underactive adrenal glands

Underactive Adrenal Glands / Addison's Disease

Underactive Adrenal Glands / Addison's Disease

F A C T :Lack of corticosteroids in the blood may cause the pituitary gland to produce more corticotropin hormones to stimulate the adrenal glands. Since corticotrophin affects melanin production, excess levels of corticotropins may cause dark pigmentation of the skin and lining of the mouth.

What is Addison's disease?Addison's disease is the result of an underactive adrenal gland. An underactive adrenal gland produces insufficient amounts of corticosteroid hormones. Four in every 100,000 people have Addison's disease.

What causes Addison's disease?Most of the time, the cause of the disease is unknown. About one-third of Addison's disease cases are caused by the actual destruction of the adrenal glands through cancer, infection, or other diseases. Other causes may include:

Use of corticosteroids as a treatment (such as prednisone) causes a slow down in production of natural corticosteroids by the adrenal glands.

Certain drugs used to treat fungal infections may block production of corticosteroids in the adrenal glands.

Results of inadequate corticosteroid production:Lack of corticosteroids has several health repercussions:

1. Lack of corticosteroids can cause elevated levels of sodium and retention of potassium. This leads to the inability to produce concentrated urine by the kidneys, which in turn can lead to excessive urination. Ultimately, a patient becomes dehydrated.

2. Lack of corticosteroids can also lead to extreme sensitivity to the hormone insulin, which normally is present in the bloodstream. This sensitivity may lead to low blood sugar levels.

3. Lack of corticosteroids means the patient is at increased risk during stressful periods, such as surgery, infection, or injury. Corticosteroids play an important role in helping the body fight infection and promote healing during physical stress.

What are the symptoms of Addison's disease?Mild Addison's disease symptoms may only be apparent when the patient is under physical stress. The following are the most common symptoms. However, each individual may experience symptoms differently:

weakness

fatigue

dizziness

dark skin

black freckles

bluish-black discoloration around the nipples, mouth, rectum, scrotum, or vagina

weight loss

dehydration

lack of appetite

muscle aches

nausea

vomiting

diarrhea

intolerance to cold

If not treated, Addison's disease may lead to severe abdominal pain, extreme weakness, low blood pressure, kidney failure, and shock -- especially when the patient is experiencing physical stress.

The symptoms of Addison's disease may resemble other conditions or medical problems. Consult a physician for diagnosis.

How is Addison's disease diagnosed?In addition to a complete medical history and medical examination, diagnostic procedures for Addison's disease may include:

blood tests to measure corticosteroid hormone levels

kidney function tests to determine if urine is concentrated

Treatment of Addison's disease:The goal of treatment is to restore the adrenal glands to normal function, producing normal levels of corticosteroid hormones. Specific treatment for Addison's disease will be determined by your physician based on:

your overall health and medical history

extent of the disease

your tolerance for specific medications, procedures, or therapies

expectations for the course of the disease

your opinion or preference

Since Addison's disease can be life threatening, treatment often begins with administration of corticosteroids. Corticosteroids, such as prednisone, may be taken orally or intravenously, depending on the patient's condition. Usually the patient has to continue taking the corticosteroid the rest of his/her life. Treatment may also include taking fludrocortisone, a drug that helps restore the body's level of sodium and potassium.

Overactive Adrenal Glands / Cushing's SyndromeF A C T :Corticosteroids help the body respond to stress. Elevated levels of these hormones are often found in pregnant women, athletes, and people suffering from depression, alcoholism, malnutrition, and panic disorders.

What are overactive adrenal glands?When adrenal glands produce excessive amounts of certain hormones, they are called "overactive." Symptoms and treatment depend on which hormones are being overproduced: androgenic steroids (androgen hormones) - an overproduction of androgenic steroids (such as testosterone) can lead to exaggerated male characteristics in both men and women, such as hairiness of the face and body, baldness, acne, deeper voice, and more muscularity.

corticosteroids - an overproduction of corticosteroids can lead to Cushing's syndrome (see below).

aldosterone - an overproduction of the aldosterone hormone can lead to high blood pressure and to those symptoms associated with low levels of potassium (i.e., weakness, muscle aches, spasms, and sometimes paralysis).

The symptoms of overactive adrenal glands may resemble other conditions or medical problems. Consult a physician for diagnosis.

How are overactive adrenal glands diagnosed?In addition to a complete medical history and medical examination, diagnostic procedures for overactive adrenal glands may include: specific blood tests to measure levels of hormones

urine tests to measure levels of hormones

Treatment of overactive adrenal glands:Treatment of overactive adrenal glands depends on the cause of the disease. Specific treatment for overactive adrenal glands will be determined by yourphysician based on: your overall health and medical history





Treatment may include surgical removal of growths or the adrenal gland(s) itself. Certain drugs that block the excessive production of certain hormones may also be administered.

What is Cushing's syndrome?Cushing's syndrome is the result of the excessive production of corticosteroids by the adrenal glands. An overproduction of corticotropin -- the hormone that controls the adrenal gland -- by the pituitary gland, which stimulates the adrenal glands to produce corticosteroids, may be one cause. In addition, certain lung cancers and other tumors outside the pituitary gland may produce corticotropins. Other causes include benign or cancerous tumors on the adrenal glands.

What are the symptoms of Cushing's syndrome?The following are the most common symptoms. However, each individual may experience symptoms differently. Symptoms may include: upper body obesity

round face

increased fat around neck

thinning arms and legs

fragile and thin skin

stretch marks on abdomen, thighs, buttocks, arms, and breasts

bone and muscle weakness

severe fatigue

high blood pressure

high blood sugar

irritability and anxiety

excess hair growth in women

irregular or stopped menstrual cycles in women

reduced sex drive and fertility in men

The symptoms of Cushing's syndrome may resemble other conditions or medical problems. Consult a physician for diagnosis.

How is Cushing's syndrome diagnosed?In addition to a complete medical history and medical examination, diagnostic procedures for Cushing's syndrome may include: x-rays to locate any tumors

24-hour urinary test to measure for corticosteroid hormones

computed tomography (CT or CAT scan) - a non-invasive procedure that takes cross-sectional images of the brain or other internal organs; to detect any abnormalities that may not show up on an ordinary x-ray

magnetic resonance imaging (MRI) - a non-invasive procedure that produces two-dimensional views of an internal organ or structure, especially the brain or spinal cord

dexamethasone suppression test - to differentiate whether the excess production of corticotropins are from the pituitary gland or tumors elsewhere

corticotropin-releasing hormone (CRH) stimulation test - to differentiate whether the cause is a pituitary tumor or an adrenal tumor

other laboratory tests

Treatment for Cushing's syndrome:Treatment for Cushing's syndrome depends on its cause. Surgery may be needed to remove tumors or the adrenal glands. Other treatment may include radiation, chemotherapy, and use of certain hormone-inhibiting drugs.What are adrenal tumors?Tumors of the adrenal glands are rare. However, when present, they can cause a multitude of disorders by excessively secreting certain adrenal-produced hormones. One type of tumor of the adrenal glands is called a pheochromocytoma.

What is a pheochromocytoma?A pheochromocytoma is a benign adrenal gland tumor that secretes epinephrine and norepinephrine hormones. These hormones are responsible for regulating heart rate and blood pressure, among other functions. Pheochromocytomas occur most frequently in young to middle-aged adults between the ages of 30 and 60.

What are the symptoms of pheochromocytoma?The most common symptom of pheochromocytoma is high blood pressure, which is sometimes extreme. Other symptoms are usually nonexistent, unless the person experiences pressure from the tumor, emotional stress, changes in posture, or is taking beta-blocker drugs for a heart disorder. Each individual may experience symptoms differently. Other symptoms may include:

rapid pulse

palpitations

headache

nausea

vomiting

clammy skin

The symptoms of pheochromocytoma may resemble other conditions or medical problems. Consult a physician for diagnosis.

How is pheochromocytoma diagnosed?In addition to a complete medical history and medical examination, diagnostic procedures for pheochromocytoma may include:

blood and urine tests to measure hormone levels

computed tomography (CT or CAT scan) - a non-invasive procedure that takes cross-sectional images of the brain or other internal organs; to detect any abnormalities that may not show up on an ordinary x-ray

radioisotope scan - uses radioactive substances introduced into the body to create an image of the functioning adrenal gland

Treatment for pheochromocytomaTreatment for pheochromocytoma usually includes removing the tumor. Before removing the tumor, however, your physician may prescribe drugs to control high blood pressure.

Rarely pheochromocytomas can be malignant and may metastasize to other organs. Chemotherapy following resection of the primary tumor is the treatment of choice for malignant pheochromocytomas.

The Thyroid Gland

What is metabolism?Metabolism is the chemical activity that occurs in cells, releasing energy from nutrients or using energy to create other substances, such as proteins. The basal metabolic rate (BMR) is a measurement of energy required to keep the body functioning at rest. Measured in calories, metabolic rates increase with exertion, stress, fear, and illness.

Anatomy of the thyroid gland:The thyroid gland is located in the front of the neck, below the larynx (voice box). The small, two-inch gland consists of two lobes, one on each side of the windpipe, connected by tissue called the isthmus.

The thyroid tissue is made up of two types of cells: follicular cells and parafollicular cells. Most of the thyroid tissue consists of the follicular cells, which secrete iodine-containing hormones called thyroxine (T4) and triiodothyronine (T3). The parafollicular cells secrete the hormone calcitonin. The thyroid needs iodine to produce the hormones.

Functions of the thyroid gland:The thyroid plays an important role in regulating the body's metabolism and calcium balance. The T4 and T3 hormones stimulate every tissue in the body to produce proteins and increase the amount of oxygen used by cells. The harder the cells work, the harder the organs work. The calcitonin hormone works together with the parathyroid hormone to regulate calcium levels in the body.

Levels of hormones secreted by the thyroid are controlled by the pituitary gland's thyroid-stimulating hormone, which in turn is controlled by the hypothalamus.

What are thyroid function tests?Thyroid function tests are common procedures performed to determine how well the thyroid is functioning. Some of the most common thyroid function tests include the following:

blood tests:

to measure the level of thyroid-stimulating hormone in the blood which helps determine thyroid function. High levels of the hormone indicate an underactive thyroid.

to measure levels of hormones thyroxine (T4) and triiodothyroxine (T3), and to measure a protein called thyroxine-binding globulin.

ultrasound exam of the thyroid gland - to detect signs of growth and other irregularities. (An ultrasound scan is a diagnostic technique which uses high-frequency sound waves to create an image of the internal organs.)

thyroid scans using radioactive iodine or technetium (a radioactive metallic element) - to reveal any physical abnormalities of the thyroid.

functional stimulation tests - tests that help differentiate whether the problem lies with the pituitary gland or the thyroid gland. One such test includes injecting thyrotropin-releasing hormone and measuring the pituitary's response.

HyperthyroidismWhat is hyperthyroidism?Hyperthyroidism means overactivity of the thyroid gland, resulting in too much thyroid hormone in the bloodstream. The oversecretion of thyroid hormones leads to overactivity of the body's metabolism.

What are the symptoms of hyperthyroidism?The following are the most common symptoms of hyperthyoidism. However, each individual may experience symptoms differently. Symptoms may include:

nervousness

irritability

increased perspiration

thinning of the skin

fine, brittle hair

weak muscles, especially in the upper arms and thighs

shaky hands

fast heartbeat

high blood pressure

increased bowel movements

weight loss

sleeping difficulty

eye sensitivity to light

staring

confusion

irregular menstrual cycle

The symptoms of hyperthyroidism may resemble other conditions or medical problems. Consult a physician for diagnosis.

Types of hyperthyroidism:There are several forms of hyperthyroidism, including:Graves' disease (diffuse toxic goiter)Graves' disease is most often associated with hyperthyroidism. Researchers believe Graves' disease is caused by an antibody which stimulates the thyroid too much, in turn causing the excess production of thyroid hormone. Graves' disease is categorized as an autoimmune disorder (a dysfunction of the body's immune system). The disease is most common in young to middle-aged women and tends to run in families.

Symptoms of Graves' disease are identical to hyperthyroidism, with the addition of three other symptoms. However, each individual may experience symptoms differently. The three additional symptoms include:

goiter (enlarged thyroid which may cause a bulge in the neck)

bulging eyes (exophthalmos)

thickened skin over the shin area

toxic nodular goiter (also called multinodular goiter)Hyperthyroidism caused by toxic nodular goiter is a condition in which one or more nodules of the thyroid becomes overactive. The overactive nodules actually act as benign thyroid tumors. Symptoms of toxic nodular goiter do not include bulging eyes or skin problems, as in Graves' disease. The cause of toxic nodular goiter is not known.

thyroiditisThyroiditis causes temporary hyperthyroidism, usually followed with hypothyroidism (an underactive thyroid). Thyroiditis is an inflammation of the thyroid gland. There are three types of thyroiditis: Hashimoto's thyroiditis

subacute granulomatous thyroiditis

silent lymphocytic thyroiditis

In addition, if a person takes too many thyroid hormone tablets, hyperthyroidism may occur.How is hyperthyroidism diagnosed?In addition to a complete medical history and medical examination, diagnostic procedures for hyperthyroidism may include:

measurement of thyroid hormone in the bloodstream

thyroid scan - uses a radioactive substance to create an image of the thyroid as it is functioning

Treatment for hyperthyroidism:Treatment for hyperthyroidism is very specific for each patient. The goal of treatment is to restore the thyroid gland to normal function, producing normal levels of thyroid hormone. Specific treatment for hyperthyroidism will be determined by your physician based on: your overall health and medical history

type of hyperthyroidism





Treatment may include: use of antithyroid drugs that help lower the level of thyroid hormones in the blood.

use of radioactive iodine, in the form of a pill or liquid, which damages thyroid cells so that production of thyroid hormones is slowed down.

surgery to remove part of the thyroid (the overactive nodule).

use of beta blocking agents, which block the action of thyroid hormone on the body (these drugs do not change the levels of thyroid hormone in the blood, but make the patient feel better).

HypothyroidismF A C T :In underdeveloped countries, a chronic lack of iodine in a diet is a major cause of hypothyroidism because the thyroid needs iodine to produce thyroid hormones. Due to the addition of iodine to table salt and iodine-laced disinfectants used on cows' udders, this cause of hypothyroidism has disappeared in the US.

What is hypothyroidism?Hypothyroidism is the condition in which the thyroid is underactive (i.e., it is producing an insufficient amount of thyroid hormones). Hypothyroidism is the most common thyroid disorder. Severe hypothyroidism can lead to a condition called myxedema, characterized by dry, thickened skin and coarse facial features.

Causes of hypothyroidism:The most common cause of hypothyroidism is an autoimmune reaction, where the body produces antibodies against the thyroid gland. One such autoimmune disorder is called Hashimoto's thyroiditis, an inflammation of the thyroid gland. Other causes include treatment of hyperthyroidism such as radioactive iodine treatment or surgery.

What are the symptoms of hypothyroidism?Symptoms of hypothyroidism are usually very subtle and gradual and may be mistaken for symptoms of depression. The following are the most common symptoms of hypothyroidism. However, each individual may experience symptoms differently. Symptoms may include: dull facial expressions

hoarse voice

slow speech

droopy eyelids

puffy and swollen face

weight gain

constipation

sparse, coarse and dry hair

coarse, dry, and thickened skin

carpal tunnel syndrome (hand tingling or pain)

slow pulse

muscle cramps

orange-colored soles and palms

sides of eyebrows thin or fall out

confusion

increased menstrual flow in women

Untreated hypothyroidism may lead to anemia, low body temperature, and heart failure.

The symptoms of hypothyroidism may resemble other conditions or medical problems. Consult a physician for diagnosis.A condition called secondary hypothyroidism sometimes occurs as a result of a failing pituitary gland. When the pituitary gland fails, it no longer stimulates the thyroid to produce thyroid hormones.

How is hypothyroidism diagnosed?In addition to a complete medical history and medical examination, diagnostic procedures for hypothyroidism may include blood tests to measure levels of thyroid hormones and the thyroid-stimulating hormones produced by the pituitary gland.

Treatment of hypothyroidism:The goal of treatment is to restore the thyroid gland to normal function, producing normal levels of thyroid hormones. Specific treatment for hypothyroidism will be determined by your physician based on:




expectations for the coarse of the disease


Treatment may include prescription of thyroid hormones to replace the deficient hormones. Dosage of thyroid hormone may need to be increased over the years. Yearly or biyearly checkups are usually required to ensure the proper dosage of thyroid hormones is taken. A patient usually takes thyroid hormones for the rest of his/her life.

Hashimoto's ThyroiditisDid you know?Hashimoto's thyroiditis is the most common cause of hypothyroidism.

It is also most prevalent in elderly women and tends to run in families.

Hashimoto's thyroiditis occurs eight times more often in women than men.

Certain chromosomal abnormalities include Hashimoto's thyroiditis as a symptom.

What is Hashimoto's thyroiditis?Thyroiditis is the inflammation of the thyroid gland. Hashimoto's thyroiditis is the most common form of thyroiditis. Classified as an autoimmune disorder, Hashimoto's thyroiditis causes an autoimmune reaction, with antibodies attacking the thyroid gland. The cause of Hashimoto thyroiditis is unknown.

What are the symptoms of Hashimoto's thyroiditis?The following are the most common symptoms. However, each individual may experience symptoms differently: goiter (enlarged thyroid gland which may cause a bulge in the neck)

other endocrine disorders such as diabetes, an underactive adrenal gland, underactive parathyroid glands, and other autoimmune disorders

fatigue

muscle weakness

weight gain

The symptoms of Hashimoto's thyroiditis may resemble other conditions or medical problems. Consult a physician for diagnosis.

How is Hashimoto thyroiditis diagnosed?In addition to a complete medical history and medical examination, diagnostic procedures for Hashimoto thyroiditis may include blood tests to detect levels of thyroid hormone and thyroid antibodies.Treatment for Hashimoto's thyroiditis:Specific treatment for Hashimoto's thyroiditis will be determined by your physician based on:






Specific treatment is currently not available for Hashimoto's thyroiditis. Hashimoto's thyroiditis usually results in hypothyroidism (an underactive thyroid gland), which can be treated with hormone replacement therapy (the administration of thyroid hormone). Hormone replacement therapy usually alleviates the goiter condition. However, if goiter does not improve, surgery may be required.Thyroid Tumors

Did you know......a nodule found in a man's thyroid is more likely to be cancer than when found in a woman?

What is radioactive iodine treatment?The thyroid needs iodine to properly produce the thyroid hormones. By administering radioactive iodine to a patient, the thyroid tissue will absorb the altered iodine, which then destroys that thyroid tissue.

What are thyroid tumors?Thyroid tumors are either benign (noncancerous) or malignant (cancerous) growths. Examples of benign tumors are adenomas, which secrete thyroid hormone. Malignant tumors are more rare and are found in many stages of malignancy.

What are thyroid adenomas?Thyroid adenomas grow from the cell layer that lines the inner surface of the thyroid gland. The adenoma itself secretes thyroid hormone. If the adenoma secretes enough thyroid hormone, it may cause hyperthyroidism. Thyroid adenomas may be treated if they cause hyperthyroidism. Treatment may include surgery to remove part of the thyroid (the overactive nodule).

What are cancerous thyroid tumors?Cancer of the thyroid occurs more often in people who have undergone radiation to the head, neck, or chest. However, most thyroid cancer can be cured with appropriate treatment. Thyroid cancer usually appears as small growths (nodules) within the thyroid gland. Some signs that a nodule may be cancerous include:

presence of a single nodule rather than multiple nodules

thyroid scan reveals the nodule is not functioning

nodule is solid instead of filled with fluid (cyst)

nodule is hard

nodule grows fast

What are the symptoms of thyroid cancer?The first sign of a cancerous nodule in the thyroid gland is a painless lump in neck.However, each individual may experience symptoms differently. Other symptoms may include:

hoarseness or loss of voice as the cancer presses on the nerves to the voice box

difficulty swallowing as the cancer presses on the throat

However, the symptoms of thyroid cancer may resemble other conditions or medical problems. Consult a physician for diagnosis.

Diagnosis of thyroid cancer:In addition to a complete medical history and medical examination, diagnostic procedures for thyroid cancer may include:

thyroid scan

ultrasound

biopsy - taking a sample of the nodule with a needle for examination under a microscope

Thyroid cancer comes in four forms:

papillary thyroid cancerPapillary thyroid cancer is the most common form of thyroid cancer, accounting for about 60 to 70 percent of all cases. This form of thyroid cancer affects more women than men.

Treatment for papillary cancer usually involves:

surgery - to remove part or all of the thyroid (called a thyroidectomy)

thyroid hormone therapy - to suppress the pituitary gland from secreting more thyroid-stimulating hormone, which may stimulate a recurrence of papillary cancer

administration of radioactive iodine - to destroy any remaining thyroid tissue

follicular thyroid cancerFollicular thyroid cancer occurs most often among elderly patients and accounts for about 15 percent of thyroid cancer cases. This type of thyroid cancer is more aggressive and tends to spread through the bloodstream to other parts of the body.

Treatment for follicular cancer may include:

surgery - to remove the thyroid gland (thyroidectomy)

administration of radioactive iodine - to destroy any remaining thyroid tissue

anaplastic thyroid cancerAnaplastic thyroid cancer tends to occur most often among elderly women and accounts for less than 10 percent of thyroid cancer cases. This quick-growing cancer usually results in a large growth in the neck. Approximately 80 percent of patients diagnosed with anaplastic thyroid cancer die within one year of diagnosis.

Treatment for anaplastic thyroid cancer may include:


medication (i.e., anticancer drugs)

radiation therapy

medullary thyroid cancerMedullary thyroid cancer tends to spread through the lymphatic system (which is part of the immune system and consists of a system of vessels that connect lymphs throughout the body) and the bloodstream to other parts of the body. This type of cancer produces excessive amounts of calcitonin, a hormone also produced by the thyroid gland itself.


Additional surgery may be necessary if the cancer has spread.

Because medullary cancer tends to run in families, screening tests for genetic abnormalities in the blood cells may be conducted.

The Parathyroid GlandsAnatomy of the parathyroid glands:The parathyroid glands are two small, oval-shaped glands located adjacent to the two thyroid gland lobes in the neck.

Function of the parathyroid glands:Parathyroid glands produce parathyroid hormone, which plays a role in the regulation of calcium levels in the blood. Precise calcium levels are important in the human body, since small deviations can cause muscle and nerve impairment.

The parathyroid hormone stimulates the following functions:

release of calcium by bones into the bloodstream

absorption of food by the intestines

conservation of calcium by the kidneys

HyperparathyroidismWhat is hyperparathyroidism?Hyperparathyroidism is caused by overactive parathyroid glands. Overactive parathyroid glands produce too much parathyroid hormones, which in turn stimulate increased levels of calcium in the blood stream.

The excess calcium released by the bones leads to osteoporosis and osteomalacia (both bone-weakening diseases). Other results of hyperparathyroidism are kidney stones, because of high levels of calcium excreted into the urine by the kidneys.

Causes of hyperparathyroidism include benign tumors on the parathyroid glands or enlargement of the parathyroid glands.

What are symptoms of hyperparathyroidism?The following are the most common symptoms of hyperparathyroidism. However, each individual may experience symptoms differently. Symptoms may include:

aches and pains

depression

abdominal pain

nausea

vomiting

fatigue

excessive urination

confusion

muscle weakness

The symptoms of hyperparathyroidism may resemble other conditions or medical problems. Consult a physician for diagnosis. How is hyperparathyroidism diagnosed?In addition to a complete medical history and medical examination, diagnostic procedures for hyperparathyroidism may include:

bone x-rays

laboratory tests to measure calcium and parathyroid hormone levels

Treatment for hyperparathyroidism:Specific treatment for hyperparathyroidism will be determined by your physician based on: your overall health and medical history





Treatment may include removal of parathyroid tissue.

underactive adrenal glands

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