Endocrinology

Endocrinology as a medical specialty deals with hormones, metabolism and associated diseases.

What is endocrinology?

Endocrinology is the medical specialty that deals with diseases related to hormonal disorders.

Hormones are produced by glands and released into the blood. They exert their effect on various organs and have a messenger function.

Examples include insulin (the hormone that plays a role in diabetes), thyroid hormones, sex hormones, cortisol, growth hormone, and parathyroid hormone.

What hormonal diseases are there?

The pituitary gland is located at the base of the brain (hence pituitary gland). It plays the role of a conductor for most hormones. It regulates the hormone production of other glands, such as the thyroid, ovaries, testes, and adrenal glands.

Diseases of the thyroid gland 

Thyroid hormones are secreted into the blood by the thyroid gland, which is located in the neck. These hormones are involved in the control of various organs and act as a kind of thermostat. When the thyroid gland produces too many hormones (hyperthyroidism), some disorders such as flushing, trembling, acceleration of intestinal transit and palpitations may occur.

On the other hand, in case of insufficient production of thyroid hormone (hypothyroidism), nervousness, mental slowdown, constipation, fatigue and weight gain are generally reported. Thanks to some medications, it is possible to reduce hormone production in hyperthyroidism or replace its function in hypothyroidism. In any case, a careful assessment (blood test, ultrasound examination of the thyroid gland) by a specialist is always required first.

The appearance of nodules in the thyroid gland is a fairly common phenomenon. They are mostly benign and only require regular monitoring by ultrasound examinations. If a nodule appears suspicious, it is recommended to perform a puncture so that a diagnosis can be made.

Disorder of the sex hormones

Sex hormones are secreted directly into the blood by the testes and ovaries and, although to a lesser extent, by the adrenal glands. In men, testosterone is responsible for sexual health in terms of libido and reproductive ability; in women, these hormones are estrogen and progesterone.

These also play an important role in maintaining healthy bones - an important prerequisite for not developing osteoporosis. An excessive presence of male hormones (androgens) in a woman can lead to so-called virilization (strong body hair, hair loss, acne, irregularity or absence of menstruation).

Cortisol

Cortisol, a vital stress hormone, is secreted by the adrenal glands, which are located above the kidneys. A deficiency of cortisol (adrenal insufficiency) can cause dizziness, nausea, abdominal pain, and weight loss. It is therefore necessary to undergo a specialist evaluation to determine the cause of a possible cortisol deficiency and to implement hormone replacement treatment.

Too much cortisol, on the other hand, can result in weight gain, the appearance of distinct purple stretch marks, weakness of muscles close to the trunk, a tendency to hematoma formation and skin fragility. Other possible consequences include diabetes and osteoporosis. In these cases, too, evaluation by a specialist is essential so that specific treatment can be initiated based on the identified cause.

Overproduction of growth hormones

Overproduction of growth hormones in childhood can be a cause of giant stature. However, if this overproduction occurs in adulthood, that is, when the bones have already completed their growth, the consequence is a pathology called acromegaly. This pathology consists in the enlargement of certain anatomical structures (tongue, interdental spaces, hands, feet, joints, some parts of the face). In such cases, it is necessary to consult an endocrinologist who will then perform the necessary tests and initiate the most appropriate treatment.

Parathyroid hormone 

Parathormone (or parathyroid hormone) is produced by four small glands located on the outside of the thyroid gland. This hormone ensures a balanced level of calcium in the blood. In the case of an excess of parathyroid hormone, which may be due, for example, to a tumor (usually benign) in one of these glands, there is an increase in the level of calcium in the blood, the possible consequences of which are kidney stones, osteoporosis and kidney failure.

This list of hormonal disorders is not exhaustive. Do not hesitate to talk to your doctor in case of any disorder that could be hormonal in nature. He or she will then refer you to a specialist.

Endocrine disorders require expert care by an endocrinologist. In addition to a specific clinical evaluation, laboratory tests are required to measure hormone levels, as well as other tests (radiology, nuclear medicine) depending on the particular disorder.

Doctors with this specialisation

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Clinica Sant'Anna

Dr. med. Pietro Gerber

Specialisation
Internal medicine, Endocrinology, Diabetology

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