Deals with disease related to endocrine gland and some important endocrine features and disease treatment. functions of all endocrine glands

1. ENDOCRINOLOGY
BY : SOMYA SOLANKI

2. WHAT IS ENDOCRINOLOGY?
Endocrinology is a specialty of medicine; some would say a sub-
specialty of internal medicine, which deals with the diagnosis and
treatment of diseases related to hormones.
Endocrinology covers such human functions as the coordination of
metabolism, respiration, reproduction, sensory perception, and
movement. Endocrinology also focuses on the endocrine glands and
tissues that secrete hormones.
The word "endocrinology" comes from the Greek endon meaning
"within", and the Greek krinein meaning "to separate".

3. WHAT IS ENDOCRINE SYSTEM?
The endocrine system refers to the collection of glands of an organism
that secrete hormones directly into the circulatory system to be carried
towards distant target organs. The endocrine system is in contrast to
the exocrine system, which secretes its hormones to the outside of the
body using ducts.
The endocrine system is an information signal system like the nervous
system, yet its effects and mechanism are classifiably different. The
endocrine system's effects are slow to initiate, and prolonged in their
response, lasting from a few hours up to weeks

4. TYPES OF ENDOCRINE GLANDS:

5. WHAT ARE ENDOCRINE DISORDERS?
Endocrine disorders are diseases related to the endocrine glands of the
body. The endocrine system produces hormones, which are chemical
signals sent out, or secreted, through the bloodstream. Hormones help
the body regulate processes, such as appetite, breathing, growth, fluid
balance, feminization and virilization, and weight control.
Most common endocrine disorders are related to improper functioning
of the pancreas and the pituitary, thyroid and adrenal glands.

6. COMMON ENDOCRINE DISORDER INCLUDES:
• Diabetes mellitus,
• Acromegaly (overproduction of growth hormone),
• Addison’s disease (decreased production of hormones by the adrenal
glands),
• Cushing’s syndrome (high cortisol levels for extended periods of
time), Graves’ disease (type of hyperthyroidism resulting in excessive
thyroid hormone production),
• Hashimoto’s thyroiditis (autoimmune disease resulting in
hypothyroidism and low production of thyroid hormone),
hyperthyroidism (overactive thyroid),
• hypothyroidism (underactive thyroid), and
• prolactinoma (overproduction of prolactin by the pituitary gland).

7. PITUTARY GLAND
The pituitary gland is a tiny organ, the size of a pea, found at the base
of the brain. As the “master gland” of the body, it produces many
hormones that travel throughout the body, directing certain processes
or stimulating (causing) other glands to produce other hormones.
Anterior Pituitary Gland
• Growth Hormone (GH)- affects growth of skeletal muscles and bones
• Prolactin (PRL)- stimulates milk production after pregnancy
• Gonadotropic- regulates hormone activity of sex organs
• Also effects adrenal cortex and thyroid hormone release

8. Posterior pituitary
• Oxytocin- helps during pregnancy
• Antidiuretic hormone (ADH)- inhibits urine production
• Alcohol inhibits ADH causing increased output of urine

9. DISORDER:
Most frequent type is a pituitary gland tumour and they are not brain
tumour
Tumours are of 2 types:-
1. secretory: produce too much of a hormone normally made by the
pituitary
2. non- secretory: do not produce hormone
• Tumours are also called adenomas.
• Causes can be due injuries, certain medications, bleeding inside or
close to the pituitary, and other conditions can also affect the
pituitary gland. Loss of normal pituitary function also can occur after
major head trauma.

10. TYPES OF SECRETORY TUMORS
• Prolactinoma
• Acromegaly and gingantism
• crushing’s diseases
• Thyroid stimulating hormone(TSH)-secreting hormone
TYPES OF NON-SECRETORY TUMORS
• Non-functioning adenoma
• Craniophyringiomas
• Rathke’s cleft cysts

11. Prolactinoma: Tumour produces too much prolactin, the hormone that
causes milk production. Prolactinomas affect both men and women.
Symptoms: Changes in menstrual cycle, Headaches , Infertility in women and
men, Peripheral vision problems, Vaginal dryness, Osteoporosis or bone loss
Treatment: Prolactinoma can be treated successfully with a type of drug
called a dopamine agonist. This kind of drug should eliminate or reduce
symptoms, lower prolactin levels and usually return them to normal, help
restore normal function to the pituitary, and usually reduce the tumour size.
Acromegaly and gingantism:
Acromegaly: caused by the excess secretion of growth hormone (GH). It
causes enlarged hands, feet, and facial features, and increased spaces
between teeth. It also can affect your metabolism. Signs of acromegaly
usually begin between the ages of 30 and 50, but can occur in older or
younger adults.

12. Gingatism : similar to acromegaly but occurs in children. Too much GH
causes a child to grow to be unusually tall. Puberty may be delayed in
children with gigantism .
Symptoms: Interrupted menstrual cycle , Deepening of the voice,
Inability to get or maintain an erection , Oily skin or acne , Joint aches ,
Excessive sweating , Thicker flesh on the palms and feet ,Fatigue ,
Headaches.
Treatment: long-acting somatostatin analogue, a drug that suppresses
GH production. Somatostatin analogues are given by a monthly
injection in the muscle or deep under the skin. The drug works directly
on the pituitary tumour to suppress GH production. It also can shrink
the size of the tumour or prevent it from getting bigger as long as you
are taking it. The best way to treat acromegaly is by removing the
tumour. This is typically done through a procedure called
transsphenoidal microsurgery.

13. Crushing’s disesase: Cushing's disease occurs when a pituitary tumour
secretes too much ACTH(adrenocortiotrophic hormrone), the hormone
that stimulates the adrenal glands. Too much ACTH causes the adrenal
glands to produce excess cortisol.
Symptoms: Wide, purple stretch marks on the skin , Rapid and
unexplained weight gain with a rounder face and abdomen, Skin
changes (bruising without injury, acne, hair growth) and red cheeks,
Memory loss , depression, High blood pressure , stroke.
Treatment: The first line therapy is surgical removal of the tumour
transsphenoidal microsurgery through the nasal sinuses. When surgery
does not work, radiation therapy may treat any remaining tumour
mass. Several medications to block the adrenal glands (such as
ketoconazole, metyrapone or mitotane) are often used while waiting
for radiation to have an effect. In some cases, a drug called a dopamine
agonist can reduce ACTH levels and cortisol production.

14. TSH-secreting tumors: A TSH-secreting pituitary tumour produces too
much thyroid-stimulating hormone, which then causes the thyroid
gland to make too much thyroid hormone. This leads to
hyperthyroidism. These tumours are very rare.
Symptoms: Heart palpitations, Fast heartbeat, Irregular menstrual
cycle, Headaches, Visual disturbances, Difficulty sleeping , More
frequent bowel movements, Inability to tolerate heat
Treatment:The first treatment for these tumours is usually
transsphenoidal microsurgery through the nasal sinuses. a
somatostatin analogue is an effective medication to reduce TSH levels,
which in turn lowers thyroid hormone levels. Radiation therapy also
may be used. Radiation therapy will destroy the remaining tumor, but
the process is slow.

15. Non functioning adenoma: Cause hyposecretion, so the pituitary does
not produce enough of the hormones necessary for good health, a
condition called hypopituitarism.
Symptoms : The symptoms of non-functioning adenomas fall into two
categories—tumour mass effects and hyposecretion effects.
Tumour mas effect: Headaches, visual disturbance, Abnormal control of
eye movements
Hyposecretion: Loss of appetite, Weight loss or weight gain, Fatigue,
Irregular or absent menstrual periods, Constipation, Dry skin, Infertility
Treatment: The first therapy your doctor probably will recommend is
transsphenoidal microsurgery, through the nasal sinuses, especially if
your vision is disturbed or the tumour has compressed nerves around
your brain, inside of your skull

16. THYROID GLAND
The thyroid gland is located below the Adam's apple wrapped around
the trachea (windpipe). A thin area of tissue in the gland's middle,
known as the isthmus, joins the two thyroid lobes on each side
• Thyroid hormone
• Controls the rate at which glucose is
“burned”
• Calcitonin
• Decreases calcium levels in blood deposits
on bone

17. Function: The thyroid gland uses iodine (mostly available
from the diet in foods such as seafood, bread, and salt) to
produce thyroid hormones. The two most important thyroid
hormones are thyroxine (tetraiodothyronine or T4) and
triiodothyronine (T3), which account for 99% and 1% of
thyroid hormones present in the blood respectively. However,
the hormone with the most biological activity is T3. Once
released from the thyroid gland into the blood, a large amount
of T4 is converted as needed into T3 - the active hormone that
affects the metabolism of cells.

18. DISORDERS
The hormones it produces, the thyroid gland influences almost all of
the metabolic processes in your body. The most common thyroid
problem involve abnormal production of thyroid hormones. the thyroid
gland is controlled by the pituitary gland and hypothalamus, disorders
of these tissues can also affect thyroid function and cause thyroid
problems.
Types of specific thyroid disorders:
• Hypothyroidism
• Hyperthyroidism
• Goiter
• Thyroid nodules
• Thyroid cancer

19. Hypothyroidism: any state in which thyroid hormone production is below
normal
Causes: Hashimoto's thyroiditis- thyroid gland is usually enlarged (goiter) and
has a decreased ability to make thyroid hormones.
• Lymphocytic thyroiditis (which may occur after hyperthyroidism)- When
the inflammation is caused by a particular type of white blood cell known
as a lymphocyte, the condition is referred to as lymphocytic thyroiditis.
• Thyroid destruction (from radioactive iodine or surgery)- Patients who have
been treated for a hyperthyroid condition (such as Graves' disease) and
received radioactive iodine may be left with little or no functioning thyroid
tissue after treatment
• Pituitary or hypothalamic disease
• Medications
• Severe iodine deficiency

20. Symptoms:
Treatment: It can be easily and completely treated with thyroid hormone
replacement. A blood test is needed to confirm the diagnosis. Synthetic
levothyroxine (T4) is used for diagnosis

21. Hperthyroidism: It is a condition in which an overactive thyroid gland is
producing an excessive amount of thyroid hormones that circulate in the
blood. Thyrotoxicosis is a toxic condition that is caused by an excess of
thyroid hormones from any cause.
Causes: Some common causes of hyperthyroidism include:
• Grave’s diseases- the thyroid gland usually is renegade, which means it has
lost the ability to respond to the normal control by the pituitary gland via
TSH.
• Functioning adenoma ("hot nodule") and toxic multinodular goiter(TMNG)
• Excessive intake of thyroid hormones
• Abnormal secretion of TSH
• Thyroiditis (inflammation of the thyroid gland)
• Excessive iodine intake

22. Symptoms:
Treatment: There are two main antithyroid drugs available for use in the United
States, methimazole (tapazole) and propylthiouracil (PTU). These drugs accumulate
in the thyroid tissue and block production of thyroid hormones. PTU also blocks the
conversion of T4 hormone to the more metabolically active T3 hormone .
Radioactive iodine is given orally (either by pill or liquid) on a one-time basis to
ablate a hyperactive gland. Surgery to partially remove the thyroid gland. It remove
the thyroid tissue that was producing the excessive thyroid hormone.

23. Goiter: A goiter is any enlargement of the thyroid gland. A goiter may
be a temporary problem that will remedy itself over time without
medical intervention, or a symptom of another, possibly severe, thyroid
condition that requires medical attention.
Causes: Goiters can occur when the thyroid gland produces either too
much thyroid hormone (hypertyroidism) or not enough
(hypothyroidism). Much more rarely, the problem may arise when the
pituitary gland stimulates thyroid growth to boost production of the
hormone.
Thyroid nodules: Nodules are lumps or abnormal masses within the
thyroid. Nodules can be caused by benign cysts, benign tumors, or, less
commonly, by cancers of the thyroid. Nodules may be single or multiple
and can vary in size. If nodules are excessively large, they may cause
symptoms related to compression of nearby structures.

24. PARATHYROID GLAND
Parathyroid glands are small glands of the endocrine system that are
located behind the thyroid
• There are four parathyroid glands which are normally about the size
and shape of a grain of rice.
• The sole purpose of the parathyroid glands is to regulate
the calcium level in our bodies within a very narrow range so that the
nervous and muscular systems can function properly

25. DISORDERS
Some specific parathyroid disorders:
• Hyperparathyroidism
• Hypoparathyroidism
• Parathyroid cancer
Hyperparathyroidism: The primary disease of parathyroid gland is
overactivity—too much parathyroid hormone is produced. One or more
of the parathyroid glands behaves inappropriately by making excess
hormone regardless of the level of calcium.
Causes: a tumour that is secreting all the hormone which are called
parathyroid adenomas.

26. Symptoms:
Treatment: Surgery is the most common treatment for primary
hyperparathyroidism and provides a cure in about 95 percent of all cases.
Medication includes a calcimimetic is a drug that mimics calcium circulating in the
blood. The drug may trick the parathyroid glands into releasing less parathyroid
hormone
Hormone replacement therapy and Bisphosphonates also prevent the loss of
calcium from bones and may lessen osteoporosis caused by hyperparathyroidism

27. Hypoparathyroidism: It is the state of decreased secretion or activity
of parathyroid hormone (PTH). This leads to decreased blood levels of
calcium (hypocalcemia) and increased levels of blood phosphorus
(hyperphosphatemia).
Causes: Cause of inadequate parathyroid hormone production is the
accidental removal of parathyroid glands during thyroid surgery.
Congenital Hypoparathyroidism: Patients in this category are born
without parathyroid tissues.
Acquired Hypoparathyroidism: The acquired form of this disease
typically arises because the immune system has developed antibodies
against parathyroid tissues in an attempt to reject what it sees as a
foreign tissue

28. Symptoms: muscle aches or cramps , tingling, burning, or numbness in
fingertips, toes, and lips, muscle spasms, especially around the mouth ,
patchy hair loss , dry skin , brittle nails , fatigue , anxiety or depress
Treatment: Medical Care. Treatment of patients with hypoparathyroidism
involves correcting the hypocalcemia by administering calcium and vitamin D
Surgical Care. Patients undergoing parathyroidectomy for parathyroid
hyperplasia are at high risk of developing permanent primary
hypoparathyroidism.
Consultations.
Diet.
Activity.

29. Parathyroid cancer: Parathyroid cancer is a cancerous malignant growth in a
parathyroid gland.
Causes: The cause of parathyroid cancer is unknown. People with a genetic
condition called multiple endocrine neoplasia type I have an increased risk of
this disease. People who had head or neck radiation may also be at increased
risk. Such radiation exposure, however, is more likely to cause thyroid cancer
Symptoms: Bone pain ,Constipation , Fatigue , Fractures , Frequent
thirst , Frequent urination , Kidney stones , Muscle weakness , Nausea
, Poor appetite , Vomiting
Treatment: A drug called gallium nitrate, which lowers the calcium level in
the blood.
• A natural hormone called calcitonin that helps control calcium level.
• Drugs that stop the breakdown and reabsorption of bones into the body.

30. THYMUS
The thymus is a specialized primary lymphoid organ of the immune
system. Within the thymus, T cells or T lymphocytes mature. T cells are
critical to the adaptive immune system, where the body adapts
specifically to foreign invaders.

31. DISORDER
The list of types of Thymus disorders mentioned in various sources includes:
• Thymus cancer
• Thymoma
Thymus cancer and thymoma: diseases in which malignant (cancer) cells
form on the outside surface of the thymus. The thymus, a small organ that
lies in the upper chest under the breastbone, is part of the lymph system. It
makes white blood cells, called lymphocytes, that protect the body against
infections.
Thymomas and thymic carcinomas are rare tumors of the cells that are on
the outside surface of the thymus. The tumor cells in a thymoma look similar
to the normal cells of the thymus, grow slowly, and rarely spread beyond the
thymus. On the other hand, the tumor cells in a thymic carcinoma look very
different from the normal cells of the thymus, grow more quickly, and have
usually spread to other parts of the body when the cancer is found. Thymic
carcinoma is more difficult to treat than thymoma.

32. Symptoms: People with thymoma often have autoimmune diseases as well.
These diseases cause the immune system to attack healthy tissue and
organs. They include: Myasthenia gravis ,Acquired pure red cell aplasia ,
Hypogammaglobulinemia , Polymyositis.
Thymoma and thymic carcinoma may not cause early signs or symptoms. The
cancer may be found during a routine chest x-ray. A cough that doesn't go
away, Chest pain , Trouble breathing.
Treatment: There are different types of treatment for patients with thymoma
and thymic carcinoma.
• Four types of standard treatment are used:
• Surgery
• Radiation therapy
• Chemotherapy
• Hormone therapy
• New types of treatment are being tested in clinical trials.

33. ADRENAL GLAND
• Has two parts cortex & medulla
• The adrenal glands are two glands that sit on top of your kidneys
• The outer part cortex secretes cortisol, a hormone similar to cortisone.
• The medulla produce adrenalin & nonadrenalin

34. The adrenal cortex—the outer part of the gland—produces hormones
that are vital to life, such as cortisol (which helps regulate metabolism
and helps your body respond to stress) and aldosterone (which helps
control blood pressure).
The adrenal medulla—the inner part of the gland—
produces nonessential (that is, you don’t need them to live) hormones,
such as adrenaline (which helps your body react to stress).
The adrenal cortex and the adrenal medulla have very different
functions. One of the main distinctions between them is that the
hormones released by the adrenal cortex are necessary for life; those
secreted by the adrenal medulla are not.

35. DISORDER
• Addison’s disease
• Adrenal cancer
• Cushing’s syndrome
• Congenital adrenal hyperplasia
Addison’s disease: This rare disorder may affect anyone at any age. It
develops when the adrenal cortex fails to produce enough cortisol and
aldosterone.
Causes: Adrenal insufficiency—when your adrenal glands don’t produce
enough of the hormone cortisol—can be caused by a primary adrenal gland
disorder.
adrenal insufficiency can be caused by a deficiency of
the adrenocorticotropin hormone (ACTH). ACTH stimulates the
adrenal glands to produce cortisol

36. Symptoms:
Treatment: Cortisol is replaced with an oral synthetic glucocorticoid. Generic drug
names for glucocorticoids include hydrocortisone, prednisone,
and dexamethasone.
Aldosterone is replaced with an oral mineralcorticoid. The generic drug name is
fludrocortisone.

37. Adrenal cancer: Adrenal cancer is an aggressive cancer. Malignant
adrenal tumours are rarely confined to the adrenal glands—they tend
to spread to other organs and cause adverse changes within the body
because of the excess hormones they produce.
Causes: No one knows for sure what exactly causes adrenal cancer—
cancer that causes abnormal growths (tumors) in your adrenal glands.
Some possible causes:
Age: 40-50
Family history: certain genetic disorders,
smoking

38. Symptoms: Most patients with adrenal cancer will have symptoms, but some
people may also feel fine. In fact, some patients don't even know they have
adrenal cancer until their doctor finds a tumor on a computed tomography
(CT) scan or a different type of imaging test done for another reason.
Excessive hormone production can lead to endocrine disorders, such as
Cushing's syndrome (from too much cortisol) and precocious puberty (from
too much aldosterone).
Treatment: The main types of treatment for adrenal cancer are:
• surgery
• radiation
• chemotherapy
• Other drugs: Ketoconazole and metyrapone can reduce adrenal steroid
hormone production.
Spironolactone , which decreases effects of aldosterone
Mifepristone , which decreases cortisol effects

39. Crushing’s syndrome: Cushing syndrome is a disorder that occurs when
your body has a high level of the hormone cortisol.
Causes: When the pituitary gland makes too much of the hormone
ACTH. ACTH then signals the adrenal glands to produce too much
cortisol. A pituitary gland tumour can cause this condition.
Tumour of the adrenal gland
Tumour elsewhere in the body that produces corticotropin-releasing
hormone
Tumours elsewhere in the body that produce ACTH

40. Symptoms:
Treatment: Surgery to remove the tumour, Radiation after removal of a
pituitary tumour in some cases , Cortisol replacement therapy after
surgery and possibly for the rest of your life.

41. OVARIES AND TESTES
OVARIES
• primary purpose is to produce
female gametes.
• The overies have three function,
The production of
• Ova
• Estrogen
• Progesterone
TESTES
• Primary purpose is to produce
male gametes.
• Testes produce
• Testosterone
• Spermatozoa

42. OVARY DISORDERS
• Osteoporosis
• Ovarian Cancer
• Ovarian Cysts
Osteoporosis: A medical condition in which the bones become brittle
and fragile from loss of tissue, typically as a result of hormonal
changes, or deficiency of calcium or vitamin D. Anyone can develop
osteoporosis, but it is common in older women.
Causes: Getting older , Being small and thin , Having a family history of
osteoporosis , Taking certain medicines , Being a white or Asian woman
, Having osteopenia, which is low bone density. Menopause is marked
by the rapid loss of estrogen. The role estrogen play in bone loss can
best be described in terms of a battle between osteoclasts (bone
absorbing cells) and osteoblasts (bone producing cells).

43. Symptoms: Back pain, caused by a fractured or collapsed vertebra ,
Loss of height over time , A stooped posture , A bone fracture that
occurs much more easily than expected
Treatment: Osteoporosis treatments include the “basic CDE’s” --
calcium(C), vitamin D (D), weight-bearing exercise (E), prevention of
Falls (F), and bone-friendly medicines.
Strontium tablets and selective estrogen receptor modulators(SERMs)
Teriparatide (Forteo) is self-injected into the skin
Ovarian cancer: It is a cancer that begins in an ovary. It results in
abnormal cells that have the ability to invade or spread to other parts
of the body. When this process begins, symptoms may be vague or not
apparent, but they become more noticeable as the cancer progresses

44. Causes: not having children is a risk factor for ovarian cancer, likely
because ovulation is not suppressed due to pregnancy. Both obesity
and hormone replacement therapy also raise the risk.
Use of fertility medication may contribute to borderline ovarian tumor
formation
Symptoms: persistent abdominal pain, indigestion, bloating, abnormal
uterine bleeding . These are common problems, so in the great
majority of cases, they will not indicate cancer
Treatment: surgery- it is the preferred treatment and is frequently
necessary to obtain a tissue specimen for differential diagnosis via its
histology. The type of surgery depends upon how widespread the
cancer is when diagnosed (the cancer stage), as well as the presumed
type and grade of cancer
chemotherapy

45. Ovarian cyst: Ovarian cysts are fluid-filled sacs that affect women of all ages,
though mostly women of child-bearing age. Cysts are very common—and
they can range in size from a pea to a grapefruit. The majority of cysts are
harmless, though larger cysts (those larger than 5 cm in diameter) may need
to be surgically removed because large cysts can twist the ovary and disrupt
its blood supply.
Cause: Cysts can form for a variety of reasons. Oftentimes, they’re simply
part of normal menstruation. You may experience no symptoms, and the
cysts will go away after a few cycles. These are known as functional cysts.
Symptoms: abnormal or pathological cysts, such as those in polysytic ovary
syndrome (PCOS), may cause painful symptoms.
Breast tenderness , Bloating , Increased hair growth on your face, back, and
chest , Pain before or after your menstrual cycle and irregular periods ,
Infertility , Weight gain , Fatigue

46. Treatment: Most ovarian cysts will go away on their own. If you don't
have any bothersome symptoms, especially if patient haven’t yet gone
through menopause , your doctor may advocate ''watchful waiting.'‘
Birth control pills may relieve the pain from ovarian cysts. They
prevent ovulation, which reduces the odds that new cysts will form.
Surgery is an option if the cyst doesn’t go away, grows, or causes you
pain

47. PLACENTA
The placenta (also known as afterbirth) is an oran that connects the
developing fetus to the uterine wall to allow nutrient uptake, waste
elimination, and gas exchange via the mother's blood supply, fight
against internal infection and produce hormones to support pregnancy.
The placenta provides oxygen and nutrients to growing babies and
removes waste products from the baby's blood. The placenta attaches
to the wall of the uterus, and the baby's umbilical cord develops from
the placenta.

48. Endocrine function: The placenta, among many of its other functions, also secretes
hormones that are essential to fetal life.
• The first hormone released by the placenta is called the human chorionic
gonadotropin (hCG) hormone. This is responsible for stopping the process at the
end of menses when the corpus luteum quits working and atrophies. If hCG did
not interrupt this process, it would lead to spontaneous abortion of the fetus.
• Progesterone helps the embryo implant by assisting passage through the
fallopian tubes. It also affects the fallopian tubes and the uterus by stimulating an
increase in secretions necessary for fetal nutrition
• Estrogen is a crucial hormone in the process of proliferation. This involves the
enlargement of the breasts and uterus, allowing for growth of the fetus and
production of milk. Estrogen is also responsible for increased blood supply
towards the end of pregnancy through vasodilation
• Human Placental Lactogen (hPL) is a hormone used in pregnancy to develop fetal
metabolism and general growth and development. Human placental lactogen
works with human growth hormone (hGH) to stimulate insulin-like growth factor
(IGF) production and regulating intermediary metabolism.

49. PANCREAS
The pancreas is a glandular organ in the digestive
system and endocrine system of vertebrates. In humans, it is located in
the abdominal cavity behind the stomach. It is an endocrine
gland producing several important hormones, including insulin ,
glucagon , somatostatin , and pancreatic polypeptide which circulate in
the blood.

50. Function: The part of the pancreas with endocrine function is made up
of approximately 3 million cell clusters called pancreatic islet.
Four main cell types exist in the islets, they secrete :
α alpha cells secrete glucagon (increase glucose in blood), β beta
cells secrete insulin (decrease glucose in blood), δ delta
cells secrete somatostatin(regulates/stops α and β cells) and PPcells, or
γ (gamma) cells, secrete pancreatic polypeptide.
The pancreatic islets play an imperative role in glucose metabolism and
regulation of blood glucose concentration.

51. Diabetes Mellitus: commonly referred to as diabetes, is a group of metabolic
diseases in which there are high blood sugarlevels over a prolonged period .
Diabetes is due to either the pancreas not producing enough insulin or
the cells of the body not responding properly to the insulin produced .
There are three main types of diabetes mellitus:
• Type 1 DM results from the pancreas's failure to produce enough insulin.
This form was previously referred to as "insulin-dependent diabetes
mellitus" (IDDM) or "juvenile diabetes". The cause is unknown.[3]
• Type 2 DM begins with insulin resistance, a condition in which cells fail to
respond to insulin properly.[3] As the disease progresses a lack of insulin
may also develop.[6] This form was previously referred to as "non insulin-
dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes". The
primary cause is excessive body weight and not enough exercise.[3]
• Gestational diabetes, is the third main form and occurs when pregnant
women without a previous history of diabetes develop a high blood-sugar
level.[

52. Symptoms:

53. Treatment: involve a healthy diet, physical exersice, maintaining
a normal body weight, and avoiding use of tonacco. Control of blood
pressure and maintaining proper foot care are important for people
with the disease. Type 1 DM must be managed
with insulin injections. Type 2 DM may be treated with medications
with or without insulin. Insulin and some oral medications can cause
low blood sugar. Weight loss surgery in those with obesity is sometimes
an effective measure in those with type 2 DM. Gestational
diabetes usually resolves after the birth of the baby

54. DISORDERS RELATED TO DIABETES
• Coeliac disease
• Thyroid disease
• Polycystic ovary syndrome
• Diabetes insipidus
• Necrobiosis lipoidica diabeticorum
• Mastopathy
• Muscular conditions, including:
• Limited joint mobility
• Frozen shoulder
• Dupuytren’s contracture
• Trigger finger
• Carpal tunnel syndrome

55. DIET AND NUTRITION
In nutrition, diet is the sum of food consumed by a person or
other organism. The word diet often implies the use of specific intake
of nutrition for health or weight-management reasons
Complete nutrition requires ingestion and absorption
of vitamins, minerals, and food energy in the form
of carbohydrates, proteins, and fats. Dietary habits and choices play a
significant role in the quality of life, health and longevity. It can define
cultures and play a role in religion

56. Nutrition: Nutrition is the science that interprets the interaction
of nutrients and other substances
in food (e.g. phytonutrients,anthocyanins, tannins, etc.) in relation to
maintenance, growth, reproduction, health and disease of an organism.
It includes food intake,
absorption, assimilation, biosynthesis, catabolism and excretion

57. HORMONE REPLACEMENT THERAPY
Hormone replacement therapy (HRT) is any form of hormone therapy wherein the
patient, in the course of medical treatment, receives hormones, either to
supplement a lack of naturally occurring hormones, or to substitute other
hormones for naturally occurring hormones.
Common forms of hormone replacement therapy include:
• Hormone replacement therapy for menoause is based on the idea that the
treatment may prevent discomfort caused by diminished circulating estrogen and
progestrone hormone, or in the case of the surgically or prematurely
menopausal, that it may prolong life and may reduce incidence of dementia.[1] It
involves the use of one or more of a group of medications designed to artificially
boost hormone levels. The main types of hormones involved are
estrogens, progestrone or progestins, and sometimes testrones. It is often
referred to as "treatment" rather than therapy.

58. • Hormoe replacement therapy for transgender
people introduces hormones associated with the gender that the
patient identifies with (notably testosterones for trans men and
estrogen for transwomen). Some intersex people may also receive
HRT. Cross-sex hormone treatment for transgender individuals is
divided into two main types: hormone replacement therapy (female-
to-male) and hormone replacement therapy (male-to-female).
• Androgen replacement theray (andropausal and ergogenic use) is a
hormone treatment often prescribed to counter the effects of
male hypgonadism. It is also prescribed to lessen the effects or delay
the onset of normal male aging. Additionally, androgen replacement
therapy is used for men who have lost their testicular function to
disease, cancer, or other causes.

59. MENOPAUSE
Menopause, also known as the climacteric, is the time in most
women's lives when menstrual period stop permanently, and the
woman is no longer able to have children. Menopause typically occurs
between 45 and 55 years of age.
Medical professionals often define menopause as having occurred
when a woman has not had any vaginal bleeding for a year.
Before menopause, a woman's periods typically become irregular,
which means that periods may be longer or shorter in duration, or be
lighter or heavier in terms of the amount of flow.

60. Symptoms: hot flashes which last from 30 seconds to 10
minutes, sweating and reddening of the skin , vaginal dryness, trouble
sleeping, and mood changes
Causes: natural change , can occur earlier in those who smoke tobacco
Other causes include surgery that removes both ovaries , or some types
of chemotherapy
menopause happens because of a decrease in the ovaries' production
of the hormones estrogen and progesterone.
Treatment : Specific treatment is not usually needed. Some symptoms,
however, may be improved with treatment. With respect to hot flashes,
avoiding smoking, caffeine, and alcohol is often recommended.
Sleeping in a cool room and using a fan may also help. he following
medications may help: menopausal hormonal
therapy (MHT), clonidine, gabapentin, or selective seretonnin reuptake
inhibitor

61. OBESITY
Obesity is a medical condition in which excess body fat has
accumulated to the extent that it may have a negative effect on health,
leading to reduced life expentancy and/or increased health problems.
In Western countries, people are considered obese when their body
mass index (BMI), a measurement obtained by dividing a person's
weight by the square of the person's height, exceeds30 kg/m2, with the
range 25-30 kg/m2 defined as overweight.
Obesity is a leading preventable cause of death worldwide, with
increasing rates in adults and children. In 2013, the American medical
association classified obesity as a disease.

62. BMI is defined as the subject's weight divided by the square of their
height and is calculated as follows:
BMI = m/h2
where m and h are the subject's weight and height respectively
Causes: At an individual level, a combination of excessive food
intake intake and a lack of physical activity is thought to explain most
cases of obesity. A limited number of cases are due primarily to
genetics, medical reasons, or psychiatric illness. In contrast, increasing
rates of obesity at a societal level are felt to be due to an easily
accessible and palatable diet, increased reliance on cars, and
mechanized manufacturing.
Treatment: weight loss goals ang weight loss treatmet