CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David

2 Physiologic Regulatory Systems o contribute to the basic processes of

Endocrine system reproduction
Nervous system o help maintain homeostasis
o Neuroendocrine System Types of Hormones
_____________________________________________ Circulating hormones/Endocrines:
Types of Glands Local Hormones
Endocrine o Paracrines
Exocrine o Autocrines

Types of Endocrine Control Functional Types of Hormones

o Releasing Hormones:
Negative feedback promote secretion of Ant. Pituitary
A homeostatic mechanism that opposes or hormones
resists a change in the body's internal o Inhibitory Hormones:
conditions. suppress the secretion of a particular
Positive feedback hormone
A mechanism that increases or enlarges a o Tropic Hormones:
change in the body's internal conditions. stimulate growth & activity of other
_____________________________________________ endocrine glands
Endocrine System o Effector Hormones:
consists of ductless glands, which secrete targets non endocrine cells
hormone directly into the circulatory system
Major Glands of Endocrine System Types of Hormones according to
Pituitary Gland Structure
Thyroid Gland Steroids
Parathyroid Gland Biogenic Amines
Adrenal Gland Peptides and Proteins
Pancreas Glycoproteins
Reproductive Glands (ovaries & testes) Eicosanoids
Thymus Gland
Pineal Gland Steroids
lipids derived from cholesterol
Hormones
transported to blood stream through
from a Greek word hormon
attachment to transport protein
meaning to set in motion
Example: Aldosterone, cortisol, estrogen,
intercellular chemical signal
progesterone, testosterone, androgen
transported to act on tissues at
another site of the body to influence
Biogenic Amines (AA)
their activity o Tyrosine
Functions of Hormones: Thyroid hormones
o regulate the chemical composition and o T3-triiodothyronine
volume of the ECF o T4-thyroxine
o help regulate metabolism and energy Adrenal hormones
balance o Epinephrine
o help regulate contraction of smooth and o Norepinephrine/cathecholamine
cardiac muscles and secretion of glands s
o help maintain activities of immune system
o plays a role in the smooth sequential Peptides and Proteins
integration of growth and development synthesized by rough ER
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
hypothalamic releasing and inhibiting
hormone
Oxytocin, ADH, Insulin, Glucagon, GH,
calcitonin

Glycoproteins
AA derivatives with CHO groups
TSH, FSH, LH
1st target: Ant.Pituitary gland
Eicosanoids Thyrotropin
Fatty acids FSH
with 20 carbon atom fatty acid LH
nd
(arachidonic fatty acid) 2 target: A. Thyroid
prostaglandin T3
T4 to muscles and liver
Mechanism of Hormone action: B. ovaries and testes:
Estrogen
Progesterone
Testosterone to reproductive organs
Post Pituitary Gland
Responsible for blood glucose
Islet cells of pancreas
Insulin
Glucagon to liver and muscles
_____________________________________________

Hypothalamus
Nonsteroid Hormones collection of specialized cells located
Steroid Hormones at the central part of the brain
_____________________________________________ main link between the endocrine &
nervous system
General Mechanism of Hormone Action control the pituitary gland by
Hormone binds to cell surface or production of chemicals that stimulate
receptor inside target cell or suppress hormone secretion of
Cells may then pituitary
o Synthesize new molecules Hormones:
o Change permeability of TRH: Thyrotropin releasing hormones
membrane GnRH: Gonadotropin releasing
o Alter rates of reaction hormone
Each target cell responds to hormone GH-IH: Growth hormone inhibiting
differently hormone
o At liver cells insulin stimulates GH:RH: Growth hormone releasing
glycogen synthesis hormone
o At Adipocytes insulin CRH: Corticotropin releasing hormone
PIF: Prolactin inhibiting factor
stimulates Triglyceride synthesis
_____________________________________________
_____________________________________________
Pituitary Gland (hypophysis)
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
small egg shaped gland located at the
base of the brain beneath the Inhibiting GH:
hypothalamus Glucose loading
master gland Beta agonist(epinephrine)
divided into 2 lobes: anterior & Alpha blockes(phentalamine)
posterior Emotional/psychogenic stress
Anterior Pituitary Gland Nutritional deficiency
regulates the activity of thyroid, Insulin deficiency
adrenals, and reproductive glands Throxine deficiency
GH, PRL, TSH, FSH, LH, ACTH Hormones that influences
o Regulate activity of thyroid, secretion and metabolic effect of
adrenals and reproductive GH: Thyroxine, cortisol, estrogen,
glands somatostatin, Somastatin releasing
also secretes ENDORPHINS factor
o
Hormones: Test of GH insufficiency:
GH: growth of bone and soft tissues Stimulation test
PRL: for lactation o after exercise or during sleep,
TSH: release of thyroid hormones GH normally increases
FSH: growth of the follicle and initial o Clonidine(potent GH stimulant)
wave of spermatogenesis
LH: ovulation and final follicular Prolactin (PRL)
growth and production of testosterone controls the initiation and
ACTH: release of cortisol maintenance of lactation
o induces ductal growth
Growth Hormone o development of breasts
stimulates AA transport and nucleic o lobular alveolar system
acid & CHON synthesis o synthesis of specific milk
exerts major effects on cartilage and proteins
growth of long bones act directly on mammary glands
o AA transport and nucleic acid requires priming by estrogens,
and CHON Synthesis progestins, corticosteroids, thyroid
o Increases hepatic glucose effect hormones, and insulin
w/ anti-insulin effect in muscles
o Increases lipolysis elevating Thyroid Stimulating Hormone (TSH)
plasma free FA(ketogenesis in increases:
diabetes) o size of thyroid follicular cells
increases hepatic glucose effect in o uptake of iodide by thyroid cells
excess and exerts anti-insulin effect in from the ECF
muscles o release of thyroxine from the
increases lipolysis elevating levels of thyroid colloid follicles
plasma free FA o biosynthesis of thyroxine
Factors affecting GH secretion: differentiates pituitary (secondary)
Stimulate GH: hypothyroidism from primary
Sleep hypothyroidism
Exercise
Physiologic stress Follicle Stimulating Hormone (FSH)
Amino acids(arginine) gonadotropic hormones
Hypoglycemia growth and maturity of ovarian
Sex Steroids(estradiol) follicles
Alpha antagonist(norepinephrine) estrogen secretion
Beta blocker(Propanolol) promotes endometrial changes
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
(1st: proliferative phase of mens), o for contraction of uterus and
spermatogenesis ejection of milk primed with
estrogen
Luteinizing Hormone (LH)/(ICSH) ADH or arginine vasopressin or
gonadotropic hormones pitressin:
ovulation and secretion of androgens o permeability of kidney tubules
and progesterone
initiates secretory phase of mens DISEASES ASSOCIATED WITH
(2nd)
formation of corpus luteum HORMONES OF THE PITUITARY
development of testicular cells GLAND
Dwarfism
hyposecretion of GH during growth years
types:
o Achrondroplasia
Adrenocorticotropic Hormone (ACTH) o Hypoachondroplasia
acts primarily on the adrenal cortex, to o Spondyloepiphyseal Dysplasia
stimulate growth and secretion of o Diastrophic dysplasia
corticosteroids Gigantism
follows circadian rhythm hypersecretion of GH during childhood
elevated during times of stress
_____________________________________________ Acromegaly
Summary of Anterior pituitary Gland: hypersecretion of GH during adulthood
GH(growth hormone) Features:
o Growth of bone and soft tissues o Course facial features
PRL(prolactin) o Soft tissue thickening(lips)
o For lactation o Spade like hands
TSH(thyroid stimulating hormone) o Protruding jaw(prognathism)
o Release of thyroid hormones o Sweating
FSH(follicle stimulating hormone) o Impaired glucose tolerance or
o Growth of follicle(Female)
DM
o Initial wave of
Dx of Acromegaly
spermatogenesis(male)
o OGTT and GH measurement
LH(luteinizing hormone)
o Hyperglycemia should suppress
o Ovulation and final follicular
GH to <1ug/L
growth(female)
o After Treatment, failure to
o Production of
suppress GH below 2ug/L may
testosterone(male)
ACTH(adrenocorticotropic cause higher prevalence of DM,
hormone) heart disease and hypertension
o Release of cortisol Galactorrhea
_____________________________________________ inappropriate production of breast milk
due to hypersecretion of PRL
Types of cells
symptoms:
Acidophils: GH, PRL
o irregular menstruation
Basophils: TSH, FSH, LH, ACTH
o menopausal symptoms
Chromophobes
o milk discharges
_____________________________________________
o difficulty in getting erection
Posterior Pituitary Gland o breast tenderness and
Hormones: enlargement
Oxytocin or pitocin:
Amenorrhea
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
absence of menstrual cycle in females Infarction
due to hypersecretion of PRL Infection
Familial
Impotence Idiopathic
inability to attain penile erection in Monotropic hormone deficiency
males Laboratory Measurement of Some
due to hypersecretion of PRL
Hormones Secreted by the Pituitary
Gland
Infertility
Sandwich ELISA
lack of FSH and LH in both male and
o Capture Ab Assay diluent Std
female
and Samples Detection Ab
inability to conceive after 1 year of
Avidin HRP Substrate Stop
unprotected intercourse
solution
o Read at absorbance at 450nm
Cushings disease
o Explained by mam basta
hypersecretion of ACTH
mukang sandwich
leads to bilateral adrenal hyperplasia
Indirect ELISA
and cortisol overproduction
o Antigen coating Diluted
Obesity!!
Samples Detection Ab +
enzyme Substrate
o Read at Absorbance 405nm
Addisons disease
secondary (ACTH) or tertiary (CRH)
adrenal insufficiency Growth Hormone Immunoassay
hyposecretion of glucocorticoids and uses specific GH antibody
aldosterone draw specimens every 20-30 minutes
over a 1224 hours period
Polyuria Insulin tolerance test: to produce
deficient ADH production or action hypoglycemia and provoke GH release
o Hypothalamic DI Basal: 2-5 ng/mL or ug/L
o Nephrogenic DI Insulin tolerance: >10 ng/mL
o Psychogenic or primary Arginine/L-dopa: >7.5 ng/mL
polydipsia

Syndrome of Inappropriate ADH hGH-EASIA

Secretion (SIADH) solid phase Enzyme Amplified
autonomous sustained production of Sensitivity Immunoassay
AVP in the absence of known stimuli Mab 1-hGH-Mab-HRP
for its release absorbance is measured after
malignancy, CNS diseases, pulmonary colorimetric reaction
disorders drug therapies Day: <0.2-10 uIU/mL
Decreased: Night: 30 uIU/mL
Urine volume
Increased: Prolactin Immunoassay
Sodium concentration homologous competitive binding
Urine osmolality immunoassay/sandwich technique
uses two or more antibodies
Hypopituitarism directed at different parts of the
o Panhypopituitarism PRL molecule
Tumors hook effect
Trauma Adult male: 3-14.7 ng/mL or ug/L
Radiation therapy Adult female: 3.8-23 ng/mL or ug/L
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
Pregnancy, 3rd tri: 95-473 ng/mL Luteinizing Hormone ( LH) 2-18 mIU/ml
Follicle Stimulating Hormone ( FSH): 2-
ACTH Immunoassay 18 mIU/ml
measures the amount of Estradiol ( Day 3): <50 pg/ml
adrenocorticotropic hormone (ACTH) in
blood Fertility test (female)
like chemiluminescence and ELISA
Phase of Cycle
using ACTH antisera related test:
Hormone Follicular Day of LH Surge
cortisol
FSH < 10 mIU/ml> 15 mIU/ml
reacts with intact ACTH and ACTH
LH < 7 mIU/ml > 15 mIU/ml
fragments
PRL < 25 ng/ml
o Adults: 5-80 pg/mL (X 0.22=
pmol/L)
FSH: measures your ovarian
o Specimen: P, EDTA
reserve (ovarian function)
low levels of FSH & LH:
ACTH Stimulation Test
hypogonadotropic hypogonadism
cosyntropin test or tetracosactide test
high LH with a normal FSH level:
small amount of synthetic ACTH is injected,
PCOD (polycystic ovarian disease)
and the amount of cortisol or Aldosterone is
high prolactin: hyperprolactinemia
measured
distinguish whether the cause is adrenal
Hormone Follicular Day of LH Surge
(low cortisol and aldosterone production) or
Estradiol < 50 pg/ml > 100 pg/ml
pituitary (low ACTH production)
Progesterone < 1.5 ng/ml > 15 ng/ml
Fasting (8 hrs)
estradiol: rises as follicle matures
mature follicles: > 200-300 pg/ml of
estradiol; for monitoring superovulation
LH Ovulation Dipstrip Urine Test
P >15 ng/ml about 7 days after ovulation:
coloured bands will appear on the test
corpus luteum is functioning normally
card to indicate whether or not the LH
low Day 21 P suggests the cycles was
surge is occurring
anovulatory
presence of two purple bands of
similar color and intensity indicate an
Serum FSH Measurement (IRMA)
increase in LH is detected
measures the amount of follicle
- test approximately the same
stimulating hormone (FSH) in blood
time each day
Mab1-serum-Mab2125I
- reduce liquid intake two hours
used to assess and manage disorders
before testing
of the endocrine glands, including
suspected infertility
LH Immunoassay (EIA/IRMA)
related tests: LH, PRL, testosterone,
Mab1-LH-Mab2HRP
estradiol
o measured using chromogenic
Normal Values for serum FSH
reaction
Female, menstruating:
o Absorbance proportional to LH
o Follicular phase: 1.4-9.9
concentration
mIU/mL (IU/L)
Mab1-LH-Mab2125I
o Ovulatory phase: 0.2-17.2
mIU/mL (IU/L)
Fertility test (male)
o Luteal phase: 1.1-9.2
Semen analysis
mIU/mL (IU/L)
Testosterone 300-1100 ng/dl
Postmenopausal: 19.3-100.6 IU/L
Prolactin 7-18 ng/ml
Male: 1-15.4 mIU/mL (IU/L)
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
Iodine deficiency
ADH Measurement
measures the amount of antidiuretic Myxedema
hormone, or vasopressin, in blood hypothyroidism during the adult years
Related tests: sodium and osmolality
270-280 mOsm/kg: <1.5 pg/mL (<1.4 pmol/L) Hashimotos disease
280-285 mOsm/kg: <2.5 pg/mL (<2.3 pmol/L) *eyes popping out*
285-290 mOsm/kg: 1-5 pg/mL (0.9-4.6 pmol/L)
acquired hypothyroidism in later childhood
290-295 mOsm/kg: 2-7 pg/mL (1.9-6.5 pmol/L)
295-300 mOsm/kg: 4-12 pg/mL (3.7-11.1 due to development of autoantibodies to
pmol/L) thyroid tissue components
_____________________________________________
Goiter
Thyroid Gland an enlarged thyroid gland which is a
located in front of the lower neck symptom of many thyroid disorders
bow tie or butterfly like
Follicles: structural units of thyroid Graves Disease
Colloid: homogenous viscous fluid hyperthyroidism which is an autoimmune
consisting mainly of a glycoprotein disorder
iodine complex called thyroglobin hypersecretion of thyroid stimulating
secretes T3 and T4 and calcitonin immunoglobulins (TSIs)
_____________________________________________
Laboratory Measurement of Some
Hormones Secreted by the Thyroid
Gland
Types of cells:
Follicular cells: T3 and T4
o calorigenesis & O2 consumption Serum Free Triiodothyronine
o CNS activity and brain measures the amount of free
development triiodothyronine (T3) in blood
o Cardiovascular stimulation, used to evaluate and manage
bone and tissue growth and disorders of the thyroid gland
development related tests: TSH, FT4
Adults: 1.4-4.4 pg/mL (0.22-6.78 pmol/L)
o GI regulation and sexual N>37 weeks (cord blood): 15-391 pg/dL (0.2-6
maturation pmol/L)
Perifollicular cells: Pregnancy, 1st: 211-383 pg/dL (3.2-5.9 pmol/L)
Pregnancy, 2nd: 196-338 pg/dL (3-5.2 pmol/L)
o calcitonin Pregnancy, 3rd: 196-338 pg/dL (3-5.2 pmol/L)
o regulation of calcium
T3 and T4 Direct Equilibrium Dialysis
Hormone Bound ( Alb,glb) Free uses undiluted serum dialyzed for
T3 99.8% 0.2% 16-18 hours at 37C
T4 99.98% 0.02 dialysate is then analyzed directly
T3: Globulin and albumin only using RIA
T4: albumin(10%) pre albumin(30%: TBPA) 2-128 ng/L (2.6 to 165 pmol/L)
Globulin(60%:TBG)
_____________________________________________ Ultracentrifugation
DISEASES ASSOCIATED WITH serum is adjusted to pH of 7.4
HORMONES OF THE THYROID GLAND incubated for 20 minutes at 37C
ultracentrifuge for 30 minutes at 37C
Cretinism and 2000 rpm
hyposecretion of thyroid hormones during ultrafiltrate is analyzed by
fetal life or infancy immunoassay
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
less time consuming than dialysis Other Laboratory Tests:
RAI uptake:
Triiodothyronine Measurement based on the ability of the
measures the level of total T3 in blood thyroid to concenrate, convert and
used to evaluate and manage release I2
thyroid dysfunction, including TBI:
hyperthyroidism based on the thyroid hormone
related tests: FT4, T3 uptake transport system indirectly
Adults: 60-181 ng/dL (0.92-2.78 nmol/L) measuring the amount of TBG
Pregnancy (last 5 mos): 116-247 ng/dL PBI:
(1.79-3.8 nmol/L)
based on thyroid hormone
concentration representing the
Serum Total T4 Competitive Immunoassay
organic fraction of blood iodine that
measures the total amount of
thyroxine/T4 (both free and CHON precipitates with serum proteins
BMR:
bound)in blood
uses barbital buffers (vs TBPA) and 8- based on metabolic response
anilino-1naphthalene-sulfonic acid (vs measuring the O2 consumption in
TBG) the resting fasting state
Adults: 4.5-10.9 g/dL (58-140
nmol/L) Parathyroid Gland
four tiny glands attached to the thyroid
TSH Immunoassay releases PTH
o actions directed to bone, kidney
measures the amount of thyroid
stimulating hormone (TSH) in blood and intestines
o controls calcium and phosphate
using chemiluminescence w/ low detection
limit metabolism with the help of
related tests: T3 and T4 calcitonin
Types of cells:
Adults: 0.5-4.7 units/L
Chief cells Synthesis and secrete
Pregnancy (1st): 0.3-4.5 units/L
hormone PTH
Pregnancy (2nd): 0.5-4.6 L
Oxyphil cells non secretory cell
Pregnancy (3rd): 0.8-5.2 L - Seen only after puberty
_____________________________________________
Anti-TSH Receptor Autoantibody
for diagnosis of Graves disease DISEASE ASSOCIATED WITH HORMONES
detects autoantibodies that interfere
OF THE PARATHYROID GLAND
with the binding of TSH to TSH
receptor
Clinical significance of PTH
serum + TSH receptor + I125 labelled
Tetany:
TSH tracer amount of free tracer is
hypoparathyroidism and deficiency of
measured
calcium
lower than 9 U/L
abnormally high PTH values may indicate
Thyrotropin Releasing Hormone (TRH)
primary, secondary, or tertiary
Stimulation Test
hyperparathyroidism, chronic renal failure,
injection of TRH and measurement of the
malabsorption syndrome, and vitamin D
output of TSH
deficiency
used in the diagnosis of combined
pituitarythyroid disorders
Laboratory method for PTH:
differentiates 2 hypothyroidism and 3
PTH level measurement:
hypothyroidism o overnight fasting
_____________________________________________ o Intact PTH: 10-65 pg/mL
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
o PTH N-terminal (includes intact PTH):
Sex hormones/Androgenic steroids
8-24 pg/mL Estrogen, progesterone,
o PTH C-terminal (includes C-terminal,
intact PTH, and midmolecule): 50-330
dehydroepiandrosterone (DHEA),
pg/mL androstenedione, and testosterone
related tests: Calcium, Phosphorus and Male: development of sexual
Creatinine characteristics, usually insignificant
Female: influence female sex drive,
ADRENAL GLAND pubic hair, axillary hair growth
a triangular gland on top of the Hormones
kidney Epinephrine (70%)
Adrenal cortex - Norepinephrine (30%)
o regulates salt & water balance, Dopamine
responds to stress, metabolism, mobilize energy stores and prepare
immune system, & sexual the body for muscular activity and
development & function stressful conditions (increase heart
Adrenal medulla rate and BP, and increase blood sugar)
consists of Chromaffin cells Urinary metabolite: vanillyl mandelic acid
produces catecholamines from (VMA)
tyrosine _____________________________________________
DISEASES ASSOCIATED WITH
Hormones: HORMONES OF THE ADRENAL GLAND
Outer zone (zona glomerulosa): Hyperaldosteronism
o mineralocorticoids (aldosterone) hypersecretion of aldosterone
Middle zone (zona fasciculata): 1: due to an adenoma, hyperplasia,
o glucocorticoids (cortisol and adrenal carcinoma, glucocorticoid
cortisone) regulate CHO, CHON, suppressible aldosteronism
and fat metabolism o greatly affects electrolyte
Inner zone (zona reticularis): balance
o sex hormones 2: stimulus outside the adrenal gland

Mineralocorticoids (aldosterone) Hypoaldosteronism

responsible for fluid and electrolyte deficient aldosterone production
balance seen in Addisons disease, kidney disease-
sodium reabsorption and water retention 2 (hyporeninemic hypoaldosteronism),
maintain osmolality enzyme defects, acquired due to heparin
therapy or surgery

Glucocorticoids (cortisol & cortisone)

enhances glucose production from Cushings syndrome
CHONs, acting as insulin antagonist hypersecretion of cortisol
(cortisol) only hormone to inhibit the due to primary adrenal disease like
anterior pituitary secretion of ACTH by adenoma features: truncal obesity, moon
negative feedback face, hypertension, hirsutism
(cortisone): reacts with stress
stimulate lipolysis, provide resistance Addisons disease
to stress and depress immune primary adrenal insufficiency
responses due to progressive dysfunction or
urinary metabolite: 17- destruction of the gland
hydroxycorticosteroids
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
symptoms: fatigue, weakness, weight o upine, low-Na diet: 2 to 5x
loss, GI disturbances, postprandial supine value
hypoglycemia o
hyposecretion of adrenal hormones Urine Free Cortisol Measurement (UFC)
measures the amount of cortisol in
Congenital Adrenal Hyperplasia urine
(Adrenogenital Syndrome) 24-hour urine collection
congenital absence or deficiency of avoid drinking alcohol before and
one or more of the biosynthetic during the urine collection
enzymes needed in cortisol normal: <2% of cortisol is seen urine
biosynthesis >120 g/day is diagnostic
hyperplasia: ACTH stimulation because o RIA (adults): 20-70 g/day
of low levels of cortisol (55-193 nmol/24 hrs)
ambiguous genitalia for girls, and o HPLC (adults): 50 g/day
precocious puberty for boys (138 nmol/24 hrs)

Virilism or hirtuism Serum Cortisol Measurement

elevated plasma testosterone in amount of cortisol in blood
women as a result of ovarian or used to help diagnose adrenal gland
adrenal tumor (virilizing adenoma) dysfunction caused by conditions such
as Addison's disease and Cushing's
Gynecomastia syndrome
excessive growth (benign) of the male related test: ACTH
mammary glands due to an adrenal pregnancy (FE)
tumor (feminizing adenoma) which 8 AM to noon: 5-25 g/dL (138-
secretes feminizing hormone 690 nmol/L)
(estrogen) 8 PM to 8 AM: 0-10 g/dL (0-276
nmol/L)
Pheochromocytoma
tumor of the adrenal medulla that is a Dexamethasone Suppression Test
cause of hypertension 1 mg at midnight
serum cortisol is measured the following
Neuroblastoma day (8:00 AM)
fatal malignant condition in children in suppressed to <5 ug/dL or 140 nmol/L
which cancer of the nervous system
causes excess production of ACTH Stimulation test
norepinephrine Cosyntropin test
_____________________________________________ evaluates the hyposecretion of
Laboratory Measurement of Some adrenal gland
Hormones Secreted by the Adrenal exogenous ACTH is administered
Gland cortisol should be increased by
measures the amount of aldosterone twofold to threefold within 60
in blood minutes
related tests: sodium and potassium
test is done in the morning
position affects the result: seat upright
Adrenal antibody test
alcohol intake
detects antiadrenal antibodies,
o supine, normal-Na diet: 2-9
which attack the body's own
ng/dL (55-250 pmol/L) adrenal gland, in blood
o upright, normal-Na diet: 2 to 5x
supine value
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
used to diagnose and monitor o Adults: 0.5 - 2.0 ng/mL
patients suspected to have (0.17 - 0.66 nmol/L)
autoimmune adrenocortical
insufficiency
related test: ACTH Anti-Insulin Antibody Test (RIA)
o Adults: Negative at 1:10 measures the amount of antibodies to
dilution insulin
_____________________________________________ used when insulin resistance in diabetes is
Pancreas suspected
lying immediately beneath the determination of the binding of 125I-Tyr-
stomach Al4- insulin to the serum fraction precipitated
both an exocrine and an endocrine by PEG
gland related test: Insulin C-peptide
<8.2% binding
Types of tissues:
Acini Glucagon Immunoassay (RIA)
Islets of Langerhans glucagon competes with 125I
tracer for binding sites
Hormones amount of 125I is measured and is
Glucagon: glycogenolysis and inversely proportional to the
gluconeogenesis concentration of glucagon
Insulin: glycogenesis, glycolysis, Fasting: 60-200 pg/mL
lipogenesis
Somatostatin Gonads
main source of sex hormones
Diabetes mellitus Testes: androgens (testosterone)
deficiency of insulin or defects in insulin sexual development (muscle
receptors enlargement, growth of body hair,
voice changes, male sexual drive)
Hyperinsulinism
hypersecretion of insulin Ovaries: located in the pelvis
may be due to a tumor, insulinoma secrete estrogen and progesterone and
relaxin
Glucagonoma for sexual development (breast
hypersecretion of glucagon by a enlargement, distribution of
tumor fats), menstruation, pregnancy
_____________________________________________
Somatostatinoma Diseases associated with Hormones
hypersecretion of somatostatin by a secreted by Gonads
tumor
_____________________________________________ Female Pseudohermaphroditism
Laboratory Measurement of some genetically female but whose
hormones secreted by the Pancreas phenotypic characteristics are,
to varying degrees, male
Insulin C-peptide Measurement exposure to androgens before
measures the level of a by-product the 12th week of gestation
of the hormone insulin called C-
peptide in blood Precocious Puberty
used to know how much insulin is development of secondary
being produced in the body sexual characteristics in girls <
fasting specimen 8 yrs old and boys < 9 years old
CC: Endocrinology Second Semester16Prepared by: Peter Limjoco David
premature hair and breast _____________________________________________
development

Kallmann Syndrome
most common form of
hypogonadotropic
hypogonadism due to deficiency
of GnRH
both seen in males and females

Testicular Feminization Syndrome Thymus Gland

Androgen insensitivity lies in the upper part of the thoracic cavity
syndrome important in the immune system,
defect in androgen action especially early in life
males w/ female habitus & secretes thymosin
develop breast tissue helps in the development of WBCs (T
blind vagina with rudimentary cells)
testes
_____________________________________________ Pineal Gland/Body
Laboratory Measurement of some small pinecone shaped located in the
hormones secreted by the Gonads middle of the brain
secretes melatonin
Estrone Measurement decreases the secretion of LH and
measures the amount of estrone in blood FSH by decreasing the release of
note pregnancy and menstruation hypothalamic releasing hormone
Pregnant: increases 10-fold (inhibits functions of reproductive
from 24th to 41st wk system)
Progesterone RIA plays an important role in the onset
Mab1-Progesterone-Mab2125I of puberty
regulates sleep and wake cycle
Serum Estradiol Measurement
used for conditions such as amenorrhea,
early puberty or hypogonadism
related tests: FSH, LH, testosterone, PRL

Total Testosterone EIA

measure the total amount of testosterone
uses salicylates or sulfactants, pH
alterations, temperature changes, and
competing steroids
related tests: FSH, LH, PRL, free
testosterone
RIA (125I)