrete hormones. when these hormones can be demonstrated to have
significant physiological functions, the organs that produce them may be categorized as endocrine glands, although they
serve other functions as well. It is appropriate then that a partial list of the endocrine glands should include the heart,
liver, adipose tissue, and kidneys. The endocrine and nervous system are the two controlling system the body and are
closely integrated. This close relationship begins during development with many of the endocrine glands originating
from the same embryonic layer as the nervous system.
In the classic description of endocrine system,a chemical messenger or hormone produced by an organ is released
into the circulation to produce an effect on a distant target organ. Currently, the definition of the endocrine system is
that of an intregrated network of multiple organs derived from different embryologic origin the release hormones
ranging from small peptides to glycoproteins, which exert their effect either in neighboring or distant target cells. This
endocrine network of organs and mediators does not work in isolation and is closely intregrated with the central and
peripheral nervous system as ell as with the immune systems, leading to currently used terminology such as
neuroendocrine or neuroendocrine immune for describing their interactions. Three basic components make up the
core of the endocrine system.
The endocrine, or hormonal system consist of a number of endocrine (ductless) glands situated in different parts of
the body. These glands secrete hormones directly into the bloodstream, in contrast to the exocrine glands which pass
their secretions directly into a body cavity or onto the surface of the skin. The hormones released are carried in the
bloodstream until they reach their target organ, where they are active. However, in addition, it is now clear that
hormones may act on adjacent cells or even on the cell of origin. Hormones are regulatory molecules secreted into the
blood by endocrine glands. Chemical categories of hormones include steroids,amines, polypeptides, and glycoproteins.
Interactions between the various hormones produce effect that may be synergistic, permissive, or antagonistic.
The function of endocrine system
1. Regulation of sodium and water balance and control of blood volume and pressure
2. Regulation of calcium and phosphate balance to preserve extracellular fluid concentrations required for
cellular membrane intergrity and intracellular signaling
3. Regulation of energy balance and control of fuel mobilization, utilization, and storage to ensure that
cellular metabolic demands are met
4. Coordination of the host hemodynamic and metabolic counterregulatory responses to stress
5. Regulation of reproduction, development, growth, and senescence
6. Coordinate and integrate cellular activity within the whole body by regulating cellular and organ
function throughtout life and mantaining homeostasis

A partial listing of the endocrine glands

Endocrine gland Major Primary terget organs Primary effects
hormones
Adipose tissue Leptin Hypothalamus Suppresses appetite
Adrenal cortex Glucocorticoids Liver and muscles Glucocorticoids influence
Aldosteron Kidneys glucose metabolism , aldosterone
promotes Na+ retention, K+
excretion
Adrenal medulla Epinephrin Heart,bronchioles, and Causes adrenergic stimulation
blood vessel
Heart Atrial natriuretic Kidneys Promotes excretion of Na+ in
hormone the urine
Hypothalamus Releasing and Anterior pituitary Regulates secretion of anterior
inhibiting hormones pituitary hormones
Small intestine Secretin and Stomach, liver and Inhibits gastric mobility and

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 cholecysitokinin pancreas stimulates bite and pancreac
secretion
Islets of Insulin Many organs Formation of glycogen and fat,
langerhans(pancreas) Glucagon Liver and adipose tissue glucagon stimulates hydrophisis of
glucagon and fat
Kidneys Erythropoietin Bone marrow Stimulates red blood cell
production
Liver Somatomedins Cartilage Stimulates cell division and
growth
Ovaries Estradiol-1 beta Female reproductive tract Mantains structure of
and progresterone reproductive tract and promotes
secondary sex characteristics
Parathyroid Parathyroid Bone, small intestine and Increase Ca2+ cocentration
glands hormone kidneys blood
Pineal gland Melatonin Hypothalamus and Affects secretion of
anterior pituitary gonadtrophic hormone
Pituitary anterior Thropic Endocrine glands and Stimulates growth and
hormones other organs development target organs,
stimulates secretion of other
hormones
Pituitary posterior Antidiuretic Kidneys and blood Antidiuretic hormone promotes
hormones vessels ratters retention and
Oxytocin Uterus and mammary vasocontriction oxytocin stimulates
glands contriction of uterus and mammary
secretory units
Skin 1,25- Small intestine Stimulates absorption of Ca2+
dihydroxyvitamin
D2
Stomach Gastrin Stomach Stimulates acid secretion
Testes Testosteron Prostate, seminal vesicles Stimulates secondary sex
and other organs development
Thymus Thymosin Lymph nodes Stimulates white blood cell
production
Thyroid gland Thyroxine and Most organs Thyroxine and triiodothyronine
triiodothyronine promote growth and development
and stimulates basal rate of cell
respiration basal metabolic rate of
BMR, calcitonin may participate in
the regulation of blood Ca2+ levels

Activities are regulated or influenced the endocrine system include

1. Reproduction and lactation
2. Process of the immune system
3. Balance of acids and bases
4. Intake of fluid, the balance of intracellular and extracellular fluid volume
5. Metabolism of carbohydrates, proteins, fats and nucleic acids
6. Digestion, absorption and distribution of nutrients
7. Blood Pressure
8. Prisoners pressure
9. Adaptation to environmental changes
Types of hormones
1 . Endocrine hormone is a hormone that is secreted by the major organ or tissue that includes the endocrine system
a. Hormones do not work locally, this substance was brought blood flow long distances to affect the target tissue
b . Endocrine hormones can be secreted by one cell or group of cells that are found in non endocrine tissues ( eg,
insulin and glucagon are produced by cells of the island, the island of exocrine pancreas )
c . Some hormones , such as placental hormone found during pregnancy, only produced for a while

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 2 . Neurohormone is synthesized in cells, nerve cells neurosecresi. This substance works and secreted as hormones,
But usually work within a shorter distance and clearly
a. One example is a neurohormone which produced neuropeptide neurons in the CNS
b . Neurotransmitter or neuromodulator operates through synapses that enhance or inhibit the response of
neurons to neurotransmitter is also referred to as hormone.
3. Prostaglandins are hormone like substances which are derivatives of fatty acids and arachidonic acid. This
substance is formed in small quantities in the body tissue when both normal and pathological conditions
a. Prostaglandins are synthesized and released to work locally on the neighboring cell
b. This hormone affects many body functions, including effects on blood pressure, smooth muscle contraction,
blood clotting, digestion, reproduction and inflammatory response
4. Hormones secreted by different endocrine glands vary widely in chemical structure. All hormones,however, can
be divided into a few chemical classes.
a. Amines, these are hormones derived from the amino acids tyrosine and tryptophan. They include the
hormones secreted by the adrenal medulla, thyroid and pineal glands.
b. Polypeptides, these are hormones composed of chains of amino acids that generally contain fewer than
100 of amino acids. Example are antidiuretic hormones and insulin.
c. Glycoproteins, these molecules consist of a long polypeptide (containing more than 100 amino acids)
bound to one or more carbohydrate groups. Examples are follicle stimulating hormones (FSH) and luteinizing
hormones (LH).
d. Steroids, these are lipids derivered from cholesterol. They include the hormones testosteron, estradiol,
progesteron, and cortisol. Steroids hormones are secreted by only two endocrine glands, the adrenal cortex
(secretes corticosteroids and small amounts of sex steroids) and the gonads (secrete sex steroids).
Biochemistry hormone composed of two main classes
1. Derivatives of amino acids, such as proteins, polypeptides, peptides, amines or complex conjugation of
proteins such as glycoproteins, is a hormone produced hipofisis gland, hypothalamus, adrenal medulla, pineal,
thyroid, pancreatic cells and the cells in the digestive tract. These substances are generally soluble in water and is
transported in a form that does not bind in the blood.
2. Steroids are fat soluble lipid compounds that are synthesized from cholesterol. This substance is produced by
the ovary, testis, placenta, and adrenal glands as well as the exterior of testosterone, estrogen, progesterone,
aldosterone, and cortisol. At this circulating plasma protein transport.
The mechanism of how hormones work
There are two main mechanisms in hormones and hormone related molecules to produce its effect. First, through the
stimulation of the enzyme present in the cell and the second, activates genes involved through transcription and
translation.
1. Activation of the enzyme involves a membrane bound receptor system (second messenger)
a. Molecules of protein and polypeptide hormones ( the first messenger ) binds to receptors on the cell surface
that remain specific to the hormone
b. Hormone receptor complex stimulate formation of adenosine 3',5' cyclic monophosphate ( cAMP ) as a
conductor of the second message, which can deliver the first message of various hormones.
(1) Synthesis of cAMP involves more than one G protein bound to the membrane, which includes family
guanine nucleotide binding protein of regular
(2) G protein to change shape, so that the guanosine diphosphate ( GDP ) which is off to be replaced by the
activating enzyme, guanosine triphosphate ( GTP )
(3) Complex G protein GTP activates the enzyme adenylate cyclase to produce cAMP
c. Each molecule cAMP activates various kinase protein dependent cAMP molecules corresponding
(1) Enzymes are kinases protein catalyze specific reactions fosfolirasi ( transfer of a phosphate group ) for
key enzymes in the cytoplasm
(2) Each molecule kinase protein activates various enzyme molecules that fit. Thus, a low concentration of
circulating hormones may be amplified, resulting in a major intracellular enzyme activity
d. Activation of the enzyme by kinase protein resulted physiologis effects and chemical reactions, depending on
the nature of innate cells
e. Camp decomposes rapidly by intracellular enzymes fosfoditerase. This process will limit the duration of the
effect of cAMP
2. Compounds in addition to the role of cAMP as a second messenger for certain hormones have been found. These
compounds include the inositol triphosphate ( IP3 ), cyclic guanosine monophosphate ( GMP ), and calcium bound
complex with calmodulin, a regulatory protein in intracellular
3. Activation of genes involved in intracellular receptor system

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 a. steroid hormones, thyroid hormones, and some types of polypeptide hormone penetrates the membrane to
enter the cell. The hormone binds to receptors in the cytoplasm or internal moving the cell nucleus.
b. Hormone receptor complex moves into the DNA at or near the transcription of genes that are stimulated
by hormones. On this side, the complex binds to specific DNA receptors for hormones
c. Then gene activated by this complex to form the mRNA transcription, which will diffuse into the cytoplasm
d. mRNA is translated into proteins and enzymes that trigger cellular responses to hormones
Setting the speed and the amount of hormone secretion
1. The secretion of hormones by the endocrine glands may be stimulated or inhibited by levels of a hormone in the
blood ( produced by themselves, or by other endocrine glands ) or by nonhormon content ( eg , glucose or calcium).
2. Feedback control mechanisms are also involved in the stimulation or inhibition of hormone secretion
a. Negative feedback
If the increased levels of hormones or nonhormon substances in the blood increase the subsequent inhibition of
hormone secretion, the mechanism is called a negative feedback system.
b. Positive feedback
Nonhormon substance if levels in the blood resulting in increased secretion of the endocrine glands. Thia
mechanism is called positive feedback.
3.Hormone release from endocrine glands can also be stimulated by nerve impulses along nerve fibers spread and
straight ends in the glandular cells or as in the posterior pituitary gland, stimulated by neurosecresi stored in glands as a
hormone.
Endocrine regulation of metabolism
Hormones are macroregulators. This is particulary well ilustrated by the example of insulin and glucagon, which in a
comprehensive manner regulate carbohydrate, fat and nitrogen metabolism. Disorders of the endocrine system can give
rise to effects at multiple metabolic pathways and affected multiple organs systems. Chemically, there are two main
types of hormone, they are proteins and steroids. Some hormones such as thyroxine, and some neurotransmitter such as
ephinephrin and nonephinephrin, are amino acid derivatifs, a broader definition of hormones would also include factors
that exert paracrine and autocrine actions such as cytokines and growth factors. PTH acts is concert with calcitonin,
secreted by the tyroid, and the steroid vitamin D to control calsium and phosphate homeostasis and bone metabolism.
Insulin and glucagon regulate fuel utilization affecting predominantly carbohydrate and lipid metabolism.
2.2 Type and classification of Endocrine and Metabolism System
1) Pituitary Glands
Pituitary gland is as a pea, located in the bony structure ( sella turcica ) at the base of brain. The pituitary controls
the function of most other endocrine glands, so called leader gland, or master gland. Pituitary gland consists of two
lobes, they are the anterior lobe and the posterior lobe.
1. Anterior pituitary function ( adenohipofise )
produce some hormones that act as agents controlling the production of all other endocrin organs. There are six
hormones are produced in anterior lobe.
a. Growth Hormone
GH promotes the movement of amino acids into cell and the incorporation of these amino acids into
proteins, thus promoting over all tissue and growth organs
b. Thyroid- stimulating hormone (TSH, or thyrotropin)
TSH stimulates the thyroid gland to produce and secrete thyroxine (tetraiodothyroinine, or T4)
c. Adrenocorticotropic hormone (ACTH, or corticotropin)
ACTH stimulates the adrenal cortex to secrete glucocorticoiuds, such as hydrocortisone (cortisol)
d. Follicle stimulating hormone (FSH, or folliculotropin)
FSH stimulates the growth of ovarian follicles in females and the production of sperm cells in the testes
of males.
e. Lituenizing hormone (LH, or luteotropin)
This hormone and FSH and FSH are collectively called gonadotropic hormones. In female, LH
stimulates ovulation and the conversion of the ovulated ovarian follicle into an endocrine structure called
corpus luteum. In males, LH stimulates the secretion of male sex hormones from the interstitial cells
f. Prolactin (PRL)
This hormone is secreted in both male and females. Its best known is the stimulation of milk production
by the mammary glands of women after the birth of a baby.
2. The posterior pituitary (posterior lobe or neurohipofise)
The posterior pituitary or pars nervosa, stores and releases two hormones, both of which are produced in the
hypothalamus.
a. Antidiuretic hormone (ADH)

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 also known as argining vasopressin (AVP). ADH promotes the retention of water by the kidneys so that
less water is excreted in the urine and more water is retained in the blood
b. Oxytocin
In females, oxytocin stimulates contractions of the uterus during labor and for this reason is needed for
parturition(childbirth). Oxytocin also stimulates contraction of the mammary gland alveoli and ducts, which
result in the milk- ejection reflex in a lactating women. In men, a rise in oxytocin secretion at the time of
ejaculation has been measured, but the physiologycal significance of this hormone in males remains to be
demonstrated.
2) Adrenal Glands
There are 2 adrenal glands in humans, and each gland located above the kidney. The adrenal gland is divided into
two parts, namely the adrenal medulla ( the center of the adrenal gland ) and adrenal cortex ( the outer gland ).
1. The adrenal gland cortex produces three groups of steroid hormones, namely glucocorticoids with
hydrocortisone prototype, especially mineralocorticoid aldosterone, and sex hormones (especially androgens).
a. Mineralocorticoid
which regulate NA+ and K+ balance. Mineralocorticoid work enhances the absorption of sodium ions in
exchange process to excrete potassium or hydrogen ions.
b. Glucocorticoids
which regulate the metabolism of glucose and other organic molecules. Glucocorticoids serve to
influence glucose metabolism, increased secretion of hydrocortisone will raise blood glucosa levels.
c. sex steroids
which are weak androgens (including dehydropiandrosterone, or DHEA) that suplement the sex steroids
secreted by the gonads. These hormones are secreted by the different zones of the adrenal cortex.
The function of the cortex adrenal gland :
Adjust the balance of water, electrolytes and salts
Affects metabolism of fat, carbohydrate, and protein
Influencing the activity of lymphoid tissue
2. Adrenal gland medulla functions as part of the autonomic nerves. It also produces adrenalin and
noradrenalin
a. Adrenalin
a hormone produced by the inner region (medulla) of the adrenal glands. There is one of these glands
above each kidney in mammals.
b. noradrenalin
noradrenalin is a natural and powerful stimulant and excessive amounts can produce feelings of immense
energy, invincibility, drive and euphoria.

The function of the medulla adrenal gland function :

Vasoconstriction of peripheral blood vessel
Relaxation of bronchial
Contraction mucous membranes and arterioles
3) Thyroid glands
The thyroid is a small gland, about 5 cm in diameter and located in the neck, just below the Adam's apple. In normal
circumstances, the thyroid gland is not visible and barely palpable , but can enlarged, the doctor can feel it with ease and
a lump can appear below or beside the Adam's apple. The thyroid gland produces thyroid hormone, which controls the
body's metabolic rate.
Thyroid hormones affect the body's metabolic rate by 2 ways :
1. Stimulating almost every tissue of the body to produce proteins
2. Increasing the amount of oxygen used by cells .
On the influence of hormones produced by the anterior lobe of the pituitary gland. the thyroid gland can produce the
hormone thyroxine. The function of this hormones is to regulate the exchange of substances thyroxine metabolism and
regulate physical and spiritual growth.
The function of the thyroid gland as follows :
Working as a stimulant oxidation process
Set the use of oxidation
Set the use carbon dioxide
Metabolic regulation in the liver in the chemical composition of tissues
In children affects the physical and psyhology
Thyroid glands are produced two hormones :

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 1. Calcitonin
This hormone is released by the thyroid, works in concert with parathyroid hormone (discussed shortly) to
regulate calcium levels in the blood. Calcitonin inhibits the breakdown of bone tissue and stimulates the
excretion of calcium by the kidneys. Both actions result in the lowering of blood calcium levels.
2. Thyroxine hormone
Thyroxine hormone is synthesized by the thyroid gland from two molecules of the amino acid tyrosine to
which are added atoms of iodine. Thyroxine regulates ATP production in almost all body cells.

4) Parathyroid Glands
Normally there are four parathyroid glands in the body, which is located just behind the thyroid gland, two embedded
in the superior pole of the thyroid gland and two in the inferior pole. These glands produce a hormone called
parathormone, which works to increase bone resorption, increase calcium resorption, and lower blood calcium levels.
Parathyroid gland function :
a. Maintain a fixed concentration of calcium ions in the plasma
b. Control of calcium and phosphate excretion through the kidneys
c. Accelerate the absorption of calcium in the intestine
d. Calcium is reduced, the thyroid hormone stimulates bone reabsorption of calcium in the blood there by
increasing
e. Stimulated calcium and phosphate transport through the cell membrane

Parathyroid glands produce hormone, the hormone is called parathyroid hormone. parathyroid hormone (PTH)
increases the amount of Ca2+ circulating in blood. The amount of Ca2+ in the blood is regulated by calcitonin and PTH.
However, PTH is more important than calcitonin in maintining Ca2+ levels in the bood.
5) Pancreas Glands
These glands are at the back of the hull in front of the first and second lumbar vertebrae. As an exocrine gland will
produce digestive enzymes into the duodenum lumen. While as endocrine consists of the islands of Langerhans for
produce a hormone . Langerhans island curved oval and spread throughout the pancreas. Langerhans island functions as
a unit in spending homeostatic secretion of nutrients, inhibits the secretion of insulin, glycogen and polypeptides. In
humans, containing four kinds of cells, namely :
- A cell ( or ) : produce glucagon
- B cells ( or ) : produce insulin
- D cell ( or ) : produce somatostatin
- F cells ( small sgt ) : produce pancreatic polypeptide
This gland produce two hormones, they are :
1. Glucagon
Alpha cells secrete glucagon in response to a fall in blood glucose concentrations. Glucagon stimulates the
liver to hydrolyze glycogen to glucose, which causes the blood glucose level to rise.
2. Insulin
Beta cells secrete insulin in response to a rise in blood glucose concentrations. Insulin promotes the entry of
glucose into tissue cells, and the conversion of the glucose into tissue cells, and the conversion of the glucose
into energy storage molecules of glycogen and fat.

6) Sex glands
In this gland there are three hormones are produced. They are Testosteron, Estrogen, Progesteron.
1. Testosteron
Testosterone is a steroid hormone from the androgen group. Testosterone is the main producer of the testes in males
and ovaries (ovaries) in females, although small amounts of this hormone is also produced by the reticular zone of the
adrenal gland cortex. Both the males and females, testoren plays an important role for health. Its functions include
increased libido, energy, immune function, and no protection against osteoporosis.
2. Estrogen
Estrogen is a group of steroid compounds that function primarily as a female sex hormone. Although there is a good
body man or woman, the content is much higher in women of childbearing age body. This hormone causes the
development and maintain secondary sex signs in women. At menopause, estrogen begins to decrease so as to give rise
to several effects, among hot flash, sweating during sleep, and excessive anxiety.
3. Progesteron
Progesterone or P4 is a steroid hormone from affecting the female menstrual cycle, pregnancy and embryogenesis.
Progesterone along with estrogen produced by corpus, which is an endocrine gland that is the remainder of the follicle

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after ovulation occurrence. Progesterone plays a major role in fetal development. Effect of progesterone on reproduction
include
- Thicken the endometrial wall after ovulation
- Inhibit the production of LH that the corpus luteum degenerates when there is no fertilization
- Inhibit lactation during pregnancy
- Prepare the endometrium for implantation of the zygote

7) Pineal glands
The pineal gland (also called the pineal body, epiphysis cerebri, epiphysis, conarium or "third eye") is an endocrine
gland in the vertebrate brain. It produces the serotonin derivative of melatonin, a hormone that affects the modulation
pattern of wake or sleep and seasonal functions. The shape is similar to a tiny pine cone (hence its name), and it is
located close to the center of the brain, between the two hemispheres, tucked in a groove where the two rounded bodies
joining the thalamus.
Melatonin is a neurotrophic hormone with antioxidant indolamina group, which is synthesized by the pineal gland
located in the brain from the amino acid tryptophan. Through the perceiver, melatonin plays a role in various
physiological processes such as biological rhythms, blood pressure regulation, oncogenesis, retinal, reproduction, the
ovaries, the immune system and osteoblast differentiation. Melatonin signal transduction in the track increases the ratio
of antioxidant enzymes such as superoxide dismutase, peroxidase, glutathione and dampen prooxidant enzymes such as
nitrogen monoxide synthase and liposigenase.
8) Thymus gland ( thymus )
The thymus is located in the mediastinum behind stemum os. Only found in children under 18 years. More 18 years
the gland is smaller and not found again. These glands are reddish color and consists of 2 lobes. It weighs about 10
grams of first born, but increases until adolescence, which is about 30-40 grams, then furrowed again as an adult. While
still active, these glands produce white blood cells called T - lymphocytes.
These cells will be settled in the body and have the memory of a foreign object entered a body and abnormal body
cells ( including cancer cells ). If the same substance entering the body 's cells will multiply and neutralize the effects of
the substance on the body. This function is a part of the body or immune system protection system (cell mediated
immune system) that is cellular.
2.3 Etiology of Endocrine and Metabolism System
The causes of endocrine disorders can be acquired or genetic.
1. Acquires causes
A. Tumors of endocrine glands
Adenomas (benign neoplasms) are one of the main causes of hyperfunctional endocrine syndrome. They
occur more frequently than malignant neoplasms, adenomas may also cause combinated endocrine disorder
characterized by the excess of one hormones (e.g., adenoma arising from one type of cell of
adenohypophysis causes destruction of other types of its cells). Malignant neoplasms of endrocine glands
are less frequent. The production of hormones by malignant tumors depends on the degree of differentiation
of their cells. If the cells are insufficiently differentiated they usually lose their hormonal activity.
B. Inflammatory lesions of endocrine glands.
There are very frequent cause of hypofunctional endocrine syndromes. Etiological factor of these lesions
may be autoimmune process or viral and bacterial infection.
C. Disorders of nutrition.
The most frequent cause is the deficiency of iodium needed for the synthesis of thyroid hormones. The
increased strumigene intake in food, which inhibits synthesis of thyroid hormones, may be also a cause of
endocrine disorders.
D. Iatrogenic causes.
Endocrine disorders may occur as a complication of various kinds of therapy (e.g., surgical intervention,
radiotherapy, inadequate hormone treatment, or therapy with some non hormone drugs).
E. Primary hyperplasia of endocrine gland cells.
as its consequence, a hyperfunctional endocrine syndrome develops.
F. Other acquired causes
They are rather rare. They include, e.g., destruction of endocrine cells by hormone inactive neoplasma,
various kinds of vascular disorders (mostly aneurysm or hemorrhage), cyst, trauma, degenerative process,
metabolic defect, and by toxic influences.

2. Genetic causes

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 Relatively frequent causes of endocrine disorder are defect of various enzymes (enzymopathies) taking part
in a hormone biosynthesis. The other inherent cause can be the synthesis of a defective prohormone or hormone
or the disorder of conversion of prohormone to active hormone. The existence of genetic disorder of cell
receptors for hormones is assumed as well. Inborn causes of endocrine disorder can also include hypoplasia or
aplasia of endocrine gland as well as chromosome anomalies concerning X or Y chromosomes (gonosomes).
2.4 Clinical appearance of Endocrine and Metabolism System
1. Hypothyroidism
Hypothyroidism often called underactive thyroid, is a common endocrine disorder in which the thyroid gland does
not produce enough thyroid hormone. The most comon cause of acquired hypothyroidism is autoimmune thyroditis, in
which antibodies destroy thyroid tissue. Signs and symptoms of hypothroidism include: Intolerance to cold, unexplained
weight gain, dysphagia, fatigue, decreased concentration, constipation, thinning of hair and eyebrows, menstrual
irregularities and dry skin.
2. Hyperthyroidism
Hyperthyroidism is a form of thyrotoxicosis in which excess hormones are secreted by the thyroid gland. It can be
caused by increased synthesis and secretion of T4 and T3; follicular cell distruction, which causes a release of stored T4
and T3; or thyroid cancer. Signs and symptoms of hyperthyroidism include: heart palpitations, heart intolerance,
anxiety, dyspnea on exertion, unintentional weight loss, diarrhea, increased perspiration and menstrual irregularities.
3. Acromegaly
Acromegaly is a hormonal disorder that develops when your pituitary gland produces too much growth hormone
during adulthood. When this happens, your bones increase in size, including those of your hands, feet and face.
Acromegaly usually affects middle-aged adults. Signs and symptoms of acromegaly include: enlarged hands, feet and
facial features, fatigue and muscle weakness, pain and limited joint mobility, menstrual irregularities in women, erectile
dysfunction in men, enlarged liver, kidneys, and other organs, barrel chest.
4. Congenital adrenal hyperplasia
Congenital adrenal hyperplasiais a collection of genetic conditions that limit your adrenal glands' ability to make
certain vital hormones. In most cases of congenital adrenal hyperplasia, the adrenal glands dont produce enough
cortisol. The production of two other kinds of hormones also may be affected, including mineralocorticoids and
androgens. There are two major types of major types of congenital adrenal hyperplasia: classic congenital adrenal
hyperplasia (detected in infancy or early childhood) and nonclassic congenital adrenal hyperplasia (detcted in late
childhood and early adulthood). Signs and symptoms of classic congenital adrenal hyperplasia include: poor weight
gain, weight loss, dehydration, vomiting, abiguous geitalia in girls and enlarged penis in boys. Signs and symptoms of
nonclassic congenital adrenal hyperplasia include: early puberty, rapid growth during childhood but shorter than
average final height, severe acne, low bone density, obesity.
5. Diabetes insipidus
Diabetes insipidus is an uncommon disorder characterized by intense thirst, despite the drinking of fluids
(polydipsia), and the excretion of large amounts of urine (polyuria). In most cases, it's the result of your body not
properly producing, storing or releasing a key hormone, but diabetes insipidus can also occur when your kidneys are
unable to respond properly to that hormone. The most common signs and symptoms of diabetes insiidus are extreme
thirst and excretion of an excessive amount of diluted urine. Depending on the severity of the condition, urine output
can range from 2 quarts (about 2 liters) a day if you have mild diabetes insipidus to 21 quarts (about 20 liters) a day if
the condition is severe and if you're drinking a lot of fluids. In comparison, the average urine output for a healthy adult
varies, but is in the range of 1.6 to 2.6 quarts (about 1.5 to 2.5 liters) a day.
6. Addisons disease
Addison's disease is a disorder that occurs when your body produces insufficient amounts of certain hormones
produced by your adrenal glands. In Addison's disease, your adrenal glands produce too little cortisol and often
insufficient levels of aldosterone as well. Addisons diease symptoms usually develop slowly, often over several
months, and may include: muscle weakness and fatigue, weight loss and decreased appetite, hyperpigmentation, low
blood pressure, hypoglycemia, depression and irritability.
7. Hypopituitarism
Hypopituitarism is a rare disorder in which your pituitary gland either fails to produce one or more of its hormones or
doesn't produce enough of them.In hypopituitarism, you have a short supply of one or more of these pituitary hormones.
This deficiency can affect any number of your body's routine functions, such as growth, blood pressure and
reproduction. Signs and symptoms of hypopituitarism include: fatigue, weight loss, sensitivity to cold, decreased
appetite, anemia, hot flashes, irregular or no periods, loss of pubic hair, and inability to produce milk for breast-feeding
in women anddecreased facial or body hair in men.