Condition "Adrenal disorders"

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Although we rarely think about them, the glands of the endocrine system and the hormones they release influence almost every cell, organ, and function of our bodies. The endocrine system is instrumental in regulating mood, growth and development, tissue function, and metabolism, as well as sexual function and reproductive processes.

In general, the endocrine system is in charge of body processes that happen slowly, such as cell growth. Faster processes like breathing and body movement are controlled by the nervous system. But even though the nervous system and endocrine system are separate systems, they often work together to help the body function properly.

About the Endocrine System

The foundations of the endocrine system are the hormones and glands. As the body's chemical messengers, hormones transfer information and instructions from one set of cells to another. Although many different hormones circulate throughout the bloodstream, each one affects only the cells that are genetically programmed to receive and respond to its message. Hormone levels can be influenced by factors such as stress, infection, and changes in the balance of fluid and minerals in blood.

A gland is a group of cells that produces and secretes, or gives off, chemicals. A gland selects and removes materials from the blood, processes them, and secretes the finished chemical product for use somewhere in the body.

Some types of glands release their secretions in specific areas. For instance, exocrine glands, such as the sweat and salivary glands, release secretions in the skin or inside of the mouth. Endocrine glands, on the other hand, release more than 20 major hormones directly into the bloodstream where they can be transported to cells in other parts of the body.

Parts of the Endocrine System

The major glands that make up the human endocrine system are the hypothalamus, pituitary, thyroid, parathyroids, adrenals, pineal body, and the reproductive glands, which include the ovaries and testes. The pancreas is also part of this hormone-secreting system, even though it is also associated with the digestive system because it also produces and secretes digestive enzymes.

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.

The Hypothalamus

The hypothalamus, a collection of specialized cells that is located in the lower central part of the brain, is the primary link between the endocrine and nervous systems. Nerve cells in the hypothalamus control the pituitary gland by producing chemicals that either stimulate or suppress hormone secretions from the pituitary.

Although it is no bigger than a pea, the pituitary gland, located at the base of the brain just beneath the hypothalamus, is considered the most important part of the endocrine system. It's often called the "master gland" because it makes hormones that control several other endocrine glands.

The production and secretion of pituitary hormones can be influenced by factors such as emotions and seasonal changes. To accomplish this, the hypothalamus relays information sensed by the brain (such as environmental temperature, light exposure patterns, and feelings) to the pituitary.

The Pituitary Gland

The tiny pituitary gland is divided into two parts: the anterior lobe and the posterior lobe. The anterior lobe regulates the activity of the thyroid, adrenals, and reproductive glands. Among the hormones it produces are:

  • growth hormone, which stimulates the growth of bone and other body tissues and plays a role in the body's handling of nutrients and minerals
  • prolactin, which activates milk production in women who are breastfeeding
  • thyrotropin, which stimulates the thyroid gland to produce thyroid hormones
  • corticotropin, which stimulates the adrenal gland to produce certain hormones

The pituitary also secretes endorphins, chemicals that act on the nervous system to reduce sensitivity to pain. In addition, the pituitary secretes hormones that signal the ovaries and testes to make sex hormones. The pituitary gland also controls ovulation and the menstrual cycle in women.

The posterior lobe of the pituitary releases antidiuretic hormone, which helps control body water balance through its effect on the kidneys and urine output; and oxytocin, which triggers the contractions of the uterus that occur during labor.

The Thyroid and Parathyroids

The thyroid, located in the front part of the lower neck, is shaped like a bow tie or butterfly and produces the thyroid hormones thyroxine and triiodothyronine. These hormones control the rate at which cells burn fuels from food to produce energy. As the level of thyroid hormones increases in the bloodstream, so does the speed at which chemical reactions occur in the body.

Thyroid hormones also play a key role in bone growth and the development of the brain and nervous system in children. The production and release of thyroid hormones is controlled by thyrotropin, which is secreted by the pituitary gland.

Attached to the thyroid are four tiny glands that function together called the parathyroids. They release parathyroid hormone, which regulates the level of calcium in the blood with the help of calcitonin, which is produced in the thyroid.

The Adrenal Glands

The body has two triangular adrenal glands, one on top of each kidney. The adrenal glands have two parts, each of which produces a set of hormones and has a different function. The outer part, the adrenal cortex, produces hormones called corticosteroids that influence or regulate salt and water balance in the body, the body's response to stress, metabolism, the immune system, and sexual development and function.

The inner part, the adrenal medulla, produces catecholamines, such as epinephrine. Also called adrenaline, epinephrine increases blood pressure and heart rate when the body experiences stress. (Epinephrine injections are often used to counteract a severe allergic reaction.)

The Pineal Gland and Gonads

The pineal body, also called the pineal gland, is located in the middle of the brain. It secretes melatonin, a hormone that may help regulate the wake-sleep cycle.

The gonads are the main source of sex hormones. In males, they are located in the scrotum. Male gonads, or testes, secrete hormones called androgens, the most important of which is testosterone. These hormones regulate body changes associated with sexual development, including enlargement of the penis, the growth spurt that occurs during puberty, and the appearance of other male secondary sex characteristics such as deepening of the voice, growth of facial and pubic hair, and the increase in muscle growth and strength. Working with hormones from the pituitary gland, testosterone also supports the production of sperm by the testes.

The female gonads, the ovaries, are located in the pelvis. They produce eggs and secrete the female hormones estrogen and progesterone. Estrogen is involved in the development of female sexual features such as breast growth, the accumulation of body fat around the hips and thighs, and the growth spurt that occurs during puberty. Both estrogen and progesterone are also involved in pregnancy and the regulation of the menstrual cycle.

The Pancreas

The pancreas produces (in addition to others) two important hormones, insulin and glucagon. They work together to maintain a steady level of glucose, or sugar, in the blood and to keep the body supplied with fuel to produce and maintain stores of energy.

What the Endocrine System Does

Once a hormone is secreted, it travels from the endocrine gland through the bloodstream to target cells designed to receive its message. Along the way to the target cells, special proteins bind to some of the hormones. The special proteins act as carriers that control the amount of hormone that is available to interact with and affect the target cells.

Also, the target cells have receptors that latch onto only specific hormones, and each hormone has its own receptor, so that each hormone will communicate only with specific target cells that possess receptors for that hormone. When the hormone reaches its target cell, it locks onto the cell's specific receptors and these hormone-receptor combinations transmit chemical instructions to the inner workings of the cell.

When hormone levels reach a certain normal or necessary amount, further secretion is controlled by important body mechanisms to maintain that level of hormone in the blood. This regulation of hormone secretion may involve the hormone itself or another substance in the blood related to the hormone.

For example, if the thyroid gland has secreted adequate amounts of thyroid hormones into the blood, the pituitary gland senses the normal levels of thyroid hormone in the bloodstream and adjusts its release of thyrotropin, the pituitary hormone that stimulates the thyroid gland to produce thyroid hormones.

Another example is parathyroid hormone, which increases the level of calcium in the blood. When the blood calcium level rises, the parathyroid glands sense the change and decrease their secretion of parathyroid hormone. This turnoff process is called a negative feedback system.

Problems With the Endocrine System

Too much or too little of any hormone can be harmful to the body. For example, if the pituitary gland produces too much growth hormone, a child may grow excessively tall. If it produces too little, a child may be abnormally short.

Controlling the production of or replacing specific hormones can treat many endocrine disorders in children and adolescents, some of which include:

Adrenal insufficiency. This condition is characterized by decreased function of the adrenal cortex and the consequent underproduction of adrenal corticosteroid hormones. The symptoms of adrenal insufficiency may include weakness, fatigue, abdominal pain, nausea, dehydration, and skin changes. Doctors treat adrenal insufficiency by giving replacement corticosteroid hormones.

Cushing syndrome. Excessive amounts of glucocorticoid hormones in the body can lead to Cushing syndrome. In children, it most often results when a child takes large doses of synthetic corticosteroid drugs (such as prednisone) to treat autoimmune diseases such as lupus. If the condition is due to a tumor in the pituitary gland that produces excessive amounts of corticotropin and stimulates the adrenals to overproduce corticosteroids, it's known as Cushing disease.

Symptoms may take years to develop and include obesity, growth failure, muscle weakness, easy bruising of the skin, acne, high blood pressure, and psychological changes. Depending on the specific cause, doctors may treat this condition with surgery, radiation therapy, chemotherapy, or drugs that block the production of hormones.

Type 1 diabetes. When the pancreas fails to produce enough insulin, type 1 diabetes (previously known as juvenile diabetes) occurs. Symptoms include excessive thirst, hunger, urination, and weight loss. In children and teens, the condition is usually an autoimmune disorder in which specific immune system cells and antibodies produced by the immune system attack and destroy the cells of the pancreas that produce insulin.

Type 1 diabetes can cause long-term complications, including kidney problems, nerve damage, blindness, and early coronary heart disease and stroke. To control their blood sugar levels and reduce the risk of developing diabetes complications, kids need regular injections of insulin.

Type 2 diabetes. Unlike type 1 diabetes, in which the body can't produce normal amounts of insulin, in type 2 diabetes the body is unable to respond to insulin normally. Children and teens with this condition tend to be overweight, and it is believed that excess body fat plays a role in the insulin resistance that characterizes the disease. In fact, the rising prevalence of this type of diabetes in kids has paralleled the dramatically increasing rates of obesity among kids in recent years.

The symptoms and possible complications of type 2 diabetes are basically the same as those of type 1. Some kids and teens can control their blood sugar level with dietary changes, exercise, and oral medications, but many will need to take insulin injections like those with type 1 diabetes.

Growth hormone problems. Too much growth hormone in children who are still growing will make their bones and other body parts grow excessively, resulting in gigantism. This rare condition is usually caused by a pituitary tumor and can be treated by removing the tumor.

In contrast, when the pituitary gland fails to produce adequate amounts of growth hormone, a child's growth in height is impaired. Hypoglycemia (low blood sugar) may also occur in kids with growth hormone deficiency, particularly in infants and young children with the condition.

Hyperthyroidism. Hyperthyroidism is a condition in which the levels of thyroid hormones in the blood are excessively high. Symptoms may include weight loss, nervousness, tremors, excessive sweating, increased heart rate and blood pressure, protruding eyes, and a swelling in the neck from an enlarged thyroid gland (goiter).

In kids this is usually caused by Graves' disease, an autoimmune disorder in which specific antibodies produced by the immune system stimulate the thyroid gland to become overactive. The disease may be controlled with medications or by removal or destruction of the thyroid gland through surgery or radiation treatments.

Hypothyroidism. Hypothyroidism is when the levels of thyroid hormones in the blood are abnormally low. Thyroid hormone deficiency slows body processes and may lead to fatigue, a slow heart rate, dry skin, weight gain, constipation, and, in kids, slowing of growth and delayed puberty.

Hashimoto's thyroiditis, which results from an autoimmune process that damages the thyroid and blocks thyroid hormone production, is the most common cause of hypothyroidism in kids. Infants can also be born with an absent or underdeveloped thyroid gland, resulting in hypothyroidism. It can be treated with oral thyroid hormone replacement.

Precocious puberty. Body changes associated with puberty may occur at an abnormally young age in some kids if the pituitary hormones that stimulate the gonads to produce sex hormones rise prematurely. An injectable medication is available that can suppress the secretion of these pituitary hormones (known as gonadotropins) and arrest the progression of sexual development in most of these children.

Reviewed by: Steven Dowshen, MD
Date reviewed: March 2012


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Keywords: Endocrinology

 

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