In the following, “endocrine, nutritional, and metabolic diseases” describes diseases that are assigned to this category according to ICD-10 (E00-E90). The ICD-10 is used for the International Statistical Classification of Diseases and Related Health Problems and is recognized worldwide.
Endocrine, nutritional, and metabolic diseases
Endocrine (hormone-related) diseases.
The endocrine system (hormonal system) consists of glands and organs, each of which produces (synthesizes) and releases (secretes) specific hormones (messengers) directly into the bloodstream to reach target cells. The endocrine system thus regulates and controls numerous bodily functions such as reproduction, growth and metabolic processes. Endocrine glands or organs are:
- Testes (Testes) – produce testosterone and are also responsible for spermatogenesis (spermatogenesis).
- Islets of Langerhans of the pancreas (pancreas) – control the release of the hormone insulin (ß-cells) and glucagon (α-cells).
- Adrenal glands – sit on the kidneys and produce, among other things, the hormone cortisol.
- Parathyroid glands (parathyroid) – usually there are four parathyroid glands, which are located on the back of the thyroid gland above and below; they produce parathyroid hormone, which regulates calcium and phosphate balance; at the same time it is involved in the biosynthesis of vitamin D
- Ovaries (ovaries) – produce mainly the hormones estradiol (the most important estrogen) and progesterone (progestogens).
- Thyroid gland – produces thyroid hormones; these include in particular triiodothyronine (T3) and thyroxine (tetraiodothyronine, T4).
- Thymus (thymus gland / Bries) – is involved in the development of the immune system.
- Pineal gland (pineal gland) – part of the diencephalon; produces melatonin, which promotes sleep and controls the day-night rhythm.
The hypothalamus (part of the diencephalon) controls the release of hormones and the pituitary gland (pituitary gland) influences other endocrine glands, such as the thyroid gland. One speaks of an endocrine disease when either too many hormones are released or too few (hormone imbalance). Causes may include:
- A problem in the endocrine gland itself.
- Too much or too little stimulation of the hypothalamic-pituitary axis.
- Tumors – they can produce excess hormones or destroy glandular tissue (hormone production ↓).
- Autoimmune disease – the body’s immune system attacks an endocrine gland (hormone production ↓)
Measuring hormone levels can be used to test how well the endocrine gland in question is functioning. Nutritional and metabolic disorders
Our current diet is partly responsible for the emergence of many diseases. We eat too much, too sweet, too fatty and too salty. Above all, a hypercaloric diet (intake of calories in excess of requirements) is a major problem, because it leads to obesity, which in turn is the cause of many diseases, e.g. tumor diseases (cancers). In Germany, every second person is overweight. The consequence of a poor diet can be metabolic disorders. In our organism, substances are constantly being absorbed, broken down, transformed and excreted. The totality of these processes is called metabolism. In the case of a metabolic disorder, one or more metabolic pathways are impaired. Metabolic disorders can be acquired – e.g. diabetes mellitus (disorder of carbohydrate metabolism), hypertriglyceridemia (disorder of fat metabolism) – or congenital. Congenital metabolic disorders are usually based on a genetically determined enzyme defect. One example is hereditary fructose intolerance (fructose intolerance). An already existing disease can be positively influenced by an adequate diet. Consequently, nutrition has a preventive as well as a therapeutic character.
Common hormonal, nutritional, and metabolic disorders
- Acromegaly – hypersecretion of somatotropin with increase in size of body end limbs or acra.
- Diabetes mellitus type – diabetes mellitus type 1, diabetes mellitus type 2.
- Diabetic nephropathy – kidney disease due to vascular disease in the presence of diabetes mellitus.
- Hashimoto’s thyroiditis – autoimmune disease that leads to chronic inflammation of the thyroid gland.
- Hyperhomocysteinemia (increased concentration of homocysteine in the blood).
- Hyperlipoproteinemias (lipid metabolism disorders) – hypercholesterolemia, hypertriglyceridemia.
- Hyperuricemia (gout)
- Latent metabolic acidosis (creeping metabolic acidosis) – disturbance of the acid-base balance.
- Malnutrition in old age
- Metabolic syndrome – collective name for various diseases and risk factors for cardiovascular disease.
- Addison’s disease – primary adrenocortical insufficiency (adrenocortical weakness), which leads to a failure of cortisol and aldosterone production.
- Cushing’s disease/Cushing’s syndrome – group of diseases leading to hypercortisolism (hypercortisolism; oversupply of cortisol).
- Wilson’s disease – autosomal recessive inherited disease in which copper metabolism in the liver is disturbed by one or more gene mutations.
- Cystic fibrosis (synonym: cystic fibrosis) – genetic disease characterized by the production of secretions in various organs to be tamed.
- Food intolerances (food intolerances) – fructose intolerance (fructose intolerance), lactose intolerance (lactose intolerance), sorbitol intolerance (sorbitol intolerance).
- Thyroid disease – hyperthyroidism (hyperthyroidism), hypothyroidism (hypothyroidism), Graves’ disease (form of hyperthyroidism caused by autoimmune disease), goiter (goiter).
- Overweight, obesity (obesity).
- Underweight
The main risk factors for hormonal, nutritional and metabolic diseases
Behavioral causes
- Diet
- High calorie intake
- High intake of carbohydrates, especially mono- and disaccharides (monosaccharides and disaccharides).
- Too low a proportion of complex carbohydrates, low-fiber diet.
- High-fat diet (saturated fatty acids), too low a proportion of monounsaturated and polyunsaturated fatty acids, high cholesterol intake.
- Excessive consumption of red meat
- Increased dietary purine intake, e.g., due to excessive meat consumption (especially offal).
- Sugar substitutes sorbitol, xylitol and fructose in high doses.
- Raw foodists
- High iodine intake/low iodine intake
- Micronutrient deficiency – selenium, vitamins B6, B12 and folic acid.
- Consumption of stimulants
- Alcohol consumption
- Tobacco consumption
- Physical inactivity
- Psycho-social situation
- Stress
- Shift work, night duty
- Sleep deprivation
- Pregnancy
- Overweight
- Increased waist circumference (abdominal girth; apple type).
Causes due to disease
- Obesity
- Apoplexy (stroke)
- Chronic inflammatory bowel disease such as ulcerative colitis, Crohn’s disease.
- Chronic renal insufficiency (kidney weakness).
- Dementia
- Depression
- Hepatitis (liver inflammation)
- Hyperlipoproteinemias (lipid metabolism disorders).
- Hypertension (high blood pressure)
- Celiac disease (gluten-induced enteropathy) – chronic disease of the mucosa of the small intestine (small intestinal mucosa), which is based on hypersensitivity to the cereal protein gluten.
Medication
- Antibiotics
- Antidepressants
- Antihistamines – medicines for allergic reactions such as cetirizine.
- Antihypertensives (blood pressure lowering drugs)
- Glucocorticoids
- Non-steroidal anti-inflammatory drugs – painkillers such as ibuprofen.
- Sedatives – tranquilizers such as bromazepam.
- Cytostatics (substances that inhibit cell growth or cell division).
- And many more
X-rays
- Radiation therapy (radiotherapy, radiatio)
Please note that the enumeration is only an extract of the possible risk factors. Further causes can be found under the respective disease.
The main diagnostic measures for hormonal, nutritional and metabolic diseases
- Laboratory parameters
- Carbohydrate metabolism: fasting glucose, glucose tolerance test, daily blood glucose profile, HbA1c level.
- Lipid metabolism: triglycerides, total cholesterol, LDL cholesterol, HDL cholesterol.
- Liver parameters
- Kidney parameters
- Hormone levels
- Gonadotropins
- Thyroid parameters
- Sex steroids
- H2 breath tests (fructose H2 breath test, lactose H2 breath test, sorbitol H2 breath test).
- Abdominal sonography (ultrasound examination of the abdominal organs).
- Renal sonography (ultrasound examination of the kidneys).
- Thyroid sonography (ultrasound examination of the thyroid gland), thyroid scintigraphy.
- Transcranial Doppler sonography
- Intima-media thickness measurement of the carotid artery.
- Perimetry (visual field examination)
- Computed tomography (CT; sectional imaging method (X-ray images from different directions with computer-based evaluation).
- Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging method (using magnetic fields, that is, without X-rays)).
Which doctor will help you?
For hormonal, nutritional and metabolic diseases, the first point of contact is the family doctor, who is usually a general practitioner or internist. Depending on the disease or its severity, a presentation to an appropriate specialist, such as an endocrinologist, may be necessary.
