Endocrinology is a branch of medicine that concerns the study of hormones and its disorders. The endocrine system consists of several glands located in different parts of the body that secrete hormones.

Endocrinologists are doctors who specialize in study of hormonal diseases like diabetes, thyroid disorders, obesity, growth disorders, etc.

The principal endocrine glands in our body are Pituitary, Thyroid, Pancreas, Adrenal, Parathyroid, and Gonads – ovary and testis. Besides hormones are secreted by various other organs like brain (hypothalamus), heart, kidney, gut, placenta, breasts, etc. The pituitary is considered as a master gland and governs the function of other endocrine glands in the body.

These are products of various endocrine glands, which are released in to the bloodstream, which then acts on various cells and tissues of body.

The endocrine disorders are a varied group of diseases resulting from deficiency or excess of various hormones.

1).Diabetes

2).Thyroid disorders

3).Obesity

4).Sexual disorders, erectile dysfunction, hypogonadism & reproductive endocrinology

5).Male infertility

6).Hirsutism (Excessive facial or body hair in females)

7).Polycystic ovary syndrome (PCOS) and other female endocrine disorders

8).Disorders of growth – Short Stature, Growth hormone deficiency & Growth hormone excess.

9).Delayed & premature puberty (delayed or early development of various secondary sexual characters in boys or girls).

10).Osteoporosis (low bone density)

11).Metabolic bone diseases - Vitamin D deficiency, Rickets, Osteomalacia, Hyperparathyroidism

12).Pituitary disorders - pituitary tumors, raised pituitary hormone levels (e.g. Prolactin, GH, etc.), deficiency of pituitary hormones, diabetes insipidus

13).Adrenal disorders - Adrenal tumors, Cushing’s syndrome, Pheochromocytoma, adrenal failure

14).Disorder of Sexual Development - Small penis, hidden testis, genital ambiguity, gynecomastia (development of breast tissue in males), Turner’s syndrome, Klinefelter’s syndrome.

1).Type 1 Diabetes: Type 1 Diabetes develops if the body is unable to produce any insulin. This type of diabetes usually develops before the age of 30 years. Type 1 Diabetes is treated with daily insulin injections, a healthy diet and regular physical activity.

2).Type 2 Diabetes: Type 2 Diabetes develops when the body can still make some insulin, but not enough or when the insulin that is produced does not work properly (known as insulin resistance). Type 2 diabetes is treated with a healthy diet and increased physical activity. In addition to this, medications and/or insulin are often required.

3).Gestational Diabetes: Gestational diabetes develops in 5% to 10% of all pregnancies but usually disappears when the pregnancy is over. Women who have had gestational diabetes are at an increased risk (up to 50%) of developing type 2 diabetes later.

Indians in general are more predisposed for developing Diabetes. In addition, other risk factors are:

1).If any of your close family member has diabetes (parent, brother or sister)

2).Overweight or obese (Body mass index more than 23)

3).Habitual physical inactivity

4).Women who delivered a baby weighing >3.5 kg or were diagnosed with diabetes during pregnancy

5).High blood pressure

6).Those with high blood cholesterol

7).Women with Polycystic ovary syndrome (PCOS)

8).Heart disease patients

When a child is diagnosed with type 1 diabetes it not only affects the child’s life but the family as a whole. The process of learning about diabetes and making adjustments continues for a long time, may be years and in this journey many times one question arises, “why does my child has type 1 diabetes” or a teenager may think, “why do I have diabetes”? Type 1 diabetes is not caused by wrong eating habits or lifestyle nor is it a sin or punishment. The question still remains unanswered as to why some children get it. The answer to this question is not as important as is the fact that with the help of regular insulin injections, proper monitoring and incorporation of nutritious foods and physical activity into each day, one can enjoy a relatively normal, healthy life. Every day technology for taking insulin is changing. Now we have finer thin and small needles, which are almost painless. We have smart glucose monitoring devices and somewhere research to find a cure is making progress. While we are not there yet, in our vision of changing diabetes we always hope to find a cure for type 1 diabetes.

1).Frequent urination

2).Increased thirst

3).Sudden weight loss

4).Increased hunger

5).Always tired

6).Wounds that won`t heal

7).Blurring of vision

8).Sexual problems

9).Vaginal infection

10).Tingling or numbness in hands or feet

Majority of diabetics in fact do not have any symptoms. After the age of 45 years all people should get their blood sugar checked routinely even in the absence of symptoms and risk factors. If your blood sugar is normal you should get it checked every 3 yearly.

You need to get your blood sugar checked in fasting as well as 2 hours after taking 75gms of glucose. You should consult your doctor for all precautions & information prior to testing.

Poorly managed diabetes can lead to various complications like blindness, kidney failure, neuropathy, heart attack, paralysis, sexual and urologic problems. Although diabetes cannot yet be cured, it can be successfully managed. In order to stay away from complications, it is important that your blood glucose is adequately controlled. Eating a balanced diet, managing your weight and following a healthy lifestyle together with taking your prescribed treatment and regular monitoring is important.

*Every visit - blood glucose, blood pressure, foot examination.

*3 monthly - HbA1C (Glycated hemoglobin)- This test gives estimate for average blood sugar control over past 3 months

*Yearly - Kidney function test (KFT), lipid profile, fundus for diabetic retinopathy, urine for mirco albumin.

*Pre meal blood sugar- 70–130 mg/dL

*Post meal blood sugar- <180 mg/dL

*HbA1C (Glycated hemoglobin)-

*Blood pressure- <130/80 mmHg

*LDL cholesterol-<100 mg/dL

A thyroid gland is an endocrine gland; which manufactures thyroid hormone that is essential for the function of every tissue in the body.

The thyroid gland is located in the lower part of the neck.

The thyroid gland produces thyroid hormones which it secretes into the bloodstream, which then act to affect cells and tissues in other parts of the body. Thyroid hormones regulate the speed at which your body cells work. Thyroid hormones also help children grow and develop

Hypothyroidism (underactive thyroid gland)

Hyperthyroidism (overactive thyroid gland)

Goiter (enlargement of thyroid gland, visible as neck swelling)

Thyroid malignancy (cancer of thyroid gland)

Hypothyroidism means that the thyroid gland can`t make enough thyroid hormone to keep the body running normally.

Most cases of hypothyroidism are caused by a condition called Hashimoto's thyroiditis, in which a patient's immune system attacks and destroys the thyroid. Iodine deficiency used to be a common cause in India but after iodized salt became widely available has now become rare. It can also be caused by treatment of hyperthyroidism or by certain medications, and it may be present from birth.

Common complaints include fatigue and lethargy, cold sensitivity, dry skin and lifeless hair, impaired concentration and memory, increased weight, puffiness and constipation. Patients may also fairly often experience a hoarse voice, tingling of the hands, heavy or delayed menstrual periods, deafness and joint aches. In childhood there may be delayed development and puberty. Some patients have a swelling in the front of the neck due to thyroid enlargement (a goiter).

Yes. Many patients have relatively few of the classical signs or symptoms just listed. In fact, nowadays most patients often are diagnosed at an early stage of disease, due to increased awareness and improved testing

Your doctor will be able to get a good assessment of your thyroid gland activity by taking a history of your symptoms and by a physical examination. However to confirm the diagnosis, it is necessary to get laboratory tests that measure thyroid function test (TFT; serum T4 and TSH levels).

With synthetic thyroxine (T4). Thyroxine (T4) is the major hormone produced by the thyroid gland and pure synthetic T4, taken once daily by mouth, successfully treats the symptoms of hypothyroidism in most patients. The current branded forms of synthetic T4 are Eltroxin, Thyronorm, Thyrox, Thyroup, Thyrofit,Thyobuild, Lethyrox, Thyrocheck etc. Because of variations in the potency of T4 made by different manufacturers, including generic preparations, it is best to stay on T4 from a single manufacturer whenever possible.

It depends on diagnosis. It can be a few months as in case of viral thyroiditis. However, in most cases, you may have to take treatment lifelong so as to keep your hormone levels in normal range.

If you are not taking enough T4, some of the symptoms of hypothyroidism may continue. If you take too much, you may have symptoms of an overactive thyroid, including nervousness, a racing heart, trouble sleeping, and shaking. You should get repeated your thyroid function test as per advice of your doctor.

If too much of the thyroid hormones are secreted, the body cells work faster than normal, and you have thyroid overactivity or 'hyperthyroidism' (also referred to as "thyrotoxicosis").

Common complaints include fatigue, heat intolerance, sweating, weight loss despite good appetite, shakiness, inappropriate anxiety, palpitations of the heart, shortness of breath, tetchiness and agitation, poor sleep, thirst, nausea and increased frequency of defecation, enlarged thyroid gland and prominent or bulging eyes. Children tend to have hyperactivity, with a short attention span. It is not uncommon for people to worry that they have cancer, because of the associated weight loss.

Goitre is an enlargement of the thyroid Gland, which is situated in front of the neck. In many cases it is related to abnormal thyroid hormone levels.