In this country, hormone-related diseases such as diabetes, rheumatism or thyroid dysfunction are common. These are part of the endocrinologist’s treatment spectrum. However, when neurological or psychiatric disorders are added, the diagnosis and treatment of these diseases are part of the tasks of neuroendocrinology.
What is neuroendocrinology?
As a subfield of endocrinology, neuroendocrine science is devoted to the intercation between the nervous and endocrine systems. Neuroendocrinology is concerned with both the study and the diagnosis and treatment of neuroendocrine disorders. As a subfield of endocrinology, neuroendocrine science is devoted to the interaction between the nervous and endocrine systems. On the one hand, the effect of the central nervous system on hormonal processes is investigated. On the other hand, it is concerned with the extent to which the hormones circulating in the blood influence the activity of nerve cells. The central interface between the nervous system and the hormonal system is located in the human brain. These are called the hypothalamus and pituitary gland and are responsible for regulating important bodily functions. For example, they control metabolic processes, food intake, reproduction and breastfeeding. The function of the thyroid gland and the adrenal glands are also controlled by the hypothalamus and the pituitary gland. Diseases of neuroendocrine origin cause varied and nonspecific symptoms, so that in many cases they are diagnosed only after many years.
Treatments and therapies
The main subject of neuroendocrine research is hormones, especially peptide hormones. These function in the body not only as messengers but also as neurotransmitters in signal transduction within the central nervous system. A disturbance in the hormone-producing cells and tissues can cause a variety of clinical pictures. Every year, thousands of patients are treated for hormone and metabolic disorders. Neuroendocrine diseases are divided into several categories:
- Diseases of the hypothalamic-pituitary axis,
- Diseases of the peripheral glands,
- Metabolic disorders,
- Disorders of sex development.
The consequence of pituitary dysfunction can be either pituitary insufficiency or even a pituitary tumor. The pathogenesis and therapy of pituitary tumors are currently the focus of neuroendocrine research. By uncovering the mechanisms interactive in pituitary tumors, immunosuppressive therapeutic methods can be developed. In addition, research on metabolic disorders plays an essential role in the development of antidepressant treatments, as alterations in metabolism are often observed in depressed patients. In patients suffering from active pituitary adenomas, the quality of life is severely impaired. They may experience sleep disturbances or increased pain. Improvement occurs only after successful therapy of the hormonal excess. Gender-equalizing hormone treatment for transsexuality is also part of the treatment spectrum of neuroendocrinology. Hormone treatment is also an option if a patient has hormone insufficiency. This is the case, for example, after a craniocerebral trauma or a subarachnoid hemorrhage. Overall, the research focus as well as the treatment spectrum of this subfield are very broad.
Diagnosis and examination methods
There are various examination methods for the diagnosis of neuroendocrine disease. Which method is the most appropriate depends entirely on the complaints and symptoms that occur. For example, noninvasive examinations can be performed with the aid of an ultrasound machine, which is also not exposed to radiation. Sonography shows a morphological image of organs such as the thyroid gland, testicles and liver. From this, the physician can tell if the tissue of an organ shows abnormalities. A bone density measurement using DXA provides information on whether a person’s bone density is reduced. As a rule, bone tissue is constantly being broken down and newly formed. In the case of an endocrinological disease, however, this process is disturbed, so that the degraded bone tissue cannot be remodeled quickly enough.This disorder occurs, for example, in women after menopause. With the help of magnetic fields and radio waves, the internal tissue structures can be imaged via MRI by using a computer to create a cross-sectional image of the body. This method can be used to detect any small change in the body, including suspected pituitary adenoma. The method of imaging the electrical activity of the heart is called ECG. This is derived and recorded as curves. From the curves, the doctor can see if there is a disturbance in the heart rhythm and heart rate. If one of the curves deviates from the norm, there may be a disease or an overdose of certain medications. By contrast, UKG (echocardiography) is used to image the anatomical structures of the heart rather than cardiac activity. This method is harmless to the patient because it is performed sonographically. In this way, the heart muscles and valves can also be imaged and their function assessed. A measurement of the body composition may be considered, for example, if weight reduction is required as a therapeutic measure. With the help of this method, the distribution of fatty tissue in the body can be calculated. For example, the ratio of waist to hip circumference is determined. Another method of measuring body composition is Bioelectrical Impedance Analysis (BIA). A weak measuring current is sent through the body via two electrodes to measure body fat percentage, muscle mass as well as water percentage. For some metabolic diseases, such as diabetes, the diet should be changed. Thus, many neuroendocrinology outpatient clinics also offer their patients nutrition and diabetes counseling to help them improve their quality of life and reduce their symptoms. In this method, the patient’s eating habits are first analyzed. Then, an individualized nutrition plan is created based on the patient’s needs. Often, a basal metabolic rate measurement is also used to create the diet plan. This is because under the influence of certain medications or diseases, the individual basal metabolic rate may also be altered.
