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Introduction to endocrinology&

endocrine function tests.

Dr. Mahmudul Huque

Endocrinologist

Department of Medicine

Holy Family Red Crescent Medical College

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Introduction to endocrinology & endocrine function tests.

Hormones:

Signaling bio-molecules - Proteins, steroids or

amines, regulates subcelluler events: inconjunction with N/S regulate organs.

Axis:

1. Hypothalamus Pituitary 7 In number

Detail target organs endo. Gland

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2. Direct metabolic signals pancreas & PTH

Nature:

Mode of action: Nuclear

Classification of endocrine diseases hormone

excess / Deficiency / Hypersensitivity / Resistance

/ Tumour example: Thyroid Gland

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Hormonal mechanism of action

Signaling bio-molecules - Proteins, steroids oramines, regulates subcelluler events: in

conjunction with N/S regulate organs.

1. Lipophilic hormones intra cellular receptors

2. Hydrophilic hormones extra cellular receptors

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1. HRC HRE ( element) DNA (derepression) Protein synthesis

for example: All steroid hormones

2. 2nd messengers: CAMP Releasing hormones PTH. Calcitonin

CGMP ANP by DNA or other effect

Ca ++1

Phosphatidyt inositol GnRH, TRH catecols.

Unknown Insulin, GH, PRL

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Endocrine function tests

Basal hormone measurement

Only florid or advanced cases.

Normal range is wide. False (+) and False (-ve)

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Steps of hormone assessment in

preclinical stage with greater accuracy

1. Serial hormone measurement.Diurnal variation

Nocturnal surge / Excludes

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(2) Paired measurement Axis Based

e.g. TSH, FT4 / PTH, calcium

LH, testosterone / ACTH, Cortisol Glucose / Insulin

Appropriate in detecting Deficiency, ectopic, resistance,

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Dynamic tests

For subtle lesions

Suppression / Stimulation of endogenousHormone production

Stimulation tests to see hypo-function

Stimulatory agent Tropic hormone Target gland stimulation

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Organs Stimulus Measured Response

Adrenal ACTH / Upright postums Cortisol / Renin,

Aldosterone

Gonads HCG Testosterone

Hypothalamo/ Pituitary Hypoglycemia GH, ACTH

L - DOPA, Exercise /

Clonidine

GH

Pituitary TRH, GnRH, CRF Trophics

Thyroid TSH T4 T3 uptake

Pancreas Glucose Insulin

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Suppression tests

To sec hyper function & negative feedback

control.

Administered a hormone or regulatory substance &

suppression of endogenous hormone production is

assessed.

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Commonly used suppression tests

Glands Agents Measured Response

Adrenal Dexmclhasomc Cortisol

Saline Renin / Advsterne

Thyroid T4 / T3 TSH, Radioiodine uptake

Hypothalamic pituitary Glucose GH, ACTH

Pancreas Fasting Glucose / Insulin

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Endocrine investigation sheet

History -

Wt

HT

Arm span

Upper segment

Lower segment of body

Testicular volume, SPL

Hair distribution / Breast staging

Pigmentation / Striae

General & Neruous sygleis in detcil

Primary and secondary, disorders

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Thank You All