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Disorders of Endocrine Glands, Practice Problems and FAQs

 Disorders of Endocrine Glands, Practice Problems and FAQs

Plants need water for their survival. But what happens when there is a decrease in water availability or when there is more than enough water in their surroundings? You must have noticed that in either of the two cases the plants eventually die. So what did you deduce from this scenario? We can conclude that too much or too little of anything can be harmful for the body.

The same holds true for the hormones of our body.

Hormones are the chemical messengers produced by the endocrine glands of our body that regulate various metabolic and physiological functions of the body. Endocrine glands are ductless glands that their secretions directly into the bloodstream. Hypothalamus, Pineal gland, Pituitary gland, Thyroid gland, Parathyroid gland, Thymus, Adrenal gland, Pancreas, Gonads (Ovary and testes) are the different endocrine glands of human body. But the imbalance in the secretion of hormones can lead to many disorders some of which can even be fatal in the long run. So what are these disorders and their effects? Let’s check out more.

List of contents:

  • Disorders of pituitary gland
  • Disorders of thyroid gland
  • Disorders of Adrenal Gland
  • Disorders of Pancreas
  • Practice problems
  • FAQs

Disorders of pituitary gland

Pituitary gland, also known as the master gland, controls the activities of all other endocrine glands. It has two lobes, anterior pituitary lobe or adenohypophysis and posterior pituitary lobe or neurohypophysis. The anterior pituitary lobe secretes different types of hormones like, Prolactin, Growth Hormone, Luteinising hormone (LH), Follicle stimulating hormone (FSH), Thyroid stimulating hormone (TSH) and Adrenocorticotropic hormone (ACTH). Antidiuretic hormone (ADH) and oxytocin are secreted by the posterior lobe of pituitary. Some of the disorders developed due to irregularities in the secretion of the hormones from pituitary are -

Gigantism

Over secretion of growth hormone in children results in the abnormal growth of the body leading to gigantism. Affected persons may be as tall as 7 feet with extraordinarily long limbs and abnormally large hands and feet.


                                               Fig: Gigantism

Dwarfism

Less than normal secretion of growth hormone in children results in stunted growth of the body, resulting in dwarfism.


                                                   Fig: Dwarfism

Acromegaly

Excess secretion of growth hormone in middle-aged adults results in the disfigurement of body parts. It is called acromegaly. It usually manifests as abnormal growth and thickening of the facial bones, long jaws and protruding forehead. It is very hard to diagnose acromegaly in the early stages and hence it often goes unchecked.


                           Fig: Acromegaly

Diabetes insipidus

Hyposecretion of ADH or vasopressin from the posterior lobe of the pituitary gland leads to diabetes insipidus. ADH is responsible for increased reabsorption of water from the kidney tubules during urine formation. Hyposecretion of ADH results in a lot of water being lost with urine. Thus, the symptoms of diabetes insipidus are extremely dilute urine and frequent urination.

Disorders of thyroid gland

The thyroid gland majorly secretes two hormones - thyroxine and calcitonin. Disorders caused due to less secretion of the thyroid hormones are categorised as hypothyroidism and those caused due to excess secretion of thyroid hormones are categorised as hyperthyroidism.


                                                   Fig: Disorders of thyroid gland

Hypothyroidism

Iodine is essential for thyroxine production by thyroid glands. Hypothyroidism may be caused due to deficiency of iodine in the diet, excess loss of iodine with urine or due to genetic factors. Some of the effects of hypothyroidism are -

Simple goitre

Simple goitre is caused due to the deficiency of iodine in the diet which results in an increase in the number of follicles in the thyroid gland and leads to enlargement of the gland. This causes a swelling in the neck.


                                          Fig: Goitre

Myxoedema

Hypothyroidism in adults results in decreased rate of metabolism which causes sluggishness and fatigue, low body temperature, poor memory and concentration, and constipation. Low metabolic rate also causes gain in weight. Swollen face with thick lips and eyelids is characteristic of myxoedema. Women undergo irregularities in the menstrual cycle. Degenerated sex organs and impotency is more common in affected women than in men.


                                       Fig: Myxoedema

Cretinism

Thyroxine is required for normal growth and brain development in children. So its deficiency in children leads to a disease called cretinism. This can result in a foetus if the mother does not take enough iodine in her diet, or from an iodine deficiency in the diet of a child. Sometimes, a child can be born with a defective thyroid. In cretinism, the growth is stunted, there is mental retardation, abnormal skin, and deaf-mutism.


                        Fig: Cretinism

Hyperthyroidism

Exophthalmic goitre or Grave’s disease

The most common disorder caused by hyperthyroidism is Grave’s disease or toxic goitre which is caused due to hyperactivity of the thyroid gland. This can be due to -

  • cancer of the thyroid gland caused due to malignant tumour formations in the thyroid gland which may even spread to other organs.


                                                       Fig: Thyroid cancer

  • increase in the number of thyroid nodules which in turn results in more secretion of the thyroxine hormone.


                                             Fig: Thyroid nodules

A very common symptom of Grave’s disease is exophthalmic goitre, in which: the eyeballs protrude and the thyroid gland is enlarged. So, goitre can be a symptom in both hypothyroidism and hyperthyroidism. To avoid confusion, the goitre in hyperthyroidism is usually referred to as toxic goitre or exophthalmic goitre.


 Fig: Exophthalmic goitre and Grave’s disease

Other symptoms associated with Grave’s disease are increased metabolic rate, weight loss, higher body temperature, increased heart rate, irregular heartbeat, mental restlessness, anxiety, osteoporosis, etc.


                                             Fig: Effects of hyperthyroidism

Hashimoto’s disease

It is an autoimmune disease in which the thyroid gland is attacked by antibodies that resemble the thyroid stimulating hormone or TSH produced by the anterior lobe of the pituitary. These antibodies stimulate the thyroid gland to produce more hormones which again leads to hyperthyroidism.


        Fig: Reason for Hashimoto’s disease

Disorders of Adrenal Gland

The adrenal gland is composed of the adrenal cortex and adrenal medulla. Adrenal cortex releases the corticoid hormones while adrenal medulla releases the adrenaline hormone. The variation in the levels of these hormones could lead to various disorders.

Addison’s disease

Carbohydrate metabolism is altered by the underproduction of the cortisol and aldosterone hormones by the adrenal cortex. This will lead to a disease called Addison’s disease.The symptoms include acute weakness, fatigue, low blood sugar and hyperpigmentation.


                                 Fig: Symptoms of Addison’s disease

Cushing’s syndrome

Cushing’s syndrome is caused due to adrenal tumour or adrenal hyperactivity when there is hypersecretion of the cortisol hormone. Pituitary tumours causing excess secretion of adrenocorticotropic hormone (ACTH) can also be a reason. The symptoms include excessive deposition of fat over the face, back of the neck and abdomen. Excessive hair growth in males, masculinisation of females with growth of beard, moustache, etc, also happens. It also results in high blood sugar, rise of Na+ and fall of K+ in plasma, absence of menstruation in females, sterility, etc.

Adrenal virilism

Adrenal virilism is caused due to overproduction of adrenal androgens and is associated with adrenal tumours. The clinical symptoms in adults are reversal of sexual characters. Females tend to develop facial features, body appearance, voice, etc similar to that of males. They develop beard and moustache, uterus and ovaries degenerate, menstruation stops and the clitoris enlarges.

Disorders of Pancreas

The disorders of pancreas will affect the balance in glucose homeostasis. Three types of disorders can be observed. These are -

Diabetes Mellitus or hyperglycaemia

Hyposecretion of insulin in the body can lead to the occurrence of diabetes mellitus. Insulin is responsible for lowering sugar levels in the blood. Lack of insulin leads to high blood sugar level or hyperglycemia. It leads to loss of glucose through urine. In diabetes, when glucose is less in the cells, the body begins to uptake fatty acids from the blood, to provide the energy. In this process, ketone bodies are formed which are toxic for the body in high concentrations. Diabetic ketoacidosis is a complication of diabetes, when the body looks for other sources of energy than glucose or sugars and turns to fats.

The symptoms include frequent urination, frequent thirst, slow wound healing, weakness and ketosis.


                                             Fig: Symptoms of diabetes mellitus

Diabetic patients are successfully treated with insulin therapy. Do you know how insulin is injected? It is usually injected in the fat under the skin or intravenously. For this we can use a syringe, insulin pen or insulin pump tubing.


                                                 Fig: Treatment for Diabetes

Hypoglycemia

It is the decrease in blood glucose level below normal. The symptoms include: sweating, unconsciousness, confusion, irritability and weakness. It can be handled by consuming sugar. It is caused due to hypersecretion of insulin in the body.

Practice Problems

1. Select the answer from the following which correctly matches the endocrine gland with its hormone secreted and its function or deficiency symptom.

 

Endocrine gland

Hormone

Function/deficiency symptoms

  1.  

Anterior pituitary

Oxytocin

Stimulates a vigorous contraction of the uterus at the time of childbirth

  1.  

Posterior pituitary

Growth hormone

Over Secretion causes dwarfism

  1.  

Thyroid gland

Thyroxine

Lack of iodine in the diet results in goitre

  1.  

Pineal

ACTH

High stress levels

Solution: The thyroid gland synthesises the hormone thyroxine. Iodine is essential for hormone synthesis in the thyroid. Deficiency of iodine in our diet results in hypothyroidism and an enlargement of the thyroid gland, commonly called goitre.

Hence the correct option is c.

2. Match the following from Column 1 and Column 2.

Column 1

Column 2

A. Cretinism

i. Swelling of the thyroid gland due to iodine deficiency

B. Hyperthyroidism

ii. Protruding eyes

C. Goitre

iii. Defective development and the maturation of the growing baby that will lead to stunted growth

  1. A- i, B- ii, C-iii
  2. A-ii, B-i, C-iii
  3. A-i, B-iii, C-ii
  4. A- iii, B-ii, C- i,

Solution: Hypothyroidism in children leads to their defective development and maturation which results in stunted growth and mental retardation. This condition is called cretinism.

When the rate of synthesis and secretion of the thyroid hormones increases to abnormally high levels, then it will lead to a condition called hyperthyroidism. This will cause an abnormal increase in the basal metabolic rate of the body. Hyperthyroidism results in exophthalmic goitre which is characterised by bulging of eyes.

The swelling of the thyroid gland is called goitre. This may be caused by dietary iodine deficiency which leads to hypothyroidism.

Hence the correct option is d.

3. A pregnant female delivers a baby, the baby suffers from stunted growth, mental retardation, low intelligence quotient and abnormal skin. What might be the reason?

  1. Deficiency of iodine in diet.
  2. Low secretion of growth hormone.
  3. Cancer of the thyroid gland.
  4. Oversecretion of TSH.

Solution: Iodine is an essential component of the thyroid hormones \(T_3\) and \(T_4\). The deficiency of iodine in the diet when a woman is pregnant causes hypothyroidism, which in turn causes a condition called cretinism in her child. It involves an abnormal growth and development of the growing baby leading to stunted growth. It also causes mental retardation, low intelligence quotient, abnormal skin, and deaf-mutism.

Hence the correct option is a.

4. The urine report of a person shows the presence of glucose and ketone bodies. This individual is most likely suffering from which disease?

  1. diabetes mellitus
  2. Graves' disease
  3. Cretinism
  4. none of the above

Solution: The deficiency of insulin results in high levels of glucose in blood, called hyperglycemia. Because insulin acts on hepatocytes and adipocytes. This stimulates the uptake and utilisation of glucose by the cells. This disorder is called diabetes mellitus, and is associated with the loss of glucose through urine and the formation of harmful compounds known as ketone bodies.

Hence the correct option is a.

FAQs

1. Can hypothyroidism affect our nervous system?
Answer:
Fluid buildup due to prolonged, severe and untreated hypothyroidism can create pressure on the nerves in our limbs. This results in tingling, pain, and numbness at the sites of nerve damage.

2. Can gigantism be cured?
Answer:
Gigantism can be cured either by surgery to remove the pituitary tumours or can be cured with drugs to bring down the growth hormone (GH) hormones.

3. What are the differences between diabetes mellitus and diabetes insipidus?
Answer:
Diabetes mellitus is a complex disorder caused by prolonged hyperglycemia due to insulin deficiency in the body. It leads to frequent urination and the urine is loaded with sugar.

Hyposecretion of ADH results in a diminished ability of the kidney to conserve water. This will lead to water loss and dehydration which leads to diabetes insipidus. Urine is highly dilute but

4. Why is insulin not digested as a tablet to cure diabetes?
Answer
: Insulin is a peptide hormone which can get digested by the protein digesting hormones of the stomach, if it is ingested as a tablet. Thus it is administered as an intravenous or subcutaneous injection.

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