Endocrinology and Metabolic Diseases

Endocrinology deals with the physiology and pathology of hormones, endocrine glands and organs. Glands and some organs that secrete hormones in the body are members of the endocrine system. Chemical messengers secreted from the endocrine system elements and carried through the blood are called hormones. Hormones have many functions in the body, such as establishing communication between tissues and organs. Hormones are involved in situations such as growth, development and repair, metabolism (production), catabolism (destruction), sexual functions and reproduction, sleep and wakefulness, and stress.

There are more than 50 hormones in the body, such as insulin, glucagon, thyroid hormone, estrogen, testosterone and growth hormone. Some of the endocrine glands involved in hormone production and secretion are the thyroid, adrenal, pituitary and parathyroid. There are also organs in the body that have the task of making and secreting hormones. The pancreas, ovaries, testicles, and hypothalamus which is part of the brain, are the endocrine organs.

Endocrinologists are medical doctors who specialize in diagnosis and treatment of endocrine system diseases, such as diabetes, metabolic syndrome, thyroid disorders, and hormonal imbalances. In addition, the follow-up of patients with disorders related to other endocrine glands, such as the adrenal, pituitary, testes and ovaries is also the field of interest of the endocrinology and metabolic diseases department.

 

What Organs Make up the Endocrine System?

The endocrine system consists organs, glands, hormone producing glands and hormone receptors. The glands of endocrine system are pituitary gland, thyroid gland, parathyroid glands and adrenal glands. There are also endocrine system member organs, such as the pancreas, hypothalamus and gonads (testes and ovaries). Endocrine system elements produce hormones that go to other body parts, take part in almost every function of the body and secrete them into the bloodstream. Hormones regulate metabolism, growth, development, reproductive functions and the body's response to stress.

 

What Are Endocrine Disorders?

The endocrinologist plays an important role in diagnosing, treating and following of many diseases involving the endocrine system. Many diseases, such as diabetes and metabolic syndrome, which are among the most significant problem of developed and developing countries, are in the field of interest of this branch. Endocrine system disorders can be summarized as diabetes and metabolic syndrome, endocrine tumors and cancers, thyroid and parathyroid diseases, hormonal imbalance, sexual development, function and reproductive problems and bone development defects.

Diabetes and Metabolic Disorders

Diagnosis and treatment planning for metabolic conditions is the field of endocrinology. Diabetes is a common chronic metabolic disease. Some of the common metabolic diseases are given below.

• Type 1 diabetes: It occurs when the pancreatic cells producing insulin are damaged as a result of an autoimmune process
• Type 2 diabetes: There is insulin production in pancreatic cells, but there is insulin receptor defect at the level of cells.
• Gestational diabetes: It is a kind of glucose intolerance, which appears for the first time during pregnancy and resolves after birth
• Pancreatic diabetes: Pancreatitis is a type of diabetes caused by inflammation of the pancreas.
• Hereditary metabolic diseases.
• Metabolic syndrome: It is a condition characterized by increased waist circumference, high triglyceride (free fat in the blood) levels, low HDL (cholesterol type) levels, high blood pressure and impaired fasting glucose level.
• Insulin resistance and obesity

Endocrine Tumors and Cancers

Endocrinologists take part in the diagnosis and treatment of endocrine cancer and tumors. The different types of endocrine cancers and tumors are as follows.

• Adrenal tumors
• Adrenocortical carcinoma
• Neuroendocrine tumors
• Pancreatic cancer
• Parathyroid cancer and tumors
• Pituitary tumors
• Thyroid cancer

Thyroid Diseases

Endocrinologists deal with the treatment of diseases caused by deficiency or excess of hormones produced by the thyroid gland. Some thyroid dysfunctions are as follows.

• Goiter: Enlargement of the thyroid gland.
• Graves' Disease: It is an immune system disease that causes overproduction of the thyroid hormone thyroxine, leading to hyperthyroidism.
• Hypothyroidism: A disease associated with low thyroid hormone levels.
• Hyperthyroidism: A disease associated with high thyroid hormone levels.
• Hashimoto's Disease: It is one of the autoimmune diseases that cause hypothyroidism.
• Thyroiditis: Inflammation of the thyroid caused by infection or autoimmunity.
• Thyroid nodules : Benign or malignant masses located in the thyroid gland.

Sexual Development, Function and Reproductive Problems

Some disorders related to sex hormones are as follows.

• Amenorrhea: Means the absence of menstruation.
• Erectile dysfunction: Erectile dysfunction (impotence) is the inability to get or maintain an adequate erection.
• Growth hormone deficiency or excess (acromegaly or gigantism): Acromegaly is an endocrine disorder in adulthood associated with the pituitary gland producing too much growth hormone. An abnormal increase in growth hormone in childhood is gigantism. The disease seen in growth hormone deficiency is known as dwarfism.
• Gynecomastia: It is the advanced development of breast tissue in men.
• Hypogonadism: Deficiency of sex hormones
• Menopause: It is a natural part of life in women and is seen due to the decrease of reproductive hormones after a certain age.
• Polycystic ovary syndrome (PCOS): It is a common hormonal problem and usually affects women of reproductive age. Women with PCOS may have ovulation problems and high androgen levels. Many small cysts may be found in the ovaries of these patients.

Calcium and Bone Defects

There are some hormones that are responsible for bone metabolism and the regulation of calcium levels in the blood. Bone health-related conditions that endocrinologists can treat include:

• Hypercalcemia: High calcium in the blood
• Hypocalcemia: Low calcium in the blood
• Metabolic bone disease
• Osteopenia and osteoporosis (decrease in bone mass and strength)
• Vitamin D deficiency

 

What Are the Causes of Endocrine Disorders?

Some conditions that affect the endocrine system can be considered as risk factors for endocrine and metabolic diseases. Risk factors can be listed as genetics, environmental conditions, infections or benign or malignant tumors. Common causes of endocrine diseases are as follows.

• Genetic background: Individuals with a family history or hereditary syndrome constitute a high-risk group for endocrine diseases. Genetic factors play an important role in hormones and metabolism.
• Infections: Some infections, such as HIV and tuberculosis (TB) cause endocrine disorders by affecting the endocrine system and metabolism.
• Tumors: Benign tumors or malignant tumors (cancer) that develop in endocrine glands or organs can disrupt hormonal production and lead to endocrine diseases.
• Autoimmune disorders: Syndromes or diseases that affect the immune system may predispose to endocrine diseases. In autoimmune disorders, the body may also attack its own healthy and functional cells and adversely affect the prognosis.
• Drugs: Drugs that suppress the immune system, especially chemotherapy drugs, often cause endocrine disorders.
• Environmental factors: Environmental factors, such as alcohol and smoking, fatty diet, sedentary life, exposure to toxins and chemicals can cause endocrine disorders.

 

How to Treat Endocrine Disorders?

In the treatment of endocrine disorders, there are options, such as regulating hormone levels, hormone replacement in hormone deficiencies, and surgery in the presence of tumor or cancer. Especially in diabetes, metabolic syndrome and thyroid diseases, lifestyle changes are as important as medications in treatment planning. The treatment of some common endocrine disorders is briefly as follows.

• Adrenal Adenoma: Treatment varies according to the characteristics of the tumor.Treatment of hormone-producing (functional) adrenal adenomas is the surgical removal of the affected adrenal gland (adrenalectomy). Drug therapy can also be applied to patients who are not suitable for tumor surgery or to regulate hormone levels after surgery.
• Type 1 Diabetes: There is currently no cure for Type 1 diabetes, but there are a number of treatment options available to control symptoms and prevent fatal complications. The most important factor in the treatment of type 1 diabetes is to educate the patient and prevent hypoglycemia. Nutritional control, controlled exercise and drug therapy are also treatment options. Insulin therapy or oral antidiabetics are frequently preferred in patients with type 1 diabetes because of the absolute absence of insulin.
• Hypothyroidism: Hypothyroidism is a complete or partial deficiency of thyroid hormone. Therefore, these patients have to use external thyroid hormone supplements. This drug therapy tries to restore thyroid functions by regulating thyroid hormone levels. Since hypothyroid patients have to use medication for life, it is important that they comply with doctor's controls and pay attention to their lifestyle.
• Hyperthyroidism: Antithyroid drugs, radioactive iodine therapy or surgical removal of the thyroid gland are treatment options in hyperthyroidism.
• Hypogonadism: In menopause or low testosterone levels, hormone replacement therapy containing estrogen or testosterone may be prescribed by a specialist. If hypogonadism is caused by a tumor in the pituitary gland, drug therapy or surgery for the tumor is also among the treatment options.
• Vitamin D Deficiency: When consuming foods containing vitamin D or getting enough sunlight is not sufficient for treatment, it may be recommended to use vitamin D supplements under expert control.

 

What Is Metabolism?

Metabolism is the whole of the reactions that occur in each cell of the body and meet the body's energy needs. It involves a series of chemical reactions that convert food into cellular energy. There are subtype of metabolism; catabolism and anabolism. Catabolism breaks down nutrients like carbohydrates and fats, whereas anabolism uses energy to synthesize molecules like proteins, complex lipids, and nucleic acids. Abnormal metabolism can lead to dangerous health complications like obesity, sudden weight loss, diabetes, and metabolic syndrome.

 

What Parts of the Human Body Contribute to Metabolism?

Metabolism is a complex metric to keep track of and understand. It involves different organs in the human body. Some main organs are as follows:

• Digestive system: The stomach and the intestines are the entry point for food to convert into expendable energy; it plays a vital role in the absorption of nutrients into the bloodstream.
• Liver: It is responsible for storing and synthesizing carbohydrates because it produces bile and detoxifies food.
• Pancreas: It produces insulin, the regulatory hormone for blood sugar levels which helps the body break down stored glycogen into glucose.
• Brain: The brain uses a large amount of energy to function; it plays a major role in regulating the production of various hormones and signaling molecules.
• Adipose and muscular tissues: Muscles use energy to contract and perform work, whereas adipose tissue is made of excess energy in the form of fat. The ratio between the two contributes to the metabolism of the human body.

 

What Are Metabolic Disorders?

In metabolic disorders, various body functions such as growth, development, repair and construction-destruction are adversely affected due to the disruption in the body's energy production and chemical reactions.Disorders cause issues in enzymes, hormones, and substances. In disorders like phenylketonuria, the disorder affects the body's ability to break down phenylalanine, and when left untreated, it can severely affect intellect and cause other health problems.

 

What Are the Causes of Metabolic Disorders?

Genetics, infections, and hormonal imbalances are responsible for metabolic disorders. Many metabolic disorders are inherited genetic mutations that can complicate the body's metabolism. Infections like HIV and TB can severely restrict the body's metabolism, causing inflammation and metabolic disorders. Hormonal imbalances can alter your body's ability to assimilate and use nutrients.

 

How to Treat Metabolic Disorders?

Each patient goes through a separate diagnosis when it's a metabolic disorder, and the treatment is done based on the diagnosis. For example, patients with diabetes are treated according to the type 1 or type 2 diabetes treatment, while patients with tumors as the source of the endocrine disorder often require surgical treatment. Drug treatments to maintain hormone balance, hormone replacement therapies, such as estrogen, testosterone, insulin, growth hormone, chemotherapy or immunosuppressant drugs, and vitamin D supplements are among the treatment options for endocrine disorders.

Genetic testing and counseling can help understand the mutation that causes the disease and can provide information about risks and treatments. Dietary and lifestyle changes include increased physical activity and a healthy diet that improves the patient's condition.

 

Experience and Expertise

A multidisciplinary approach and experience with a holistic perspective is critical in solving problems related to endocrinology and metabolic diseases. As an institution affiliated with Ministry of Health of the Republic of Türkiye, USHAŞ, as part of its initiatives to assist medical tourism, operates under the name of HealthTürkiye service in many health fields, including Endocrinology and Metabolic Disorders Department, with its expert staff and health institutions with advanced technology. It aims to bring together private and public studies on health tourism and to guide guests from abroad to receive health services.