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Chapter 14 - Endocrine Gland Symptoms Endocrine Gland Symptoms Chapter contents A) Overview of endocrine glands B) Thyroid symptoms C) Hashimoto’s thyroiditis D) Grave’s disease A) Overview of endocrine glands In our modern world we use telephones, computers, shortwave radios, and many other tools to communicate with one another anywhere in the world. Our bodies, too, require communication tools; both for managing their own “inhouse” messaging system as well as to communicate with one another. This communication begins within the cell itself (Section XII, chapter 1) and reaches all the way to the top—the cells of the brain. By using both electrical and chemical (hormones) messengers, the brain is able to influence specific sites, or the body as a whole. The following list includes some of the more common hormone producing endocrine glands. 1 / 12 Chapter 14 - Endocrine Gland Symptoms 1. Hypothalmus (a specialized center in the brain) The hypothalamus is an area in the brain that makes a number of “releasing” hormones that direct the pituitary gland, telling it how much of the various hormones to produce and release into the circulation. 2. Pituitary gland, front and back portions The pituitary gland is a small gland located in a saddle of bone behind the eyes. It is often known as the “master gland” of the body, serving to drive (or regulate) most of the other glands of the body—and is largely responsible for normal growth. The posterior (back) portion of the pituitary gland produces hormones that manage water balance and control tension in the blood vessels, thus helping to maintain correct blood pressure. 3. Pineal gland The pineal gland is a small gland located near the center of the brain. It is affected by light and darkness and plays a role in regulating sleep and other functions. 4. Thyroid gland The thyroid gland is located in the neck just below the voice box. It produces chemicals that regulate body metabolism. Excessive amounts of thyroid hormone speed all of the body machinery into high gear, and insufficient amounts slow everything down. Calcitonin, one of the hormones produced in the thyroid gland, aids in making strong bones. 5. Parathyroid glands 2 / 12 Chapter 14 - Endocrine Gland Symptoms There are usually four parathyroid glands. They are located in the neck near the thyroid gland. They function to regulate calcium balance in the body. 6. Adrenal glands, the central core and the cortex An adrenal gland is present at the top of each kidney, like a cap. It has a central core and an outer cortex (a thick wall). Adrenalin, a hormone produced in the core (center) of the adrenal glands, stimulates those functions that raise the pulse and blood pressure and other functions necessary to deal with emergencies—preparing one to escape potential danger. Steroid hormones, cortisone, etc., are produced in the cortex (outer portion of the gland). They regulate the metabolism of carbohydrates, proteins and fat as well as salt and water. Cortisone and other steroid compounds are sometimes used as medicine to reduce inflammation. 7. Insulin-producing beta cells in the pancreas Scattered throughout the pancreas are small clusters of cells, known as beta cells that produce insulin. Insulin helps to regulate blood sugar levels. 8. Sex glands, ovaries, testicles The ovaries and testicles produce hormones that control sexual physical characteristics and reproductive functions. 3 / 12 Chapter 14 - Endocrine Gland Symptoms 9. Placenta Even the placenta, the baby’s place of attachment to the mother’s womb, produces hormones that support the growth and development of the baby. 10. Other In addition to these, there are many organs or groups of cells that produce hormones in conjunction with their other functions. We might note a few, for example, the hormone, gastrin, is produced in the stomach, secretin, in the small bowel, cholecystokinin, by the gall bladder and renin and erythropoietin by the kidneys. Many other normal cells produce many additional hormones. Even some cancer cells produce hormones, some of which mimic the action of our normal hormones. It is interesting to note how the endocrine system works. Messages arrive at the brain via nerve pathways or as hormones in the blood. When received by the specialized cells of the hypothalamus, specialized clusters of cells produce specific hormones that are then carried to the pituitary gland where they instruct the pituitary gland what to produce, when, and how much. With this information, the pituitary releases its cargo of chemical hormones into the bloodstream to do their work. Known as the “master gland” of the body, specific hormones from the pituitary gland stimulate the various other glands. One pituitary hormone directs the thyroid gland to produce more thyroid hormone. Another gives the adrenal gland a “kick,” instructing it to turn on the cortisone hormones. Several other pituitary hormones talk to the ovaries and testicles, telling them it is time to boost their activity. So it is with all of the glands of the pituitary axis. In turn, blood levels of the hormones produced by the glands are monitored in the brain, providing it with information necessary to keep all of the glands working in harmony throughout the body. B) Thyroid The thyroid is a dumbbell-shaped, glandular organ positioned to lie in the neck immediately below the voice box. Normally it blends into the structures of the neck so well that it is not even noticed. It produces a hormone (a chemical substance) that regulates the speed at which the body clock (and hence the functions of the body) runs, much like the adjuster on a clock speeds up or slows down a clock. 4 / 12 Chapter 14 - Endocrine Gland Symptoms A number of things determine how well the thyroid does its job: A deficiency of iodine, a key ingredient in the thyroid hormone, causes the gland to enlarge in an attempt to compensate for the loss. This is the reason people get goiters who live in places where iodine is in short supply in the food. Goiters are nothing more that enlarged glands—sometimes very large. In many places of the world, this is the most common cause of an enlarged thyroid gland. Sometimes, things happen in the body that turn the adjustment knob on the thyroid clock and speeds it up, causing it to produce toxic amounts of hormone. When this happens the body functions are made to go much faster than normal in what is commonly known as thyrotoxicosis. The cause for this condition is usually not known, but stress seems to be a factor for some. At other times, things happen to slow the clock way down. Sometimes the body’s immune mechanism gets messed up, causing it to fight against itself. When the thyroid gland happens to be the target of attack, its hormone-producing cells may be put out of commission, resulting in insufficient production of hormone and sometimes enlargement of the gland. The cause of this warfare against self is not usually known, but virus infections may play a role, and stress often appears to be a contributing factor. When the body clock thus gets slowed down, we end up with just the opposite condition, hypothyroidism, where the body nearly stops functioning. Either of these conditions—too much, or too little—in the extreme can be fatal. Though men are not exempt, thyroid problems are most common in young women of childbearing age. Certain foods are prone to cause goiters (thyroid enlargement), but probably only in people who already have malfunction of the thyroid gland. These foods include all of the cabbage family (cruciferous vegetables contain isothiocyanates) and products made from soybeans (contain isoflavins). Millet, peanuts, peaches, strawberries, spinach, and radishes may also contribute substances that may act to enlarge goiters (goitrogens). 5 / 12 Chapter 14 - Endocrine Gland Symptoms Often, as people age and slow down, the thyroid slows down also. Cancer, non-cancerous tumors and fluid-filled cysts can also involve the thyroid. 1. Symptoms of thyroid disease Symptoms will depend upon the particular process going on with the thyroid. When there is a deficiency of iodine, the thyroid gland enlarges. If it gets large enough, it can place pressure on the esophagus and trachea, interfering with swallowing and breathing. Depending upon the degree of iodine deficiency, the thyroid may not be able to supply sufficient hormone, even in its enlarged size, causing hormone deficiency and signs of hypothyroidism (low thyroid). Symptoms of hypothyroidism (low thyroid hormone) may involve almost all functions of the body. Common symptoms include: tiredness, feeling cold, constipation, swelling of the skin (edema) most noticeable on the legs, sallow color to the skin, thinning of the eyebrows and hair, slowing of pulse and low blood pressure and sometimes, heart failure. Symptoms of overactive thyroid (hyperthyroidism, thyrotoxicosis) are nearly the opposite of hypothyroidism. These include: rapid pulse, warm, moist skin, hunger, weight loss (in spite of a ravenous appetite), diarrhea, fine tremor of the tongue, fine tremor of hands and fingers, nervousness, etc. Frequently the eyes appear to protrude a bit from their sockets and may have associated pain, tears, and visual loss. Cancer of the thyroid may occur at any age. When occurring in the first half of life, the disease seldom kills if adequately treated. When occurring in older people, cancer is often very aggressive and resistant to treatment. Cancer of the thyroid may cause difficulty breathing, swallowing and sometimes hoarseness of the voice. 6 / 12 Chapter 14 - Endocrine Gland Symptoms Non-cancerous tumors and cysts may not cause symptoms, or may cause mild pain, and rarely symptoms of trouble swallowing and breathing. 2. Treatment of thyroid deficiency symptoms Patients with goiter due to iodine insufficiency need iodine supplementation. This may be administered as sea salt, kelp, saturated solution of potassium iodide, 2–3 drops daily by mouth, or as thyroid hormone tablets. They ought to limit the intake of goitrogentic foods (as listed above). (Note: Cooking reduces the amount of goitrogenic substance in the foods.) Low thyroid symptoms may be treated the same as goiter, but most people will need thyroid hormone-supplement tablets. This must be started at a very low dose and gradually increased for persons with severe deficiency. As with all illness, one has much to gain by adhering to the HEALTH SMART principles (Section VI, chapter 1). Non-cancerous tumors and cysts need no treatment unless symptomatic. If symptomatic, they may be aspirated with a needle and syringe or surgically removed. 3. Indications for professional help Slow and careful treatment with thyroid hormone supplement for persons with severe hypothyroidism (low thyroid) is best done with professional help. Thyroid cancer is an indication for professional help. 7 / 12 Chapter 14 - Endocrine Gland Symptoms 4. Treatment when professional help not available Supplemental thyroid hormone should be used daily in persons who have all of the findings of low thyroid output. There is no known substitute for thyroid hormone supplement for one whose gland is not producing it. C) Hashimoto’s thyroiditis This is a chronic form of inflammation of the thyroid gland associated with infiltration of lymphocytes throughout the gland and eventually destroying most of thyroid hormone production, leading to a hypothyroid status. Antibodies to thyroid peroxidase and thyroglobulin suggest an autoimmune (allergy to one’s self) relationship. 1. Symptoms Symptoms include an enlarged, painless swelling of the gland in the neck. One may occasionally be aware of trouble swallowing or breathing. If untreated during the hypothyroid phase, classic signs will develop and include: fatigue, loss of hair and eyebrows, change in color and texture of skin to edematous, sallow appearance, constipation, and eventually, heart failure and death. There is some increase in incidence of thyroid cancer and lymphoma. 2. Treatment There is little, if any, scientific “proof” that anything will reverse the disease process once begun. However, sufficient evidence does exist to suggest that with the blessing of God, the human body has many very effective healing capabilities. Based upon this evidence, every patient diagnosed with autoimmune disease deserves a careful therapeutic program of HEALTH SMART mana 8 / 12 Chapter 14 - Endocrine Gland Symptoms gement (Section VI, chapters 1 – 10). The amply demonstrated benefits of hydrotherapy, with alternating hot and cold treatments, to the involved area of the neck warrants the use of these treatments on an empirical basis (Section VII, chapter 7, Q). Thyroid hormone replacement therapy is always indicated when one’s own production has slowed down or ceased. Sea kelp contains iodine and may offer help, but careful measurement of hormone levels is necessary if thyroid hormone replacement is not used. (Kelp does not contain thyroid hormone and cannot replace non-existent hormone.) 3. Indications for professional help Patients who are hypothyroid (not producing enough thyroid hormone) need long-term thyroid hormone replacement. Surgical consultation may be indicated in patients with symptomatic enlarged glands, and in anyone whose gland changes over time suggesting possibility of developing malignancy. D) Grave’s disease, toxic goiter or thyrotoxicosis Like Hashimoto’s thyroiditis, Graves’ disease is generally believed to be an autoimmune disorder. Unlike Hashimoto’s disease, in which the autoimmune reaction destroys the thyroid hormone-producing cells and causes hypothyroidism; in Graves’ disease, the antibody is directed against the receptor molecules on the thyroid cells that are stimulated by thyroid-stimulating hormone (TSH) from the pituitary gland in the brain. This causes continuous 9 / 12 Chapter 14 - Endocrine Gland Symptoms and excessive amounts of thyroid hormone (hyperthyroidism) that in turn cause an exaggerated metabolic state. The disorder tends to go into remission and tends to recur at intervals, a thing that may or may not be altered by medical treatment. 1. Symptoms Symptoms of rapid metabolism, (toxicity) include: thyroid enlargement, rapid heart rate, increased intestinal peristalsis (sometimes with diarrhea), fine muscular tremor, weight loss, nervousness, increased appetite, etc. Thyroid storm, a very severe form of thyroid toxicity often has a rapid onset of exaggerated symptoms and may include fever, restlessness, confusion, psychosis and coma, weakness, jaundice, and cardiovascular shock. Death may ensue. Storm tends to occur in untreated or inadequately treated patients who are then subjected to a high stress situation as may occur with injury or trauma, childbirth, surgery, an infection, diabetic acidosis, etc. Two other conditions often accompany Graves’ disease. These are swelling of the shins, (pre-tibial myxedema) and protrusion of the eyes from their sockets, (exopthalmos). The former is not generally a problem. The latter may be, in that it can be an embarrassing cosmetic problem and more importantly, may be a cause of blindness. This accompanying disorder of Graves’ disease may also be an autoimmune phenomenon, but is apparently not due to the same antibody as causes the thyroid malfunction and does not always resolve with treatment of the thyroid disorder. 2. Prevention Graves’ disease is often found in persons, mostly young women, who have recently been under high levels of emotional stress. Whether or not this is a causative factor or rather that, before the disease was suspected or diagnosed, the capacity to deal with stress was already impaired is not certain. In any event, a healthy, God-centered lifestyle is always to be expected to give improved health and to prevent many illnesses (Section VI, chapters 1 – 10) . 10 / 12 Chapter 14 - Endocrine Gland Symptoms 3. Treatment Untreated or unsuccessfully treated, Graves’ disease may lead to complications causing death. There are no proven natural remedies for this disorder, though lifestyle factors are often important. Cabbage and cruciferous vegetables are known to alter thyroid functions and contribute to low thyroid states in normal individuals, but though they have been used—apparently successfully—by some specialists to treat Graves’, there is no well documented scientific support for their use. Excessive hormone production (hyperthyroidism) may be a life-threatening disorder, and in all but the mildest cases requires professional help in management. 4. Indications for professional help Thyroid storm is always a medical emergency requiring prompt and aggressive management. Graves’ disease, even in its less severe forms has the potential for causing serious complications and deserves adequate control of the toxicity. Failure to respond—or for symptoms to increase while receiving non-medical measures—is a strong indication to seek medical care Iodine, propylthiouracil or methimazole, propranolol (beta-blockers), and corticosteroids all have a place in the management of thyrotoxicosis. Though iodine may be a useful emergency measure, it is not generally advised for extended care because of potential complications. Surgical thyroidectomy or radioactive iodine is sometimes indicated. Vision-threatening exopthalmus (protrusion of eyes) may require treatment with non-steroidal anti-inflammatory medications, corticosteroids, radiation therapy or surgery. 11 / 12 Chapter 14 - Endocrine Gland Symptoms 12 / 12