How to check the endocrine system. How does our hormonal system work? Main organs of the endocrine system

Hormonal regulation ensures the constancy of the internal environment of the body and quick response to unfavorable external influences. Thus, thanks to the rapid change hormonal levels All the forces of the body are mobilized under stress factors. And this same system provides rest and restoration of expended energy.

Thanks to genetically programmed changes in hormonal levels, growth, development and maturation of the body occurs. A gradual decrease in the level of hormones in the blood leads to aging. The most complex changes in hormonal levels in a woman’s body provide the possibility of the birth of a new life, normal childbearing, childbirth and the process of lactation.

Most hormones are produced in specialized organs - glands internal secretion(endocrine glands). These glands received this name because they secrete their product inside - directly into the blood.

Endocrine glands obey central complex neuroendocrine regulation, the so-called hypothalamic-pituitary system, located in the brain.

Features of preparation for taking a hormonal analysis: one day before, it is necessary to exclude sexual contact and thermal procedures (sauna, bathhouse).

Human chorionic gonadotropin
Human chorionic gonadotropin is a specific pregnancy hormone, which is similar in action to gonadotropins (LH and FSH).

Progesterone
Progesterone is a hormone corpus luteum ovary, formed after the release of a mature egg from the follicle. This hormone is necessary for the flow normal pregnancy, therefore its concentration increases throughout gestation.

Outside of pregnancy, progesterone levels begin to increase immediately before ovulation, and reach a maximum in the middle of the luteal phase of the cycle (the interval between the release of the egg and the beginning of the next menstruation - days 14-28 of the cycle).

A hormonal blood test for progesterone is taken on the 22-23rd day of the cycle in the morning, on an empty stomach.

Estradiol
Estradiol is the most active female sex hormone, which is produced in the ovaries, placenta and adrenal cortex under the influence of gonadotropic hormones of the pituitary gland.

A hormonal test for estradiol is taken on the 6-7th day of the cycle in the morning, on an empty stomach.

Estriol
Estriol is a female sex hormone, which is called the main estrogen of pregnancy. When taking a hormonal test for estradiol, it should be taken into account that taking antibiotics and some other medications can significantly reduce the concentration of estriol in the blood.

Testosterone
Testosterone is the main one male hormone, causing the development of secondary sexual characteristics, puberty and reproductive function.

In men, most of the testosterone is produced in the testicle, and less in the adrenal cortex. In women, testosterone is partially formed during the transformation process from other steroids, as well as in the cells of the inner lining of the follicle and the reticular layer of the adrenal glands.

Hormonal tests for amenorrhea

There are primary and secondary amenorrhea. Primary amenorrhea is when a woman has never menstruated, secondary is when the monthly cycle was present and then stopped.

It should be noted that in both primary and secondary amenorrhea, first of all, it is necessary to do a pregnancy test (determine the level of hCG (chorionic gonadotropin) in the blood).

Primary amenorrhea
Primary amenorrhea can be caused by a number of reasons, such as congenital abnormalities (including chromosomal), infectious or immune damage to the ovaries, adrenal tumors, pathologies of the pituitary-hypothalamic system. Depending on the characteristics of hormonal imbalance, there are four groups of primary amenorrhea:
1. Hypergonadotropic hypogonadism.
2. Hypogonadotropic hypogonadism.
3. Eugonadotropic hypogonadism.
4. Hyperandrogenemia.

Hypergonadotropic hypogonadism (increased levels of pituitary stimulating hormones with decreased levels of ovarian hormones) indicates ovarian pathology, which may be the result of primary agenesis (underdevelopment) of the ovaries or Shereshevsky-Turner syndrome. This is a chromosomal pathology in which the set of chromosomes (karyotype) is missing one sex chromosome (karyotype X0).

With hypergonadotropic hypogonadism, there is an increase in the secretion of gonadotropins FSH (the level of follicle-stimulating hormone is especially increased in Shereshevsky-Turner syndrome) and LH (luteinizing hormone). A stimulation test with hCG (human chorionic gonadotropin) is negative.

To verify Shereshevsky-Turner syndrome, it is necessary to conduct a karyotype study. In addition, it is recommended to do hormonal tests that determine the level of testosterone (male sex hormone) and cortisol (adrenal cortex hormone) in the blood.

Hypogonadotropic hypogonadism (simultaneous decrease in the level of stimulating hormones of the pituitary gland and ovarian hormones) indicates damage to the hypothalamic-pituitary system. To determine the level of damage, a stimulation test with GnRH (gonadotropic-releasing hormone) is performed. If, in response to stimulation, the level of the hormone in the blood increases, then we can conclude that the cause of the pathology lies in insufficient allocation releasing factors by hypothalamic cells. If the stimulation test is negative, then the cause of ovarian hypofunction is pathology of the pituitary gland.

Eugonadotropic hypogonadism (reduced level of ovarian hormones with normal concentration of gonadotropins in the blood). Occurs with anatomical defects, testicular feminization syndrome, polycystic ovary syndrome.

With anatomical defects leading to amenorrhea, the hormonal status is usually normal.

Thus, with the onset of placental insufficiency, the level of hCG and progesterones decreases, and with the development chronic failure placenta, when fetal suffering is expressed, a decrease in estrogen levels also occurs.

During a frozen pregnancy, it occurs a sharp decline concentrations of hCG and estrogen (100% below the average norm).

An increase in hCG levels is also very important sign, which may indicate a multiple pregnancy or incorrect determination of gestational age. In addition, the level of hCG increases in pathological conditions such as early and late toxicosis of pregnancy, maternal diabetes, multiple fetal malformations, and Down syndrome.

Fetal malformations may also be indicated by a reduced level of estradiol, which is observed with anencephaly, intrauterine infection, fetal adrenal hypoplasia, Down syndrome.

Hormonal blood tests for thyroid pathology

Since thyroid hormones are necessary for the normal functioning of all cells of the body without exception, diseases of the organ have systemic manifestations(the central nervous activity, vegetative-vascular reactions are disrupted, dystrophic processes occur in the myocardium, and the coordinated activity of all endocrine system organism).

Hormonal tests for suspected thyroid pathology

• a sharp decrease in body weight;
• exophthalmos (bulging eyes);
• goiter (severe enlargement of the gland).

• bradycardia;
• myxedema (mucoedema);
• endophthalmos (sunk eyes);
• hypothermia.

• amenorrhea;
• infertility;
• depression;
• cardiac arrhythmias;
• delayed mental and physical development in children.

Thyroid-stimulating hormone (TSH)

TSH production is characterized by pronounced daily fluctuations with a maximum at 2-4 a.m. and a minimum at 5-6 p.m. This rhythm gets lost during night vigils.

The concentration of TSH physiologically increases during pregnancy and with age (in the latter case - slightly).

The production of TSH is inhibited by thyroid hormones, therefore, when the level of fractions of its hormones increases, the concentration of TSH decreases, and when the gland is hypofunction, it increases.

Fractions of hormones synthesized by the thyroid gland

All fractions are subject to seasonal and diurnal rhythms. A physiological decrease in the level of thyroid hormones is observed after the age of 65 years, an increase during pregnancy, as well as during rapid rise body weight.

An increase in the level of thyroid hormone fractions may indicate its hyperfunction, or the presence of other diseases (hepatitis, nephrotic syndrome, HIV infection, increased content estrogen).

In addition to hypothyroidism, decreased levels of thyroid hormones are observed in following cases:

• low protein diet or fasting;
• adrenal insufficiency;
• severe general exhaustion of the body;
• chronic liver diseases.

The concentration of total T4 has pronounced daily fluctuations with a maximum occurring between 8 and 12 o'clock in the afternoon, and a minimum between 23 and 3 o'clock at night.

Free thyroxine
Free thyroxine (free T4) is the fraction of T4 not bound to proteins. In women, the concentration of free thyroxine is lower than in men and increases during pregnancy, reaching a maximum in the last trimester.

Triiodothyronine total
Total triiodothyronine (T3 total) is formed in the thyroid gland from T4, and has the same effect, but is 4-5 times more active than its predecessor. This hormone is characterized by seasonal fluctuations: its maximum level is found in the blood from September to February, the minimum in summer.

Free triiodothyronine
Concentration free triiodothyronine(Free T3) is the fraction of triiodothyronine in the blood that is not bound to proteins. Free T3 levels physiologically decrease in the last trimester of pregnancy.

Hormones of the adrenal cortex. Symptoms indicating cortical pathology
adrenal glands

Biological action of adrenal hormones

Glucocorticoids are the most important hormones of the adrenal cortex and, as the name implies, regulate glucose metabolism, having an effect opposite to insulin. They help increase blood glucose levels, causing its synthesis and reducing its uptake by peripheral tissues. So, with an increase in the concentration of glucocorticoids, so-called steroid diabetes develops.

In addition, glucocorticoids are involved in protecting the body from stress and shock and have a powerful anti-inflammatory and immunosuppressive effect.

Mineralocorticoids regulate water-salt metabolism, helping to maintain blood pressure and preserve water, sodium and chlorine in the body. With an increase in the concentration of mineralocorticoids in the body, hypertension and edema syndrome develop.

Adrenal androgens are secreted in small quantities, so their effect becomes noticeable only in the case of pathology (masculinization of women with tumors of the adrenal cortex, etc.).

All hormones of the adrenal cortex are secreted under the influence of the hormone of the anterior pituitary gland - ACTH (adrenocorticotropic hormone). In this case, regulation occurs according to the type feedback: with a decrease in the production of hormones from the adrenal cortex, the secretion of ACTH increases - and vice versa.

Clinical manifestations of hormonal imbalance requiring analysis
level of adrenal hormones in the blood

• growing muscle weakness, constant feeling fatigue;
• decreased blood pressure with increased heart rate;
• irritability, tendency to depression, anxiety;
• loss of appetite and weight, diarrhea, vomiting, abdominal pain;
• education dark spots on open areas of skin;
• craving for salty foods, constant thirst;
• excess urine in the presence of symptoms of dehydration.

Less commonly, Itsenko-Cushing syndrome develops with hyperplastic processes of the adrenal cortex, as well as with long-term treatment medicines glucocorticoids, and has very characteristic symptoms:
alcoholism, some neuropsychiatric diseases, sometimes during pregnancy. In such cases they talk about Pseudo-Cushing syndrome, or functional hypercortisolism.

We take hormonal tests if we suspect cortical pathology
adrenal glands

Adrenocotricotropic hormone (ACTH)

Increased levels occur with primary adrenal insufficiency, as well as with tumors that produce ACTH.

A decrease in the level of ACTH is observed with insufficiency of its production by the anterior lobe of the pituitary gland, as well as with hormone-producing tumors of the adrenal cortex (inhibition of synthesis according to the feedback principle).

Cortisol

It should be remembered that during pregnancy there is a physiological increase in the concentration of cortisol levels in the blood.

Aldosterone

A physiological increase in aldosterone levels is observed during pregnancy, salt-free diet, increased water and physical activity.

Everyone knows that the endocrine system controls quite a lot of functions in the body. This control especially concerns metabolism and cell activity. It should be noted that the endocrine system consists of many organs that produce hormones, the most important of which are the pancreas and thyroid glands, adrenal glands, ovaries and testes. Therefore, disruption of the endocrine system leads to neoplasms in the glands, which, in turn, causes the production of hormones in large quantities. Autoimmune and other diseases whose causes are still unknown (for example, diabetes) are the result of system dysfunction. Many endocrine disorders cause characteristic symptoms in the form of various changes in the body.

Diseases are paired organ which releases hormones. They are located behind abdominal cavity between the kidneys. The adrenal glands consist of an outer part called cortical layer, and the inner or medulla layer. Any problems that arise with the functioning of the adrenal glands are associated with excess or insufficient production of hormones. In cases of cortical disease, the adrenal glands produce too much of the hormone, which can lead to a disease such as Cushing's syndrome. There is also a risk of developing hypertension or hirsutism, increased blood glucose and other symptoms. A deficiency of adrenal hormones can result in skin pigmentation. Most common cause The disease is a tumor in the adrenal glands.

Pituitary gland diseases. The pituitary gland is a gland that is located in the brain next to sphenoid bone, at the level of the nasal cavity. Pituitary dysfunction can have two different symptomatic pictures. Pituitary hormones play an important role in the human body, therefore, regardless of whether they are absent or in excess, their dysfunction leads to a number of anomalies in which the endocrine system begins to malfunction. Dwarfism or gigantism is a consequence malfunction namely the pituitary gland.

Diseases of the hypothalamus. The hypothalamus is a small area in the brain that lies midway between the right and left hemispheres of the brain. The hypothalamus, like the endocrine system as a whole, performs many various functions, so that its malfunction can lead to disruption of sleep and body temperature regulation, as well as problems with sexual activity. Insufficient amounts in the hypothalamus can lead to significant losses water in the body, which very quickly leads to dehydration.

Diseases thymus gland. The thymus is located behind the sternum in the chest. Along with the growth and development of the body, the gland also increases, which atrophies in adolescence. Thus, the thymus plays a fairly important role precisely at the initial stage of life. Congenital absence of the thymus gland can result in a lack of T lymphocytes and therefore immunity. Thymus in children early age not yet fully developed, resulting in increased susceptibility to infectious diseases.

Thyroid disease, which produces iodine-containing hormones, plays an important role in the development, growth and function of the entire nervous system. Most problems in functioning are caused by inflammation, hyperthyroidism (excess hormones leads to rapid weight loss, diarrhea and rapid heartbeat) or hypothyroidism (lack of hormones leads to weight gain, constipation, lethargy, inactivity and dry skin).

Instructions

All disturbances in the functioning of the endocrine system should be addressed to you by a specialist. The doctor will conduct the necessary examination and prescribe medications that will help restore the normal functioning of all organs that are involved in its work. Please note that without an accurate diagnosis, even herbal infusions can be harmful.

Negative influence to endocrine system also have unfavorable external factors: ecology, radiation, chemical pollution, nervous stress and stress. Especially background radiation, which disrupts the iodine balance. Try to eliminate the influence of these factors on your health.

note

Check your first aid kit. Frequent use of certain medications can negate all your efforts to restore the endocrine system. These are steroids that are taken for arthritis, diuretics and contraceptives. If the endocrine system malfunctions, immediately eliminate diets.

In the lives of athletes, dancers and most ordinary people People of all ages sometimes experience unpleasant injuries, and one of them is a knee injury. can be both common and very dangerous, and in all cases it is necessary to know how to properly care for the damaged knee and how to avoid negative consequences from improper treatment.

Instructions

If you have bruised or damaged your knee, first of all you need to protect the joint from stress and sudden movements. Apply cold to the bruise to reduce swelling and hematoma, relieve pain by taking any anti-inflammatory analgesic, and apply a pressure bandage.

Special attention Take the time to apply a pressure bandage to the knee - for example, elastic bandage. Pressure bandage fixes the knee, reduces swelling, prevents hemorrhages. Relax your legs, accept comfortable position and bandage tightly knee-joint, making several turns of the bandage, first up and then down the same number of times.

Also, to quickly restore the functionality of the knee, it needs to be lubricated with a medicinal gel - for example, Diclofenac, Indomethacin, Voltaren-gel, Lyoton are suitable for this. The ointment will relieve local inflammation, pain syndrome, and also restore blood vessels and strengthen them.

Video on the topic

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Before starting any treatment, consult your healthcare professional.

In order to human body worked like clockwork, it hormonal levels must meet normal standards. Alas, for many reasons, the endocrine glands that produce malfunction, which entails the most various diseases. Due to greater complexity female body these problems are more common among the fairer sex.

Instructions

First of all, visit an endocrinologist and gynecologist, get examined, get tested. Let us remind you once again about the inadmissibility of self-medication. If only because there are a lot of reasons for hormonal imbalance, and only qualified specialist.

Along with drug therapy It is recommended to correct it by introducing foods rich in microelements such as zinc and selenium into your diet. You can, in agreement with your doctor, take multivitamin complexes or nutritional supplements containing these microelements.

Treatment hormonal disorders can be carried out in a variety of ways. The so-called “hormone therapy” is very common and effective. Many people are still wary of it, fearing side effects such as weight gain, changes in voice timbre, etc. But that was typical hormonal drugs first generation, modern means lead to such consequences in extremely rare cases.

Good effect can give treatment with leeches, then there is hirudotherapy. It can help at any stage of a woman’s life: in adolescence, adulthood, reproductive age And . Some women cannot even bear the thought of such treatment. But this is a reliable, proven remedy, known since ancient times, so fear and disgust should be overcome.

You can also resort to herbal medicine, that is, herbal treatment. Correction of nutrition gives good results. It is recommended to reduce the proportion of meat and meat products in the diet, respectively, increasing the consumption of fruits and vegetables, vegetable oil(preferably olive), nuts.

In some cases the most severe cases have to resort to surgical intervention.

It is part of the endocrine system. Located in the front of the neck, lateral to the trachea, immediately behind the Adam's apple. Its tasks include the production of hormones responsible for metabolism and normal development body. For the normal functioning of this organ, iodine is necessary, which enters the body with food and water. A deficiency or excess of it can lead to disruption of the thyroid gland.

You will need

• - hawthorn flowers;
• - St. John's wort;
• - red rowan flowers;
• - fruits of black rowan;
• - walnut leaf;
• - White bloodroot;
• - nettle;
• - Oak bark;
• - sweet clover;
• - knotweed;
• - evasive peony.

Instructions

For hypothyroidism, prepare the following collection. Take in equal amount hawthorn flowers, St. John's wort, red rowan flowers, black rowan fruits, walnut leaf. Grind all ingredients and mix. Place 2 tablespoons of the mixture in a thermos, pour 600 ml of boiling water, leave for 4-5 hours. After straining, drink 0.5 glasses three times a day half an hour before meals. The course of treatment is 7-8, according to the scheme: 20 days of infusion, 10 days of rest, during which it is recommended to drink an infusion from one plant: dandelion root, chickweed, echinacea flowers and leaves, mint (one tablespoon per 200 ml of boiling water).

For hyperthyroidism, prepare the following effective. Take equal quantities of white cinquefoil, nettle, oak bark, sweet clover, knotweed, chop everything and mix. 2 tablespoons, pour 0.5 boiling water, leave in a warm place for 2-3 hours. After straining, drink a third of a glass three times a day half an hour before meals.

For nodular formations and tumors, take tincture of peony root. Take 10 grams of carefully crushed root and add 100 ml of 70% medical alcohol and leave for 2 weeks in a warm, dark place. Drink 30 drops dissolved in 30 ml boiled water three times a day 1.5 hours of food. One serving is required per course of treatment. Carry out the next course through tincture of other plants (monkshood, hemlock, etc.).

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Before you treat thyroid gland, it is necessary to cleanse the intestines, liver, blood and lymph.

Violations and their causes in alphabetical order:

endocrine system disorder -

Endocrine system disruption- pathological conditions that occur as a result of improper activity of the endocrine glands or endocrine glands, releasing the substances they produce (hormones) directly into the blood or lymph.

TO endocrine glands include pituitary gland, thyroid and parathyroid glands, adrenal glands and glands with mixed function Carrying out, along with internal and external secretion: the gonads and the pancreas. The main role of the endocrine glands in the body is expressed in their influence on the processes of metabolism, growth, physical and sexual development. Disruption of the endocrine system leads to various violations vital activity of the body. At the core endocrine disorders lies either an excessive increase or decrease in the functions of a particular gland.

Pituitary is considered the center of regulation of the endocrine system, since it produces hormones that specifically stimulate the growth, differentiation and functional activity of certain endocrine glands. Violation complex functions pituitary gland leads to the development of a number of pituitary disorders: excessive function of the anterior pituitary gland causes acromegaly ( big sizes skull, brow ridges, cheekbones, nose, chin, hands, feet); decreased function of the anterior lobe of the pituitary gland can cause obesity, dwarfism, severe exhaustion and atrophy of the gonads; decreased function of the posterior lobe of the pituitary gland - development does not diabetes mellitus, (copious discharge urine, increased thirst).

Increased thyroid function manifests itself in an increase in its volume, palpitations, emaciation, depending on increased metabolism, diarrhea, sweating, and phenomena of increased neuropsychic excitability. With a pronounced increase in the function of the thyroid gland (the so-called Graves' disease), protrusion is observed eyeballs- bulging eyes.

Decreased thyroid function accompanied by a decrease in the thyroid gland, slow heart rate and sunken eyeballs. There is a tendency towards obesity, constipation, dry skin, decreased general excitability, changes in the skin and subcutaneous tissue, which become as if edematous. This condition is called myxedema.

Increased function of the parathyroid glands is rare. Much more often the function of these glands decreases.

At the same time, the calcium content in the blood decreases, which leads to increased excitability mainly musculoskeletal systems nervous system and a tendency to tetanic convulsions, developing more often in the upper extremities. Convulsive seizures last from a few minutes to 1-2 hours.
This complex of symptoms is called spasmophilia or tetany.

Increased adrenal function accompanied by premature puberty (most often due to tumor formation).

Decreased function of the adrenal cortex in severe cases gives a picture of Addison's disease (bronze disease), in which characteristic dark, bronze pigmentation of the skin appears, exhaustion, and decreased blood pressure, blood sugar decreases, and the body's resistance decreases.

Increased function of the adrenal medulla causes development arterial hypertension in the form of attacks.

Increased function of the gonads observed rarely (usually due to the development of malignant tumors of these glands), mostly in childhood. The gonads reach their full development prematurely.

A decrease in the function of these glands leads to eunuchoidism - increased growth with disproportionate lengthening of the lower and upper limbs, tendencies towards obesity, with the distribution of fat in men according to female type and underdevelopment of the genital organs, lack of secondary hair.

Increased pancreatic function not sufficiently studied. Some manifestations include a persistent decrease in blood sugar and a tendency toward obesity. A decrease in the function of this gland leads to an increase in sugar levels in the blood and urine, increased urination, and a decline in nutrition (diabetes mellitus).

What diseases cause disruption of the endocrine system:

Regulation of the activity of the endocrine glands is carried out by the autonomic nerve centers of the interstitial brain through autonomic nerve fibers and through the pituitary gland under the control of the cerebral cortex. The nervous and endocrine systems are closely interconnected and constantly interact.

The endocrine glands have a great influence on the growth and development of the body, metabolic processes, excitability and tone of the nervous system. Features of the functioning of individual parts of the endocrine system play a large role in the formation of the body in general and its constitutional characteristics in particular.

Natural course age-related changes in the body can be sharply disrupted under the influence of disorders of internal secretion from one or more endocrine glands.

Causes of endocrine system disorders:

1. Primary dysfunction of the peripheral endocrine glands.

Various pathological processes can develop in the gland itself and lead to disruption of the formation and secretion of the corresponding hormones.

Infections occupy an important place among the causes of damage to peripheral endocrine glands. Some of them (for example, tuberculosis, syphilis) can be localized in various glands, causing their gradual destruction, in other cases there is a certain selectivity of damage (for example, meningococcal sepsis is often accompanied by hemorrhage in the adrenal glands, viral parotitis often causes orchitis and testicular atrophy, and orchitis may also occur with gonorrhea, etc.).

A common cause of gland damage and hormone production disorders are tumors that can develop in any gland. Character endocrine disorders it depends on the nature of the tumor. If the tumor originates from secretory cells, excess amounts of hormones are usually produced and a picture of hyperfunction of the gland occurs. If the tumor does not secrete the hormone, but only compresses and causes atrophy or destroys the tissue of the gland, its progressive hypofunction develops. Often tumors are metastatic in nature. In some cases, tumors of the endocrine glands produce hormones that are not characteristic of this gland; ectopic foci of hormone production are also possible in tumors of non-endocrine organs.

Endocrine system disorders can be caused by congenital defects in the development of glands or their atrophy. The latter is called for various reasons: sclerotic process, chronic inflammation, age-related involution, hormonally active tumor of the paired gland, long-term treatment with exogenous hormones, etc. Damage and atrophy of the gland are sometimes based on autoimmune processes (for example, in some forms of diabetes mellitus, diseases of the adrenal glands, thyroid gland, etc. .).

Autoimmune processes can also cause hyperproduction of hormones (for example, by the thyroid gland).

The formation of hormones is disrupted due to hereditary defects in the enzymes necessary for their synthesis, or inactivation (blockade) of these enzymes. In this way, for example, some forms of corticogenital syndrome, endemic cretinism and other endocrine diseases arise. It is also possible that abnormal forms of hormones are formed in the gland. Such hormones have inferior activity or are completely devoid of it. In some cases, the intraglandular conversion of prohormone into hormone is disrupted, and therefore inactive forms are released into the blood.

The cause of disturbances in the biosynthesis of hormones can be a deficiency of specific substrates included in their composition (for example, iodine, necessary for the formation of thyroid hormones).

One of the causes of endocrine disorders is the depletion of hormone biosynthesis as a result of prolonged stimulation of the gland and its hyperfunction. In this way, some forms of pancreatic islet beta cell failure occur, stimulated by prolonged hyperglycemia.

2. Extraglandular (peripheral) forms of endocrine disorders.

Even with quite normal function peripheral glands and the body's adequate need for hormone secretion, various endocrinopathies can occur.

The causes of such extraglandular “peripheral” endocrine disorders may be disturbances in the binding of hormones to proteins at the stage of their transport to target cells, inactivation or destruction of the circulating hormone, disturbances in the reception of hormones and their metabolism, and disturbances in permissive mechanisms.

Inactivation of circulating hormones by modern ideas, most often associated with the formation of antibodies to them. This possibility has been established in relation to exogenous hormones: insulin, ACTH, growth hormone.

The possibility of forming autoantibodies to one’s own hormones has now been proven. The possibility of other ways of inactivating hormones at the stage of their circulation cannot be excluded.

An important form of extraglandular endocrine disorders is associated with disturbances in hormone reception in target cells - on their surface or inside the cell. Such phenomena may be a consequence of the genetically determined absence or small number of receptors, defects in their structure, various damages cells, competitive blockade of receptors by “antihormones”, gross shifts physical and chemical properties pericellular and intracellular environment.

Great importance is currently attached to antireceptor antibodies. It is believed that the mechanisms of production of antireceptor antibodies may be associated with certain features of the immune system itself.

The formation of antibodies may be caused by a viral infection; it is assumed that in such cases the virus binds to a hormonal receptor on the cell surface and provokes the formation of antireceptor antibodies.

One form of deficiency hormonal effects may be associated with a violation of the permissive “mediating” action of hormones.

Thus, the lack of cortisol, which has a powerful and versatile permissive effect on catecholamines, sharply weakens the glycogenolytic, lipolytic effects of adrenaline, the pressor effect and some other effects of catecholamines.

With absence required quantities thyroid hormones cannot normally realize the effect of somatotropic hormone on early stages development of the body.

Violation of the “mutual assistance” of hormones can lead to other endocrine disorders.

Endocrinopathies can occur as a result of disturbances in hormone metabolism. A significant part of hormones is destroyed in the liver, and with its lesions (hepatitis, cirrhosis, etc.), signs of endocrine disorders are often observed. It is also possible excessive activity enzymes involved in hormone metabolism.

Thus, the causes and mechanisms of endocrine disorders are very diverse.

Moreover, these disorders are not always based on insufficient or excessive production of the corresponding hormones, but always on the inadequacy of their peripheral effects in target cells, leading to a complex interweaving of metabolic, structural and functional disorders.

Which doctors should you contact if an endocrine system disorder occurs:

Have you noticed an endocrine system disruption? Do you want to know more detailed information or do you need an inspection? You can make an appointment with a doctor– clinic Eurolab always at your service! The best doctors will examine you and study you external signs and will help you identify the disease by symptoms, advise you and provide necessary help. you also can call a doctor at home. Clinic Eurolab open for you around the clock.symptoms of diseases and do not realize that these diseases can be life-threatening. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. Each disease has its own specific symptoms, characteristic external manifestations- so called symptoms of the disease. Identifying symptoms is the first step in diagnosing diseases in general. To do this, you just need to do it several times a year. be examined by a doctor to not only prevent terrible disease, but also support healthy mind in the body and the organism as a whole.

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Hormones are biologically active substances that are produced by various glands of the endocrine system and then enter the blood. They influence the functioning of the entire organism, largely determining the physical and mental health person. Hormone tests help to significantly clarify clinical picture disease and prevent its development.

Of course, not every pathology requires urgent such tests, especially since the human body produces dozens of types of hormones, each of which has its own “sphere of influence.”

Hormonal tests: when and why are they prescribed?

Hormone levels are most often determined in the blood, less often in the urine. Hormone tests may be prescribed, for example, in the following cases:

• disturbances in the development of certain organs;
• pregnancy diagnosis;
• infertility;
• pregnancy with threat of miscarriage;
• kidney dysfunction;
• metabolic disorders;
• problems with hair, nails and skin;
• depressive states and others mental problems;
• tumor diseases.

A referral for analysis can be given by a pediatrician, therapist, endocrinologist, gynecologist, gastroenterologist, or psychiatrist.

Preparing for hormone tests

What rules should be followed when donating blood to analyze hormone levels so that the results are as accurate as possible? It is necessary to refrain from eating for 7-12 hours before blood collection. During the day before the study, alcohol, coffee, physical activity, stress, and sexual contact should be excluded. The possibility of taking medications during this period should be discussed with your doctor. When studying hormonal status, it is important for women to know which day of the cycle they should take tests. Thus, blood is donated for follicle-stimulating hormone, luteinizing hormones and prolactin on days 3–5 of the cycle, for testosterone on days 8–10, and for progesterone and estradiol on days 21–22.

If you donate daily urine, you should strictly adhere to the collection scheme and observe the storage conditions.

General principles of conducting and interpreting analysis

Blood for research is taken from a vein in the morning on an empty stomach. The study period is usually 1–2 days. The obtained result is compared by the doctor with the hormone concentration standards developed taking into account the patient’s gender, age and other factors. The patient himself can study these norms.

Laboratory diagnostic methods

Only a specialist (endocrinologist, gynecologist, therapist, gastroenterologist, etc.) can decide which tests need to be taken for hormones based on the results of the examination. Moreover, the number of tests is commensurate with the number of hormones, and there are more than 100 of them in the body. In the article we will consider only the most common types of studies.

Assessment of somatotropic function of the pituitary gland necessary for people who have gigantism, acromegaly (enlarged skull, hands and feet) or dwarfism. The normal level of somatotropic hormone in the blood is 0.2–13 mU/l, somatomedin-C is 220–996 ng/ml at the age of 14–16 years, 66–166 ng/ml after 80 years.

Pathologies of the pituitary-adrenal system manifest themselves in disruption of the body's homeostasis: increased blood clotting, increased carbohydrate synthesis, decreased protein and mineral metabolism. To diagnose such pathological conditions It is necessary to determine the content of the following hormones in the body:

• Adrenocorticotropic hormone is responsible for skin pigmentation and the breakdown of fats; the norm is less than 22 pmol/l in the first half of the day and no more than 6 pmol/l in the second.
• Cortisol regulates metabolism, the norm is 250–720 nmol/l in the first half of the day and 50–250 nmol/l in the second (the difference in concentration should be at least 100 nmol/l).
• Free cortisol - is given if the presence of Itsenko-Cushing's disease is suspected. The amount of hormone in urine is 138–524 nmol/day.

These tests are often prescribed by endocrinologists for obesity or underweight; they are taken to determine whether there are serious hormonal imbalances and which ones.

Thyroid dysfunction manifests itself increased irritability, changes in body weight, increased blood pressure, is fraught gynecological diseases and infertility. What tests should be taken for thyroid hormones if at least several of the above symptoms are detected? First of all we're talking about about the study of the level of triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH), which regulate metabolic processes, mental activity, as well as the functions of the cardiovascular, reproductive and digestive systems. Normal indicators hormones look like this:

• Total T3 – 1.1–3.15 pmol/l, free – 2.6–5.7 pmol/l.
• Total T4 – 60–140 nmol/l, free – 100–120 nmol/l.
• TSH – 0.2–4.2 mIU/l.
• Antibodies to thyroglobulin – up to 115 IU/ml.
• Antibodies to thyroid peroxidase – 35 IU/ml.
• T-Uptake – 0.32–0.48 units.
• Thyroglobulin – up to 55 ng/ml.
• Antibodies to microsomal antigen of thyrocytes – less than 1.0 U/l.
• Autoantibodies to thyroid-stimulating hormone receptors – 0–0.99 IU/l.

Failures in the regulation of calcium and phosphorus metabolism lead to osteoporosis or increased bone mineralization. Parathyroid hormone promotes the absorption of calcium into intestinal tract, as well as reabsorption in the kidneys. The content of parathyroid hormone in the blood of an adult is 8–24 ng/l. Calcitonin promotes calcium deposition in bones, slowing its absorption in the gastrointestinal tract and increasing excretion in the kidneys. The normal level of calcitonin in the blood is 5.5–28 pmol/l. It is recommended to donate blood for tests of this type at the onset of menopause, since women during this period are most susceptible to osteoporosis.

The body of any person produces both male and female hormones. Their correct balance ensures stable operation reproductive system, normal secondary sexual characteristics, smooth mental condition. The production of certain sex hormones may be disrupted due to age, bad habits, heredity, and endocrine diseases.

Reproductive system dysfunctions, conditioned hormonal imbalances, lead to male and female infertility, and also provoke miscarriages in pregnant women. In the presence of similar problems donate blood for analysis female hormones, such as:

• Macroprolactin is the norm for men: 44.5–375 µIU/ml, for women: 59–619 µIU/ml.
• Prolactin - the norm is 40 to 600 mU/l.
• Pituitary gonadotropic hormones and prolactin - before menopause the ratio is 1.
• Follicle-stimulating hormone: its content in the follicular phase is normally 4-10 U/l, during the ovulation period - 10-25 U/l, during the luteal phase - 2-8 U/l.
• Estrogens (the norm in the follicular phase is 5–53 pg/ml, during the ovulation period – 90–299 pg/ml and 11–116 pg/ml during the luteal phase) and progestins.
• Luteinizing hormone - the norm in the follicular phase is 1-20 U/l, during the ovulation period - 26-94 U/l, during the luteal phase -0.61-16.3 U/l.
• Estradiol – the norm in the follicular phase is 68–1269 nmol/l, during the ovulation period – 131–1655 nmol/l, during the luteal phase – 91–861 nmol/l.
• Progesterone is the norm in the follicular phase - 0.3-0.7 µg/l, ovulation period - 0.7-1.6 µg/l, during the luteal phase 4.7-8.0 µg/l.

Assessing androgen function produced for infertility, obesity, high cholesterol, hair loss, juvenile acne, decreased potency. So:

• Testosterone – normal content in men – 12–33, in women – 0.31–3.78 nmol/l (hereinafter in the list, the first indicator is the norm for men, the second – for women).
• Dehydroepiandrosterone sulfate – 10–20 and 3.5–10 mg/day.
• Sex hormone binding globulin is –13–71 and 28–112 nmol/l.
• 17-hydroxyprogesterone – 0.3–2.0 and 0.07–2.9 ng/ml.
• 17-ketosteroids: 10.0–25.0 and 7–20 mg/day.
• Dihydrotestosterone – 250–990 and 24–450 ng/l.
• Free testosterone– 5.5–42 and 4.1 pg/ml.
• Androstenedione – 75–205 and 85–275 ng/100 ml.
• Androstenediol glucuronide – 3.4–22 and 0.5–5.4 ng/ml.
• Anti-Mullerian hormone – 1.3–14.8 and 1.0–10.6 ng/ml.
• Inhibin B – 147–364 and 40–100 pg/ml.

Diagnosis of diabetes and assessment of endocrine pancreatic function necessary for abdominal pain, nausea, vomiting, excess weight, dry mouth, skin itching, swelling. Below are the names and standard indicators pancreatic hormones:

• C-peptide – 0.78-1.89 ng/ml.
• Insulin – 3.0–25.0 µU/ml.
• Insulin resistance assessment index (HOMA-IR) – less than 2.77.
• Proinsulin – 0.5–3.2 pmol/l.

Pregnancy monitoring carried out in order to prevent developmental pathologies and fetal death. At the antenatal clinic, when registering, they tell you in detail what hormone tests need to be carried out and why you should donate blood for hormone analysis during pregnancy. In general, the following are investigated:

• Chorionic gonadotropin (hCG) - its concentration depends on the stage of pregnancy: from 25–200 mU/ml at 1–2 weeks to 21,000–300,000 mU/ml at 7–11 weeks.
• Free b-hCG – from 25–300 mU/ml at 1–2 weeks of pregnancy to 10,000–60,000 mU/ml at 26–37 weeks.
• Free estriol (E3) – from 0.6–2.5 nmol/l at 6–7 weeks to 35.0–111.0 nmol/l at 39–40 weeks.
• Pregnancy-associated plasma protein A (PAPP-A) - the test is done from the 7th to the 14th week, the norm is from 0.17–1.54 mU/ml at 8–9 weeks to 1.47–8.54 honey/ml at 13–14 weeks.
• Placental lactogen - from 0.05–1.7 mg/l at 10–14 weeks to 4.4–11.7 mg/l at 38 weeks.
• Prenatal screening for trisomy 1st trimester (PRISCA-1) and 2nd trimester of pregnancy (PRISCA-2).

Malfunctions of the sympathoadrenal system should be sought if available panic attacks and others autonomic disorders. To do this, you need to donate blood for analysis and check which hormones from the list are outside the normal range:

• Adrenaline (112–658 pg/ml).
• Norepinephrine (less than 10 pg/ml).
• Metanephrine (less than 320 mcg/day).
• Dopamine (10–100 pg/ml).
• Homovanillic acid (1.4–8.8 mg/day).
• Normetanephrine (less than 390 mcg/day).
• Vanillylmandelic acid (2.1–7.6 mg/day).
• 5-hydroxyindoleacetic acid (3.0–15.0 mg/day).
• Plasma histamine (less than 9.3 nmol/l).
• Serum serotonin (40–80 mcg/l).

State of the renin-angiotensin-aldosterone system, which is responsible for maintaining circulating blood volume, allow us to evaluate hormones such as aldosterone (in blood) - 30–355 pg/ml and renin (in plasma) - 2.8–39.9 μIU/ml in the patient’s supine position and 4 .4–46.1 µIU/ml – standing.

Regulation of appetite and fat metabolism carried out using the hormone leptin, the concentration of which in the blood normally reaches 1.1–27.6 ng/ml in men and 0.5–13.8 ng/ml in women.

Assessment of the state of endocrine function of the gastrointestinal tract carried out by determining the level of gastrin (less than 10–125 pg/ml) and stimulated gastrin-17 (less than 2.5 pmol/l)

Assessment of hormonal regulation of erythropoiesis(erythrocyte formation) is based on data on the amount of erythropoietin in the blood (5.6–28.9 IU/L in men and 8–30 IU/L in women).

The decision about what tests need to be taken for hormones should be made based on the existing symptoms and preliminary diagnosis, as well as taking into account concomitant diseases.