By Ramaz Mitaishvili, MD
Endocrinology is a branch of medicine dealing with disorders of the endocrine system and its specific secretions called hormones.
An Endocrinologist is a physician engaged in the study and practice of the endocrine system. Generally, these individuals will hold an M.D. or D.O. degree if medical doctors, or a Ph.D. degree if they are performing academic research. Endocrinologists play important roles in university academic research, clinical medical practice and in the pharmaceutical industry. They are specialists, experts in their field, and should serve as your main physician for endocrine disease related problems.
The area of endocrinology and metabolic disease is among the leading therapeutic categories for clinical drug development. It's a diverse area of research that ranges from widespread conditions such as diabetes and obesity to more uncommon illnesses. Endocrinology and metabolic disease demand specialized expertise.
As the need for expertise in endocrinology and metabolic disease emerged, we began cultivating our knowledge in endocrinology and metabolic disorders, hiring experienced key staff members who could deliver exceptional service in this therapeutic specialty.
ENDOCRINE SYSTEM
1. Introduction
• produce, store, and secrete chemical substances – Hormones, which transfer information and instructions from one set of cells to another.
• regulate the body's growth and development
• control the function of various tissues
• support pregnancy and other reproductive functions
• regulate metabolism.
• hormones are released directly into the bloodstream.
2. Organs of Endocrine System
Organs of Endocrine System are the hypothalamus, pituitary, thyroid, parathyroid, adrenal, pineal body, and reproductive glands—the ovary and testis. The pancreas, an organ often associated with the digestive system, is also considered part of the endocrine system. In addition, some non-endocrine organs are known to actively secrete hormones. These include the brain, heart, lungs, kidneys, liver, thymus, skin, and placenta. Almost all body cells can either produce or convert hormones, and some secrete hormones.
A. HYPOTHALAMUS (coordinator of the endocrine system)
• found deep within the brain
• directly controls (stimulate or suppress) the pituitary gland.
• is the primary link between the endocrine and nervous systems.
B. PITUITARY GLAND (master gland)
• located in a bony cavity just below the base of the brain
• secretes several hormones that regulate the function of the other endocrine glands.
• is divided into two parts, the anterior and posterior lobes, each having separate functions.
Anterior lobe
• regulates the activity of the thyroid, adrenal glands, and the reproductive glands.
• regulates the body's growth and stimulates milk production in women
• secretes Adrenocorticotropic hormone (ACTH), Thyrotropic hormone (TSH), Luteinizing hormone (LH), Follicle-stimulating hormone (FSH), Growth hormone (GH), and Prolactin.
• secretes Endorphins, chemicals that act on the nervous system to reduce sensitivity to pain.
Posterior lobe
• contains the nerve endings (axons) from the hypothalamus, which stimulate or suppress hormone production.
• secretes Antidiuretic hormones (ADH), which control water balance in the body, and Oxytocin, which controls muscle contractions in the uterus.
C. THYROID GLAND
• located in the neck
• secretes Thyroxine and three-Iodothyronine—that regulate growth and metabolism, and play a role in brain development during childhood.
D. PARATHYROID GLANDS
• are four small glands located at the four corners of the thyroid gland.
• secrete Parathyroid hormone, regulates the level of calcium in the blood.
E. ADRENAL GLAND
– is located on top of the kidneys, the have two distinct parts.
Adrenal cortex (outer part)
• produces Corticosteroids
• regulates salt and water balance in the body,
• prepares the body for stress,
• regulate metabolism, interact with the immune system, and influence sexual function.
Adrenal medulla (inner part)
• produces Catecholamines, such as Epinephrine(Adrenaline), which increase the blood pressure and heart rate during times of stress.
F. GONADS
Gonads secrete sex hormones.
The female gonads (ovaries), produce eggs and secrete female sex hormones, including Estrogen and Progesterone, which control development of the reproductive organs, stimulate the appearance of female secondary sex characteristics, and regulate menstruation and pregnancy.
The male gonads (testes), produce sperm and secrete male sex hormones (Androgens) which regulate development of the reproductive organs, stimulate male secondary sex characteristics, and stimulate muscle growth.
G. PANCREAS
– is located just under the stomach.
Exocrine pancreas
– secretes digestive enzymes into the gastrointestinal tract.
Endocrine cells
– secrete Insulin, Glucagon, and Somastatin, which regulate energy and metabolism in the body.
H. PINEAL GLAND
• is located in the middle of the brain.
• secretes Melatonin, which regulates the wake-sleep cycle.
.
.3. Clinical Consideration
Endocrine disorders are classified in two ways: disturbances in the production of hormones (production disorders)- hypofunction (insufficient activity) and hyperfunction (excess activity),
and the inability of tissues to respond to hormones.
A. ACROMEGALY & GIGANTISM
– are caused by a pituitary tumor that stimulates production of excessive growth hormone, causing abnormal growth in particular parts of the body.
Acromegaly is rare and usually develops over many years in adult subjects.
Gigantism occurs when the excess of growth hormone begins in childhood.
B. ADDISON’S DISEASEIS
caused by decreased function of the adrenal cortex.
Symptoms
• weakness
• fatigue
• abdominal pains
• nausea, dehydration
• fever, and hyperpigmentation (tanning without sun exposure) are among the many possible symptoms.
Treatment
involves providing the body with replacement corticosteroid hormones as well as dietary salt.
C. CUSHING’S SYNDROME
• is caused by excessive secretion of glucocorticoids (subgroup of corticosteroid hormones that includes hydrocortisone) by the adrenal glands.
• Symptoms
• obesity
• physical weakness
• easily bruised skin
• acne, hypertension, and psychological changes.
Treatment
may include surgery, radiation therapy, chemotherapy, or blockage of hormone production with drugs.
D. DIABETES INSIPIDUS
– is caused by a deficiency of vasopressin, one of the antidiuretic hormones (ADH) secreted by the posterior lobe of the pituitary gland.
Symptoms
– increased thirst and urination.
Treatment
– is with drugs, such as synthetic vasopressin, that help the body maintain water and electrolyte balance.
E. DIABETES MELLITUS
• occurs in two forms- Type 1, is caused by inadequate secretion of insulin by the pancreas, and Type 2 is caused by the body's inability to respond to insulin.
• can cause a variety of complications, including kidney problems, pain due to nerve damage, blindness, coronary heart disease, and impotence.
Symptoms
• excessive thirst
• hunger
• urination
• weight loss.
Diagnosis
• Detection glucose in the urine and elevation levels of glucose in the blood.
Treatment
Type 1 requires regular injections of insulin;
Type 2 can be treated with diet, exercise, or oral medication.
F. HYPOTHYROIDISM
• is caused by an underactive thyroid gland, which results in a deficiency of thyroid hormone.
• cause Myxedema (usually after age 40, and causes lethargy, fatigue, and mental sluggishness) and Cretinism (Congenital Hypothyroidism cause mental retardation).
By providing the body with replacement thyroid hormones, almost all of the complications are completely avoidable.
G. THYROTOXICOSIS (Hyperthyroidism)
• caused by overproduction of thyroid hormones.
Graves' disease (most common) an autoimmune disorder in which specific antibodies are produced, stimulating the thyroid gland.
Symptoms
• weight loss despite increased appetite.
• increased heart rate, higher blood pressure and increased nervousness, with excessive perspiration.
• more frequent bowel movements, sometimes with diarrhea.
• muscle weakness, trembling hands.
Treatment
Drugs that inhibit thyroid activity, surgery to remove the thyroid gland, and radioactive iodine that destroys the gland
Did you know that:
– Some of the body's glands are described as endo-exocrine glands because they secrete hormones as well as other types of substances. Even some nonglandular tissues produce hormone-like substances—nerve cells produce chemical messengers called neurotransmitters, for example.
– The earliest reference to the endocrine system comes from ancient Greece, in about 400 BC. However, it was not until the 16th century that accurate anatomical descriptions of many of the endocrine organs were published.
– 16th President of the United States Abraham Lincoln had acromegaly
– Thyrotoxicosis is eight to ten times more common in women than in men.
********************************************************
Proven experience in endocrinology and metabolic disease
Our experience spans a broad range of services across this diverse therapeutic category. Our work ranges from early to late phase studies of sexual dysfunction in many patients to global trials in diabetes to niche studies in more diverse areas. We've provided specialized services in endocrinology and metabolic disease that include feasibility planning and protocol development, clinical monitoring, regulatory consulting, comprehensive data management and biostatistics.
Our experience includes the following indications:
• Birth Control
• Diabetes
• Diabetic Macular Edema
• Diabetic Neuropathy
• Gaucher's Disease
• Hormone Replacement Therapy
• Hypercholesterolemia
• Hyperlipidemia
• Menopause
• Obesity
• Osteoporosis
• Precocious Puberty
• Sexual Dysfunction
• Women's Health
Strategic thinking, operational excellence
Our specialized approach to endocrinology and metabolic disease means we provide in-depth scientific insights and tailor our processes and teams to meet the demands of the project and the therapeutic category – maintaining speed, precision, and quality. Our therapeutic leads not only offer strategic thinking, but also a high level of medical and scientific oversight throughout study execution. On the operational level, we continue to build our clinical and medical staff with substantial expertise in endocrine and metabolic trial delivery and management. The seamless integration of scientific, medical, and operations teams – combined with a unique eye on the therapeutic nuances – means every aspect of a study is more efficient and exact.
www.abkhazia.com
