A small note to tell you….. A young executive after consulting for her thyroid asked “Anyway doc, what is your relation with criminals, why are you called Endocriminologist?” It goes without saying the colour of her face after she was explained it is Endocrinology and there is nothing as Endocriminology neither we have any connection with criminals!
Endocrinology is the branch of the medical science what deals with hormones. Hormones play a big role in normal and abnormal life of ours. Endocrine problems are common, most of which are easily treatable and can be kept under reasonable control. We in this section have tried to discuss some of the issues which we come across in our everyday practice.
- Weight gain / loss Though there are endocrine causes of weight gain, yet the most common cause seems to be our food habits and lifestyle which are the key players today. The thyroid hormones manage our body’s metabolism and an alteration in the circulating thyroid balance can cause a weight-related issue.
People with low thyroid hormone levels (Hypothyroidism) tend to gain more weight. On the contrary people with increased levels of thyroid hormone (Hyperthyroidism) tend to lose weight despite an increased appetite. People with decreased circulating levels of steroid hormones (Addison’s disease) also have a tendency to lose weight. The opposite that is a high steroid in the body may push your weight up.
The polycystic ovarian disease is a common cause of weight gain in women. These hormonal problems can be tested easily. There are some other hormonal problems that can be responsible for weight problem like Hypothalamic disturbance, fortunately, they are rare. Insulin resistance can make you overweight on the other hand deficiency of Insulin you lose weight.
- Anxiety/ palpitations / Increased sweating We tend to feel anxious and can feel our own heartbeat normally when we are stressed, tensed and scared. This is a response due to Catecholamine hormones which are the hormones which help us cope with stressful situations.
But there is another relatively rare condition where such hormones are produced excessively; this can cause episodes of anxiety & palpitations. Increased levels of thyroid hormones in the blood is another common cause for this complaint.
- Bowel problems: Hormonal imbalance can cause a variety of bowel-related issues. Low levels of thyroid hormones can cause constipation and high levels increase the frequency of bowel movements.
High levels of calcium in the body can also cause constipation. Diabetes affecting the intestinal nerves can upset bowel movements.
- Hair loss: A common complaint can be due to a thyroid-related issue or calcium-related problem. In general, there are so many non-hormonal causes of hair loss.
In fact, any significant physical illness is known to cause hair loss, nail disturbance, weakness, weight loss etc.
- Acne, Excess facial and body hair: Just about every woman may have experienced unwanted hair or acne at one point or another. This is the most common worry, in adolescent and young females.
This is mainly due to a condition called polycystic ovaries, where there is a hormonal imbalance due to which the sebaceous glands are more sensitive to circulating levels of androgens.
- Hirsutism is the clinical name for excessive hair growth. Any condition that increases the blood level of testosterone, male sex hormones or androgens results in hirsutism.
The most probable cause would be PCO, rarer causes being late-onset congenital adrenal hyperplasia (LOCAH) or androgen-secreting tumour to name a few.
Drugs such as oral contraceptives containing progesterone, Cyclosporine, Minoxidil, Phenytoin, Androgens, Penicillamine, heavy metals, or Acetazolamide can cause hirsutism.
- Irregular Cycles: Hormonal disturbance can affect the normal menstrual cycles. The common reasons being a disturbance in thyroid imbalance, polycystic ovaries, pituitary hormonal imbalance. Please do not forget there are so many non-hormonal causes for a period to get upset.
- Infertility means not being able to become pregnant. One-third of infertility cases are female factor infertility, one-third are malefactor, and the remaining third involve problems on either side or unexplained causes.
Ovulatory defects due to polycystic ovaries can cause infertility. Abnormal thyroid can cause a problem with conception.
- Headache/ Visual Disturbance: The pituitary gland is very close to the eye nerve. Any swelling or enlargement in the pituitary gland can affect the vision. This can also cause a headache.
Again headache can be a non-specific manifestation of so many different diseases, from eye-related problems, migraine, etc. Commonest causes of headache in the general population are stress and refractory problem. In the same way, the commonest cause of visual disturbance is a change in refraction.
- Breast discharge: Prolactin secreted from the pituitary gland is responsible for lactation. Increased levels of prolactin can cause galactorrhoea – abnormal milk secretion. Up to around 25-30% of women with polycystic ovaries can also have raised prolactin levels.
- Erectile dysfunction: This is due to low levels of the male hormone testosterone; can be due to a primary testicular problem or due to a problem in the pituitary gland. The commonest cause remains stress and fear of failure.
- Increased thirst/ urination Increased frequency of urination and excessive thirst is most commonly due to high sugar. A rarer cause can be due to a deficiency of a pituitary hormone, vasopressin, which is responsible for maintaining the water balance in the body
- Hot flushes are due to vasomotor instability and are usually related to the female climacteric. The cause of hot flushes would seem to be related to very high levels of gonadotrophins (pituitary hormones) as the ovaries fail but there is still much that is not understood about their aetiology..