Chapter 1

Introduction to Endocrine Diseases

Pharmacotherapeutics
 Lecture 1
Gland System
Human Endocrine Glands
Human Endocrine
Glands

Ductless glands:
transport hormones in
the blood

Duct glands or Exocrine

glands: that use tubes to
carry the secretion
(salivary, tears)

2003-2004
 Human Endocrine Glands

1. Ductless glands:
Transport hormones in the blood
1. Hypothalamus
2. Pineal Gland
3. Pituitary Gland
4. Thyroid Gland
5. Parathyroid Gland
6. Thymus Gland
7. Adrenal Gland
8. Pancreas
9. Ovaries
10. Testes

2. Duct glands or Exocrine glands:

That use tubes to carry the secretion (salivary, tears)
 Endocrine System

• The endocrine system coordinates functioning between different

organs through hormones, which are released into the bloodstream
from specific types of cells within endocrine (ductless) glands.

• Once in circulation, hormones affect function of the target tissue.

Some hormones are released from cells and bind to receptors
nearby cells and affect their function (paracrine effect), some
hormones even bind to receptors on to the cells and affect the cells
that produce them (autocrine effect).

• Hormones can be Peptides of various sizes, Steroids (derived from

cholesterol), or Amino acid derivatives.

• It is notified that cholesterol is the precursor of the five major

classes of steroid hormones: progestagens, glucocorticoids,
mineralocorticoids, androgens, and estrogens.
• Progestogens : are a class of steroid hormones that bind to
and activate the progesterone receptor (PR). The most
important progestogen in the body is progesterone

• These hormones are powerful signal molecules that

regulate a host of organismal functions.

• Hormones bind selectively to receptors located inside or

on the surface of target cells. Receptors inside cells
interact with hormones that regulate gene function
(corticosteroids, thyroid hormone).

• Receptors on the cell surface bind with hormones that

regulate enzyme activity or affect ion channels (growth
hormone and thyrotropin-releasing hormone).
 Endocrine System & Types of Hormones

• The hypothalamus modulates the activities of the anterior

and posterior lobes of the pituitary in different ways.

• Neurohormones synthesized in the hypothalamus reach the

anterior pituitary (adenohypophysis) through a specialized
portal vascular system and regulate synthesis and release of
the 6 major peptide hormones of the anterior pituitary.

• Glands are located throughout various parts of the human

body. These glands take on the critical task of releasing
hormones, and as a whole, they are most commonly referred
to as the endocrine system.
 Learn the 3 endocrine organs on this slide:
Hypothalamus
Pituitary (hyophysis)
Pineal

Hypothalamus__
Anterior pituitary__
_____________Posterior pituitary
(adenohypophysis)
(neurohypophysis)

Hypothalamus___________
Pituitary__________
(hypophysis)

11
• These anterior pituitary hormones regulate peripheral endocrine
glands (thyroid, adrenals, and gonads) as well as growth and
lactation. No direct neural connection exists between the
hypothalamus and the anterior pituitary.

• In contrast, the posterior pituitary (neurohypophysis) comprises

axons originating from neuronal cell bodies located in the
hypothalamus.

• These axons serve as storage sites for two peptide hormones:

Antidiuretic hormone and oxytocin

• Antidiuretic and oxytocin hormones are synthesized in the

hypothalamus; these hormones act in the periphery to regulate
water balance, milk ejection, and uterine contraction.
• Virtually all hormones produced by the hypothalamus and
the pituitary are released in a pulsatile fashion.

• Pulsatile fashion means that release of hormone occurring

discontinuously, ie, in bursts or pulses that may be either
cyclical or regular or sporadic in frequency.
• Periods of such release are interspersed with periods of
inactivity.

• Some hormones (eg, adrenocorticotropic hormone [ACTH],

growth hormone, prolactin) have definite circadian rhythms.

• Others such as LH and FSH during the menstrual cycle have

month-long rhythms with superimposed circadian rhythms.
 Hypothalamic-Pituitary Relationships

• Peripheral endocrine organ functions are controlled to

varying degrees by pituitary hormones which are
controlled by the hypothalamus.

• Some functions (secretion of insulin by the pancreas,

primarily controlled by the blood glucose level) are
controlled to a minimal extent, whereas many (e.g.,
secretion of thyroid or gonadal hormones) are
controlled to a great extent.

• The interaction between the hypothalamus and

pituitary (hypothalamic-pituitary axis) is a feedback
control system.
• The hypothalamus receives input from virtually all other areas
of the CNS and uses it to provide input to the pituitary. In
response, the pituitary releases various hormones that
stimulate certain endocrine glands throughout the body.

• Changes in circulating levels of hormones produced by these

endocrine glands are detected by the hypothalamus, which
then increases or decreases its stimulation of the pituitary to
maintain homeostasis (stable state of equilibrium).

• Neurohormones may control the release of multiple pituitary

hormones.
• Regulation of most anterior pituitary hormones depends on
stimulatory signals from the hypothalamus; the exception is
prolactin, which is regulated by inhibitory stimuli.
 {I} Anterior Pituitary Function

The cells of the anterior lobe (which constitutes 80% of the

pituitary by weight) synthesize and release several hormones

necessary for normal growth and development and also

stimulate the activity of several target glands.

 {I} Anterior Pituitary
(a) Thyroid-stimulating Hormone (TSH)

• TSH regulates the structure and function of the thyroid

gland and stimulates synthesis and release of thyroid
hormones.

• TSH synthesis and release are stimulated by the

hypothalamic hormone thyrotropin-releasing hormone
(TRH) and suppressed (by negative feedback) by circulating
thyroid hormones.
 {I} Anterior Pituitary
(b) Adrenocorticotropic hormone (ACTH)

• ACTH is also known as corticotropin. Corticotropin-releasing hormone

(CRH) in the hypothalamous is the primary stimulator of ACTH release,
but antidiuretic hormone plays a role during stress.

• ACTH induces the adrenal cortex to release cortisol and several weak
androgens, such as dehydroepiandrosterone (DHEA).

• Circulating cortisol and other corticosteroids (including exogenous

corticosteroids) inhibit the release of CRH and ACTH.

• The CRH-ACTH-cortisol axis is a central component of the response to

stress. Without ACTH, the adrenal cortex atrophies and cortisol release
virtually ceases.
 {I} Anterior Pituitary
(c)Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH)

• LH and FSH control the production of the sex hormones. Synthesis

and release of LH and FSH are stimulated by gonadotropin-releasing
hormone (GnRH) and suppressed by estrogen and testosterone .

• In women, LH and FSH stimulate ovarian follicular development and

ovulation. In men, FSH acts on Sertoli cells and is essential for
spermatogenesis.

• Sertoli cells a type of somatic cell around which spermatids develop

in the tubules of the testis

• LH acts on Leydig cells of the testes to stimulate testosterone

biosynthesis.
 {I} Anterior Pituitary
(d) Growth Hormone (GH)

• GH stimulates somatic growth and regulates

metabolism. Growth hormone–releasing hormone
(GHRH) is the major stimulator and somatostatin is
the major inhibitor of the synthesis and release of GH.

• Somatropin (rDNA) polypeptide hormone posses

primary structure to that of human growth hormone.

• In hormone deficient pediatric patient it induces

skeletal growth at the epiphyseal plates of the long
bones as well as growth of skeletal muscles and body
organs.
• GH controls synthesis of insulin -like growth
factor 1 (IGF-1, also called somatomedin-C),
which largely controls growth. Although IGF-1 is
produced by many tissues, the liver is the major
source.

• A variant of IGF-1 occurs in muscle, where it

plays a role in enhancing muscle strength. It is
less under control of GH than is the liver variant.
• The metabolic effects of GH are biphasic.
• GH initially exerts insulin -like effects, increasing glucose uptake in muscle
and fat, stimulating amino acid uptake and protein synthesis in liver and
muscle, and inhibiting lipolysis in adipose tissue.

• Several hours later, more profound anti– insulin -like metabolic effects
occur.
• They include inhibition of glucose uptake and use, causing blood glucose
and lipolysis to increase, which increases plasma free fatty acids.

• GH levels increase during fasting, maintaining blood glucose levels and

mobilizing fat as an alternative metabolic fuel. Production of GH decreases
with aging.

• Ghrelin, a hormone produced in the fundus of the stomach, promotes GH

release from the pituitary, increases food intake, and improves memory.
 {I} Anterior Pituitary
(e) Prolactin

• Prolactin is produced in cells called lactotrophs that constitute

about 30% of the cells of the anterior pituitary.

• The pituitary doubles in size during pregnancy, largely because of

hyperplasia and hypertrophy of lactotrophs. In humans, the major
function of prolactin is stimulating milk production.
• Also, prolactin release occurs during sexual activity and stress.
Prolactin may be a sensitive indicator of pituitary dysfunction.

• Prolactin is the hormone most frequently produced in excess by

pituitary tumors, and it may be one of the hormones to become
deficient from infiltrative disease or tumor compression of the
pituitary.
• Bromocriptine is dopamine D2 receptor agonist that activates the
postsynaptic dopamine receptors to inhibit prolactin secretion.
 (f) Other Hormones

• Several other hormones are produced by the anterior pituitary.

These include pro-opiomelanocortin (POMC, which gives rise to
ACTH), α- and β-melanocyte-stimulating hormone (MSH), β-
lipotropin (β-LPH), the enkep halins, and the endorphins.

• POMC and MSH can cause hyperpigmentation of the skin and are
only significant clinically in disorders in which ACTH levels are
markedly elevated (eg, Addison disease, Nelson syndrome).

• The function of β-lipotropin β-LPH is unknown. Enkephalins and

endorphins are endogenous opioids that bind to and activate
opioid receptors throughout the CNS.
 {II}Posterior Pituitary Function

• The posterior pituitary releases antidiuretic hormone (also

called vasopressin or arginine vasopressin and oxytocin .

• Both hormones are released in response to neural impulses

and have half-lives of about 10 min.
 {2} Posterior Pituitary
(1) Antidiuretic Hormone (ADH, Vasopressin)

• ADH acts primarily to promote water conservation by the kidney

by increasing the permeability of the distal tubular epithelium to
water. At high concentrations, ADH also causes vasoconstriction.

• Like aldosterone, ADH plays an important role in maintaining fluid

homeostasis and vascular and cellular hydration.

• The main stimulus for ADH release is increased osmotic pressure of

water in the body, which is sensed by osmoreceptors in the
hypothalamus.

• The other major stimulus is volume depletion, which is

sensed by baroreceptors in the left atrium, pulmonary veins,
carotid sinus, and aortic arch, and then transmitted to the
CNS through the vagus and glossopharyngeal nerves.
• Other stimulants for ADH release include pain, stress, emesis, hypoxia,
exercise, hypoglycemia, cholinergic agonists, β-blockers, angiotensin,
and prostaglandins.

• Inhibitors of ADH release include alcohol, α-blockers, and

glucocorticoids.
• A lack of ADH causes central diabetes insipidus. An inability of the
kidneys to respond normally to ADH causes nephrogenic diabetes
insipidus.

• Removal of the pituitary gland usually does not result in permanent

diabetes insipidus because some of the remaining hypothalamic neurons
produce small amounts of ADH.

• Copeptin is coproduced with ADH in the posterior pituitary. Measuring it

may be useful in distinguishing the cause of hyponatremia.
 (2) Oxytocin

Oxytocin has two major targets:

1. The myoepithelial cells of the breast, which surround the alveoli of the
mammary gland, and the smooth muscle cells of the uterus.

• Suckling stimulates the production of oxytocin, which causes the

myoepithelial cells to contract. This contraction causes milk to move from
the alveoli to large sinuses for ejection (ie, the milk letdown reflex of
nursing mothers).

2. Oxytocin stimulates contraction of uterine smooth muscle cells, and

uterine sensitivity to oxytocin increases throughout pregnancy.

• However, plasma levels do not increase sharply during delivery, and the
role of oxytocin in the initiation of labor is unclear.

• There is no recognized stimulus for oxytocin release in men, although men

have extremely low levels
 Some Hormones & Terms Used
(1) Hypophysis
• The hypophysis refers to the pituitary gland, also known as the master
gland of the endocrine system. It is located at the base of the brain, and
is responsible for the release of hormones that regulate growth and
metabolic processes.

• Hypophysis is considered as the master gland as the hormones secreted

are very vital for the proper development & functioning of the body.

• Disorders are classified under hyper & hyposecretion of hormones and

pituitary cancer leading to alteration of the structure of hormone.

• The major disorders of pituitary are : Acromegaly, diabetes insipidus,

hypopituitarism, pituitary tumor.
 (2) Thymus
The Gland that Protects Long after It’s Gone

• The thymus which is a lymphoid organ situated in the neck of vertebrates

which produces T-lymphocytes for the immune system.

• The human thymus becomes much smaller and reaches its maximum
weight (about 1 ounce) during puberty.

• The thymus is located in the upper anterior (front) part of chest directly
behind sternum and between lungs. The pinkish-gray organ has two
thymic lobes.

• Thymosin is the hormone of the thymus, and it stimulates the

development of disease-fighting T cells.

• The thymus gland will not function throughout a full lifetime, but it has a
big responsibility when it’s active, helping the body protect itself against
autoimmunity, which occurs when the immune system turns against itself.
• Therefore, the thymus plays a vital role in the lymphatic system (body’s
defense network) and endocrine system.

• Before birth and throughout childhood, the thymus is instrumental in

the production and maturation of T-lymphocytes or T cells, a specific
type of white blood cell that protects the body from certain threats,
including viruses and infections.

• The thymus produces and secretes thymosin, a hormone necessary for T

cell development and production

• The thymus is special in that, unlike most organs, it is at its largest in

children. Once child reaches puberty, the thymus starts to slowly shrink
and become replaced by fat.

• By age 75, the thymus is little more than fatty tissue. Fortunately, the
thymus produces all of T cells by the time child reaches puberty.
• Throughout childhood years, white blood cells called lymphocytes
pass through the thymus, where they are transformed into T cells

• Once T cells have fully matured in the thymus, they migrate to

the lymph nodes (groups of immune system cells) throughout the
body, where they aid the immune system in fighting disease.

• However, some lymphocytes, regardless if they reside in the

lymph nodes or thymus, can develop into cancers (known as
Hodgkin disease and non-Hodgkin lymphomas).

• Though the thymus gland is only active until puberty, its double-
duty function as an endocrine and lymphatic gland plays a
significant role in long-term health.
 (3) Pineal Gland
• It is also known as the pineal body, conarium or epiphysis cerebri, is a small
endocrine gland in the vertebrate brain.

• It produces melatonin, which is a serotonin derived hormone, which affects

the modulation of sleep patterns in both seasonal and circadian rhythms.

• Its shape resembles a tiny pine cone (hence its name), and it is located in
the epithalamus, near the center of the brain, between the two
hemispheres, tucked in a groove where the two halves of the thalamus join.

• Nearly all vertebrate species possess a pineal gland. The pineal gland has a
colorful and misunderstood history. It’s considered a somewhat mysterious
organ, as its function was discovered last of the endocrine glands.

• Located deep in the center of the brain, the pineal gland was once known as
the “third eye.”
• The pineal gland secretes a single hormone melatonin.
• This simple hormone is special because its secretion is dictated by light.
• Researchers have determined that melatonin has two primary functions in
humans—to help control circadian (or biological) rhythm and regulate
certain reproductive hormones.

1. Control Circadian Rhythm

o Circadian rhythm is a 24-hour biological cycle characterized by sleep-wake
patterns.
o Daylight and darkness help dictate circadian rhythm.
o Light exposure stops the release of melatonin, and in turn, this helps
control your circadian rhythms.

o Melatonin secretion is low during the daylight hours and high during dark
periods, which has some influence over reaction to photoperiod (the
length of day versus night). Naturally, photoperiod affects sleep patterns,
but melatonin’s degree of impact over sleep patterns is disputed.
. 2. Reproduction
o Melatonin blocks the secretion of gonadotropins (luteinizing
hormone and follicle stimulating hormone) from the anterior
pituitary gland.
o These hormones aid in the proper development and
functioning of the ovaries and testes.

o The pineal gland’s full purpose is still a bit of a mystery.

o But research suggests that we’re getting closer to
understanding the pineal gland—and more about the
endocrine system as a whole.
 (4) Parathyroid Gland

• There are four parathyroid glands behind the thyroid gland.

• These secretes parathormone which regulates the calcium

and phosphorus in our body.

• Deficiency of this hormone weakens the muscles. Excess of

this hormone weakens the bones by absorbing the calcium.

• The absorbed calcium in the blood may form stones in the

kidneys.
Parathyroid Gland
2003-2004
2003-2004
Thyroid and Parathyroid help regulate calcium metabolism

Feedback!

2003-2004
 Pancreas helps regulate blood glucose

feedback

Insulin from Beta cells reduce blood sugar

Glucagon
2003-2004 from Alpha cells increase blood sugar
 feedback
Female sex traits
include the menstrual
cycle and the changes
seen during puberty

LH and FSH from the

pituitary

Estrogen and
progesterone from the
ovary

2003-2004
 Disorders of the Endocrine System
(1)Addison's disease
• Adrenal cortex gland disease caused by hyposecretion of the hormones produced by
the cortex of the adrenal gland

• In Addison's disease, adrenal glands produce too little cortisol and often insufficient
levels of aldosterone as well.

• It is also called adrenal insufficiency, that occurs in all age groups and affects both
sexes. Addison's disease can be life-threatening.

• Treatment for Addison's disease involves taking hormones to replace the insufficient
amounts being made by adrenal glands, in order to mimic the beneficial effects
produced by the naturally made hormones.

• The disease usually involves Addison's disease symptoms that develop slowly, often
over several months, and may include: Extreme fatigue, Weight loss and decreased
appetite, darkening of skin (hyperpigmentation), lw blood pressure, even fainting,
salt craving, low blood sugar (hypoglycemia), nausea, diarrhea or vomiting,
abdominal pain, muscle or joint pains, depression, body hair loss or sexual
dysfunction.
(2) Cretinism
– Condition resulting from a congenital deficiency of thyroid
secretion or hypothyroidism and is usually due to maternal hypothyroidism.

– Poor length growth is apparent as early as the first year of life. Adult
stature without treatment ranges from 1 to 1.6 metres (3.3 to 5.2 ft),
depending on severity, sex, and other genetic factors.

– In adults, Cretinism results in mental deterioration, swelling of the skin,

loss of water and hair.

– Bone maturation and puberty are severely delayed. Ovulation is

impeded, and infertility is common.
Cretinism
Cretinism is a condition of severely stunted
(not growing) physical and mental growth
due to untreated congenital deficiency of
thyroid hormones (congenital
hypothyroidism) usually due to maternal
hypothyroidism.
Cretinism
• Results from thyroid hormone
insufficiency in infancy

• Protuberant abdomen
• Short Stature
• Infertility
• Neurological impairment
• Constant Fatigue
• Obesity
 (3) Acromegaly
• An enlargement of the
bones of the hands, feet,
and jaws
• Over production of growth
hormone after the
epiphyseal plates have
fused
• Bone shape changes
• Cartilaginous areas of
skeleton enlarge
• Broad facial features
• Enlarged lower jaw
Endocrine System…. Professor KS Satyapal
 Disorders of the Endocrine System (continued)
(4) Cushing’s syndrome
o Adrenal gland disorder that causes hyperactivity of the adrenal glands, which
is triggered by the oversecretion of the pituitary hormone ACTH
o Usually caused by an ACTH-secreting pituitary tumor
o Rarely by tumor of adrenal cortex
o Iatrogenic

(5) Diabetes insipidus (DI)

o It is a condition characterized by excessive thirst and excretion of large
amounts of severely dilute urine, with reduction of fluid intake having no
effect on the concentration of the urine.
o There are different types of DI, each with a different set of causes. The most
common type in humans is the neurological form, called Central DI (CDI),
which involves a deficiency of arginine vasopressin (AVP), also known as
antidiuretic hormone (ADH). If the cause is central (low or absent hormone
secretion), hormone replacement is achieved with the drug desmopressin. In
mild cases, increasing water intake can be sufficient treatment.
• The second common type of DI is nephrogenic diabetes insipidus (NDI), which is due to
kidney or nephron dysfunction caused by an insensitivity of the kidneys or nephrons
to ADH. In this case then treatment is aimed at the kidney condition.

• DI can also be gestational, in rare cases, pregnancy can cause a disturbance of

vasopressin (antidiuretic hormone). This is due to the placenta releasing an enzyme
that degrades vasopressin. This effect peaks during the third trimester of pregnancy.
• DI also may be caused by alcohol or some types of drug abuse. DI should not be
confused with nocturia.

• Although they have a common name, diabetes mellitus and diabetes insipidus are two
entirely separate conditions with unrelated mechanisms. Both cause large amounts of
urine to be produced (polyuria), and the term "diabetes" is derived from the Greek
word meaning siphon.

• But diabetes mellitus is due to the high blood sugar leaking into the urine and taking
excess water along with it.
 Disorders of the Endocrine System (continued)

(6) Diabetes mellitus

A disorder of carbohydrate, fat, and protein metabolism resulting
from insufficient insulin production by the pancreas .

(7) Gigantism
An excessive growth of the long bones caused by hypersecretion of the
somatotropic hormone which is growth hormone (GH),
• also known as somatotropin (or as human growth hormone [hGH or
HGH], is a peptide hormone that stimulates growth, cell reproduction, and
cell regeneration in humans and other animals.
• It is thus important in human development. It is a type of mitogen which is
specific only to certain kinds of cells. Growth hormone is a 191-amino
acid, single-chain polypeptide that is synthesized, stored, and secreted by
somatotropic cells within the lateral wings of the anterior pituitary gland.
(8) Dwarfism
• It results from hyposecretion of the growth hormone of the pituitary gland, which
has been caused by a tumor, infection, genetic factors, or trauma

• It is a condition of short stature. It is defined by the advocacy group Little People of

America (LPA) as an adult height of 4 feet 10 inches or under, as a result of a
medical or genetic condition. Although other groups may extend the criteria for
certain forms of dwarfism to 5 feet, the average height of an adult with dwarfism is
4 feet.

• There are two main categories of dwarfism -- disproportionate and proportionate.

• Disproportionate dwarfism is characterized by an average-size torso and shorter
arms and legs or a shortened trunk with longer limbs. In proportionate dwarfism,
the body parts are in proportion but shortened.
 (9) Graves’ disease
Caused by hyperthyroidism or thyrotoxicosis
 Disorders of the Endocrine System (continued)
(10) Hyperparathyroidism
-- Causes hypercalcemia, an increased calcium blood level
- Overactive: Kidney Stones and Osteoporosis
- Underactive: Tetany

(12) Hypoparathyroidism
• Hypoparathyroidism is a condition of parathyroid hormone (PTH) deficiency.
• Primary hypoparathyroidism is a state of inadequate PTH activity. In the absence of adequate
PTH activity, the ionized calcium concentration in the extracellular fluid falls below the
reference range.
• Primary hypoparathyroidism, is a syndrome resulting from iatrogenic causes or one of many
rare diseases.
• Secondary hypoparathyroidism is a physiologic state in which PTH levels are low in response
to a primary process that causes hypercalcemia. It causes tetany

(13) Syndrome of inappropriate antidiuretic hormone (SIAD)

–Involves water intoxication and the dilution of intracellular and extracellular body tissues,
usually resulting from lung cancer
 Disorders of the Endocrine System (continued)

(14) Hypothyroidism
–Also called Hashimoto's disease, results from an insufficient
production of thyroxine

(15) Hypoglycemia
–Results from increased insulin production by the pancreas

(16) Virilism
–Results from increased secretion in the adrenal glands is a female
syndrome in which there is development of secondary male sexual
characteristics, as hirsutism and lowered voice, caused by various
conditions affecting hormone regulation.
 Thyroxin – increases metabolic rate
Underactive
Overactive • Goitre
• Goitre • Hypothyroidism
• Hashimoto’s Disease
• Hyperthyroidism
• Myxoedema (adults)
• Grave’s Disease • Cretinism (kids)

Calcitonin is a hormone that is produced in humans by the parafollicular cells

(commonly known as C-cells) of the thyroid gland.
Calcitonin is involved in helping to regulate levels of calcium and phosphate in the
blood, opposing the action of parathyroid hormone i.e. increase Ca uptake by bones
and decrease Ca level in blood.

Overactive Underactive
• Tetany • Kidney Stones
• Osteoporosis
Myxoedema
• Puffiness (swelling)
• Fatigue
• Obesity
• Dry, thickened skin
• Mental impairment
• Thin, brittle hair
 Goiter
• It is a swelling in the thyroid gland, which can lead to a swelling of the
neck or larynx (voice box).

• Goitre usually occurs when the thyroid gland is not functioning properly.

• Worldwide, the most common cause for goitre is iodine deficiency.

• They are classified in different ways:
o Diffuse goiter: is a goiter that has spread through all of the thyroid.

o Toxic goiter: refers to goiter with hyperthyroidism. These are most

commonly due to Graves disease, but can be caused by inflammation .

o Nontoxic goiter: associated with normal or low thyroid levels refers to

all other types
 ENDOCRINE DISORDERS

GOITER
• Enlarged thyroid gland
• Results from thyroid
hormone hyposecretion
• Due to iodine
insufficiency

Endocrine System…. Professor KS Satyapal

Goiter: Iodine deficiency and feedback causes the thyroid to
enlarge

This people have a goiter, a condition

that is easily preventable with iodized
salt
•Results from thyroid hormone
hyposecretion
•Due to iodine insufficiency
 References
1. Basic and Clinical PharmacologyCall Number: REF RM301.28 .B37 2015. Publication
Date: 2015
2. Endocrine and Reproductive Physiology, 4th ed. by Bruce White; Susan PorterfieldCall
Number: REF QP187 .P657 2013. Publication Date: 2013
3. Endocrine Physiology, 4th ed. by Patricia MolinaCall Number: REF QP187 .M58 2010.
Publication Date: 2013
4. Goodman and Gilman's the Pharmacological Basis of Therapeutics by Laurence L.
Brunton (Editor); John S. Lazo (Editor)Call Number: REF RM300 .G644 2006. Publication
Date: 2005
5. Greenspan's Basic and Clinical Endocrinology by David G. Gardner; Dolores ShobackCall
Number: REF RC648 .G7 2007. Publication Date: 2007
6. Harrison's Endocrinology by J. Larry Jameson; Tinsley Randolph HarrisonCall Number:
REF RC648 .H27 2013. Publication Date: 2013-04
7. Textbook of Medical Physiology by Arthur C. Guyton; John E. HallCall Number: REF
QP34.5 .G9 2006
8. Publication Date: 2005
9. Williams Textbook of Endocrinology by Henry M. Kronenberg; Shlomo Melmed
(Editor); Kenneth S. Polonsky (Editor); P. Reed Larsen (Editor)Call Number: REF
RC648 .T46 2008. Publication Date: 2007
Questions