Endocrinology deals with hormonal processes and their disorders in the organism. For this reason, it has many points of contact with other medical disciplines. For the diagnosis of endocrine diseases, a variety of endocrinological functional tests are also available in addition to the classical examination methods.
What is endocrinology?
Endocrinology is concerned with the study, investigation and diagnosis of hormonally related processes and diseases. The main focus is on the endocrine glands and cells, which structurally and functionally produce different hormones. For example, the thyroid gland. Endocrinology is a medical discipline concerned with the study, investigation and diagnosis of hormonally related processes and diseases. In the body, there are a large number of endocrine glands and cells that produce structurally and functionally different hormones. Hormones are active substances that control important life processes in the organism even in very low concentrations. These are often processes that are subject to a regulatory mechanism and only function optimally through the complex interaction of several hormones. Endocrinology is closely linked to many other medical fields. First of all, it is a branch of internal medicine. There it has close links to diabetology. Adjacent medical fields are urology, gynecology or pediatrics. It is also of great importance for surgery and nuclear medicine. In addition, endocrinology also has many points of contact with intensive care medicine, neurology or psychiatry. Endocrine processes are closely linked to all other biological processes. Endocrinology still includes, among others, the subfields of neuroendocrinology, diabetology, reproductive endocrinology and pediatric endocrinology.
Treatments and therapies
The spectrum of treatments for endocrine disorders includes very many different diseases that have primarily hormonal causes. These diseases include diabetes mellitus, thyroid dysfunction, hormonally induced hypertension, disorders of fluid and electrolyte balance, diseases of bone metabolism, dysfunction of the adrenal glands, regulatory disorders of sexual function, growth disorders, disorders of energy metabolism, or diseases of the neuroendocrine system. Thus, diabetes mellitus is caused by an absolute or relative deficiency of the hormone insulin. Insulin is a protein hormone that regulates blood glucose levels. The secondary diseases of diabetes mellitus extend far into the spectrum of internal diseases. Therefore, the example of diabetology already shows the immense importance of endocrinology for other areas of medicine. In the event of dysfunction or even failure of the pituitary gland, several hormones and thus regulatory and control processes in the body are affected. The pituitary gland synthesizes hormones that act directly on the organs as well as hormones that have a regulatory effect on other hormones. For example, the growth hormone is produced there, which acts directly on the organs by stimulating growth. A deficiency of this hormone can lead to short stature, for example. Furthermore, hormones are produced there that stimulate the gonads, the thyroid gland or the adrenal cortex. These three organs are in turn endocrine glands. Their hormone production is stimulated by certain hormones of the anterior pituitary. The most important superior organ of hormone regulation is the hypothalamus. At the same time, it is the supreme control center of the autonomic nervous system. Thus, the hypothalamus coordinates the cooperation of the autonomic nervous system with the endocrine system. The diseases of the neuroendocrine system have their starting point there. This is the subject of the large field of neuroendocrinology. In turn, diseases of the adrenal gland can lead to various syndromes such as Cushing’s syndrome, Addison’s syndrome or Conns syndrome. Furthermore, the electrolyte metabolism is often disturbed. Diseases such as osteoporosis or rickets are also at least partly hormonal. Hormonal disorders can be both primary and secondary. In primary hormonal disorders, the trigger of the disease is either hypofunction or hyperfunction of the corresponding endocrine gland. In secondary endocrine disorders, there is another underlying disease that triggers the hormonal disorder.Causes may include infections or autoimmune diseases.
Diagnosis and examination methods
Diagnosis of endocrine disorders can be very difficult because of their often nonspecific symptoms. At times, actual endocrinology comes into play only after lengthy investigations. Within endocrinology, all classical examination methods are initially used. At the beginning there is always the anamnesis of the medical history. Sometimes a suspicion of a hormonally caused disease can already be expressed here. Laboratory tests to determine hormones in the blood, serum or plasma play an important role. In addition, conventional blood tests must of course also be carried out. Furthermore, hormone tests are also carried out in the urine. Dynamic and static endocrinological function tests are of great importance. In the dynamic function tests, the transitional behavior within the regulatory circuit is examined by administering interfering substances. Static function tests are performed without test substances. This works by measuring various parameters in a state of equilibrium, calculating the quotients between hormones and substrates. On the basis of these calculated quotients, a disturbance of the regulatory mechanism can be concluded. In the SPINA method, structural parameters of endocrine regulatory circuits are calculated from measured hormone levels. HOMA, in turn, is a special method for calculating the control loop of carbohydrate homeostasis. Using fasting insulin and glucose levels, insulin sensitivity and beta cell function can be calculated. In addition to these examination methods, direct organ examinations of endocrine organs are of course also performed in endocrinology. This is done by their puncture and cytological examination. With the help of ultrasound examinations, thyroid, parathyroid and adrenal sonographies can be performed. Other imaging techniques used to visualize endocrine organs include X-ray diagnostics, computed tomography, magnetic resonance imaging, scintigraphy or PET (positron emission tomography) examinations. Both scintigraphy and PET use radioactively labeled materials to identify tumor cells in various organs. Often, tumors within endocrine organs are the starting point of hormonal disorders.
