Endocrinology

What is endocrinology?

Endocrinology is a branch of medicine that focuses on and treats patients suffering from diseases related to hormonal imbalances.

Hormones are made by glands and then released into the bloodstream. They have effects on different organs, acting, for example, as messengers.

Hormones include insulin, involved in diabetes, thyroid hormones, sex hormones, cortisol, growth hormone, parathyroid hormone, etc.

Hormonal pathologies

The pituitary gland, located in the brain, acts as a conductor for most hormones. In fact, it regulates what glands, such as the thyroid, ovaries, testes, or even adrenal glands, produce in terms of hormone levels.

Thyroid hormones are secreted by the thyroid gland, an organ located in the neck. These hormones contribute to regulating different organs like a thermostat. If the thyroid makes too many hormones (hyperthyroidism), symptoms such as hot flushes, shaking, an increase in intestinal transit and palpitations may occur.

In contrast, in the event of a lack of hormones (hypothyroidism), sensitivity to the cold, mental slowdown, constipation, fatigue and even weight gain are reported. Medications may either reduce the production of hormones in the event of hyperthyroidism or replace their production in the event of hypothyroidism. A detailed assessment (blood test, thyroid ultrasound) must first take place with a specialist.  

Nodules are often found in the thyroid gland. These nodules are largely benign and only require ultrasound monitoring. When a nodule seems suspicious, a puncture is recommended to be able to establish a diagnosis.

Sex hormones are secreted by the testes and the ovaries, as well as by the adrenal glands to a smaller extent. On the one hand, testosterone in men and oestrogen and progesterone in women are responsible for ensuring adequate sexual health in terms of libido and reproduction.

They play a very important role in maintaining adequate bone health and avoiding osteoporosis. An excess of male hormones (androgens) in women may lead to virilisation (excess hair, hair loss, acne, irregularity or lack of periods).

Cortisol is a vital stress hormone. It is secreted by the adrenal glands, which are organs located above the kidneys. In the event of a lack of cortisol (adrenal insufficiency), vertigo, nausea, abdominal pain and weight loss may occur. A specialised assessment should be performed to define the cause of the lack of cortisol and introduce a substitution treatment.

In the event of an excess of cortisol, weight gain, large purple stretch marks, a loss of proximal muscle, tendency to haematomas and skin fragility are observed. Diabetes and osteoporosis may also be caused by this hormone excess. Again, a specialised assessment is required before establishing a treatment that will depend on the aetiology.

With an excess of growth hormone during childhood, gigantism is observed. In adulthood, when the bones have finished growing, if an excess of growth hormone occurs, we refer to acromegaly. This pathology is manifested by an enlargement of certain structures (tongue, interdental space, hands, feet, joints, certain facial features). These symptoms should result in a consultation with an endocrinologist who can perform the investigations necessary and propose suitable treatment.

The parathyroid hormone is produced by four small glands located around the thyroid. This hormone ensures that calcium levels in the blood are balanced. Where there is an excess of parathyroid hormone in one of these glands, for example, as a result of a tumour (usually benign), calcium in the blood increases. This may lead to kidney stones, osteoporosis or kidney failure.

This list of hormonal pathologies is not exhaustive. If you suspect an endocrine disorder, do not hesitate to talk to your doctor about it, who will then refer you to a specialist. 

Endocrine diseases require specialised care, which starts with an endocrinologist. Besides a specific clinical examination, laboratory tests will be necessary to measure your hormone levels. Depending on the pathology, further tests (radiology, nuclear medicine) will be prescribed.