Endocrinology

ENDOCRINOLOGY

Endocrinology and endocrinologists focus on the hormones, the many glands and tissues that produce them, and how to redress the balance when things go wrong.

Hormones regulate metabolism, respiration, growth, reproduction, sensory perception, and movement. Hormone imbalances can lead to a wide range of medical conditions.

Humans have over 50 different hormones. They can exist in tiny amounts but still significantly affect bodily function and development.

Here, find out why a person might need to see an endocrinologist and some diseases they can help with. Then, read about the different parts of the endocrine system, the hormones they produce, and some health conditions that can arise if they do not function effectively.

What is an endocrinologist?

If a person sees a physician about symptoms of a health problem, the physician may refer them to an endocrinologist. They will do this if they believe the underlying cause may be hormone related.

Endocrinologists are doctors trained to diagnose and manage diseases that affect the glands and hormones. They aim to restore hormonal balance within the body’s systems.

Diseases an endocrinologist can help with

There are three broad groups of endocrine disorders:

• Hyposecretion: A gland does not produce enough hormones.
• Hypersecretion: A gland produces too much of its hormones.
• Tumors: These may be malignant (cancerous) or benign (noncancerous).

A hormonal imbalance can result from genetic or environmental factors.

A person may be born with a genetic feature that affects hormone production, or they may acquire a disease, such as type 2 diabetes, that changes hormone activity in the body.

Environmental factors that can affect hormone function include the use of endocrine-disrupting chemicals. These are present in the air, soil, water supply, and manufactured products.

Sometimes, both environmental and genetic features play a role.

Here are just a few of the conditions endocrinologists often treat:

• diabetes
• osteoporosis
• menopause
• metabolic disorders
• thyroid diseases
• excessive or insufficient production of hormones
• some cancers
• short stature
• fertility issues

What is the endocrine system?

The endocrine system consists of a number of glands. The hormones they release affect many different functions. When the hormones leave the glands, they enter the bloodstream, where they travel to organs and tissues throughout the body.

Hormones regulate a wide range of functions, such as:

• breathing
• metabolism, which is how the body converts food into energy
• touch, feel, and other senses
• movement
• sexual development, reproduction, and fertility
• growth

Glands and hormones of the endocrine system

The endocrine system consists of many glands that produce and regulate hormones. The body needs an appropriate balance of these hormones to work effectively.

Adrenal glands

The adrenal glands are located above the kidneys. They are divided into two regions. The right gland is triangular, and the left is crescent-shaped.

The adrenal glands secrete:

• corticosteroids, the steroids involved in stress responses, the immune system, inflammation, and more
• catecholamines, such as norepinephrine and epinephrine, also in response to stress
• aldosterone, which affects kidney function
• androgens, or male sex hormones, including testosterone.

Both males and females have some androgen, but males have higher levels. Androgens play a key role in the development of characteristics associated with males, such as facial hair and a deeper voice.

Health issues

Hypersecretion, or high levels of adrenal hormones, may lead to:

• over-nervousness
• sweating
• high blood pressure
• Cushing’s syndrome

What is hyperaldosteronism?

Hyposecretion, or low levels, may lead to:

• Addison’s disease
• mineralocorticoid deficiency
• weight loss
• loss of energy
• anemia

Hypothalamus

The hypothalamus is located just above the brain stem and below the thalamus.

This gland activates and controls involuntary body functions, including:

• appetite
• fluid balance in the body
• body temperature
• the circadian cycle or body clock
• milk production
• growth

The hypothalamus links the nervous system to the endocrine system via the attached pituitary gland.

The hormones it manages affect the activity of the:

• thyroid gland
• adrenal glands
• reproductive organs

Which nutrients support the hypothalamus and pituitary gland?

Ovaries and testicles

The ovaries are located on either side of the uterus in females. They are the female gonads and secrete estrogen, progesterone, testosterone, and other hormones.

The ovaries are part of the female reproductive system and essential for:

• sexual development
• puberty
• menstruation
• fertility
• pregnancy
• childbirth
• menopause

The testicles or testes are the male gonads. They are located in the scrotum, below the penis. They secrete androgens, mainly testosterone. They are part of the male reproductive system.

Androgens are essential for:

• sexual development
• puberty
• facial hair
• sexual behavior
• libido
• erectile function
• fertility and conception
• the formation of sperm cells

Both males and females produce estrogen and testosterone, but the levels and balance are different. For this reason, people consider estrogen a female hormone and testosterone a male hormone.

What is the difference between sex and gender?

Pancreas

Located in the abdomen, the pancreas is both an endocrine gland and a digestive organ.

It releases:

• Insulin: Insulin is essential for carbohydrate and fat metabolism in the body.
• Somatostatin: This hormone regulates endocrine and nervous system functions. It also controls the secretion of several hormones, such as gastrin, insulin, and growth hormone.
• Glucagon: This peptide hormone raises blood glucose levels when they fall too low.
• Pancreatic polypeptide: This helps control the secretion of substances made by the pancreas.

How do insulin and glucagon regulate blood sugar?

Health issues

Diabetes and digestive issues can result from problems with the pancreas. The main concerns relate to blood sugar imbalance.

If the pancreas produces too much insulin, hypoglycemia will result. This is when blood glucose levels are too low. If it produces too little, a person will have hyperglycemia, or high blood glucose levels.

Diabetes happens when the pancreas can no longer produce or use insulin effectively, also known as insulin resistance. A wide range of complications can result.

What is insulin therapy?

Parathyroid glands

These are small endocrine glands in the neck. They produce parathyroid hormone, which regulates calcium and phosphate in the blood.

Health issues

Muscles and nerves can only operate effectively if these chemicals are at the correct levels.

High levels of parathyroid hormone may lead to brittle bones that fracture easily and stones in the urinary system.

Low levels may lead to involuntary muscle contractions caused by low calcium levels in plasma.

Pineal body, or pineal gland

The pineal gland is a small endocrine gland located deep in the brain. It secretes melatonin and helps control the body’s sleep and wakefulness patterns.

Changes that can disrupt the function of this gland include:

• tumors
• cysts
• calcifications
• changes to light-dark or sleep-wake patterns, for instance, due to jet lag

Pituitary gland

This is an endocrine gland attached to the hypothalamus, at the base of the brain.

It is sometimes called the main endocrine master gland because it secretes hormones that regulate the functions of other glands, as well as growth and several other bodily functions.

The anterior, or front, pituitary secretes hormones that affect:

• reproduction
• growth
• metabolism
• response to stress or trauma
• thyroid function
• adrenocortical function

The posterior, or rear, pituitary secretes oxytocin, a hormone that increases contractions of the uterus. It also secretes an antidiuretic hormone (ADH) that encourages the kidneys to reabsorb water.

Health issues

Depending on the hormone produced, an overactive pituitary gland may lead to gigantism, or excessive growth. Underactivity may lead to limited growth, short stature, and low activity in other endocrine glands.

If the gland produces too much ADH, fluid retention can occur. Too little can lead to excess water in the urine.

Thymus gland

The thymus gland is located beneath the breastbone, or sternum. It is the main organ responsible for the production and maturing of immune cells or lymphocytes, which protect the body from infections and other diseases.

Problems with this gland can seriously affect a person’s health.

Health issues

Hypersecretion may cause the immune system to overreact to perceived threats. This may result in an autoimmune disease.

Hyposecretion may lead to a weakened immune system, where the body is unable to fight infection and easily succumbs to viruses, bacteria, and other pathogens.

Thyroid gland

The thyroid gland is a butterfly-shaped gland located just below the Adam’s apple in the neck.

The hormones it produces are crucial for regulating:

• blood pressure
• body temperature
• heart rate
• metabolism
• how the body reacts to other hormones

The thyroid gland produces two types of hormones. The inactive thyroid hormone thyroxine (T4) makes up 90% of hormones produced while the active thyroid hormone, triiodothyronine (T3) makes up 10%.

Thyroxine is converted either to active thyroid hormone or another inactive hormone for various purposes throughout the body.

What are the signs of an iodine deficiency?

Health issues

Hyperthyroidism, or an overactive thyroid, often stems from Graves’ disease.

It can lead to:

• accelerated metabolism
• sweating
• arrhythmia or irregular heartbeat
• weight loss
• nervousness

Hypothyroidism may lead to:

• tiredness
• weight gain
• depression
• unusual bone development
• developmental delay
• slow growth

Visiting an endocrinologist

During the first visit, the doctor will ask a series of questions to help reach a diagnosis.

These might cover:

• current medications
• family history of hormonal problems
• other medical conditions, including allergies
• dietary and lifestyle habits

It can help to list any existing symptoms before the visit.

The endocrinologist might ask about symptoms that do not seem to be related. This is because small changes in one gland can affect the whole body.

The endocrinologist may check the person’s

• heart rate
• blood pressure
• skin, hair, teeth, and mouth

They may take blood and urine samples for testing.

Following a diagnosis, the endocrinologist will suggest a treatment plan. This will depend on which underlying condition is causing the symptoms.

What to know about hormonal imbalances

• Symptoms
• Acne
• Weight gain
• Pregnancy
• Hair loss
• Tests
• Causes
• Treatment
• Natural remedies
• Outlook

Hormonal imbalances occur when there is too much or too little of a hormone in the blood. Common symptoms include weight changes, lower sex drive, and acne, but depend on which hormone is out of balance.

Hormones are chemicals produced by glands in the endocrine system. Hormones travel through the bloodstream to the tissues and organs, delivering messages that tell the organs what to do and when to do it.

Hormones are essential for regulating most major bodily processes, so a hormonal imbalance can affect many bodily functions. Hormones help to regulate:

• metabolism
• blood sugar
• growth
• blood pressure
• reproductive cycles and sexual function
• general growth and development
• mood and stress levels

Imbalances in insulin, steroids, growth hormones, and adrenaline can affect males and females alike.

Females may also experience imbalances in estrogen and progesterone levels, while males are more likely to experience imbalances in testosterone levels.

Symptoms

The symptoms of a hormonal imbalance can vary according to which gland is affected and whether the person is male or female.

Symptoms in females

In women, the symptoms more frequently include:

• mood swings
• constipation or diarrhea
• irregular menstrual cycle
• infertility
• pain in the abdomen or the back during menstruation
• low sex drive
• insomnia
• unexplained weight gain or weight loss
• brittle bones
• hirsutism, or excessive hair growth
• rashes on the skin

Symptoms in males

When a male has low testosterone levels, their symptoms will typically include:

• decrease in sex drive
• erectile dysfunction (ED)
• loss of muscle mass
• thinning hair and reduced hair growth
• tenderness in the area of the chest

Acne

Acne can occur due to the overproduction of oil in the skin’s sebaceous glands. This excess oil can clog pores and attract bacteria that further inflame the skin.

The hormones testosterone, estrogen, and progesterone can affect the sebaceous glands in a person’s skin. Some ways these hormones can influence acne include:

• Testosterone helps to regulate sebum (oil) production. Excess amounts can potentially block pores, resulting in acne.
• Increasing progesterone levels likely play a role in pregnancy-related acne, although doctors are not sure exactly how.
• Women can experience post-menopausal acne, which may be due to changes in estrogen and progesterone levels.

In addition, females who have polycystic ovary syndrome (PCOS) are more likely to experience severe and persistent acne. Doctors think increased exposure to androgen hormones, such as testosterone, and resistance to insulin hormones may increase acne risks.

Weight gain

Hormone imbalances can affect several processes in the body that lead to weight gain. Some examples include:

• Thyroid hormones act to regulate the body’s metabolism or the rate it burns energy. Too few thyroid hormones can slow metabolism and result in weight gain.
• Decreasing levels of estrogen can lead to weight gain in menopause.
• Hormonal imbalances due to PCOS can result in weight gain.
• More than 80% of people with Cushing’s disease report weight gain as a symptom. This disorder causes the body to produce excess amounts of cortisol.

Ideally, treating the underlying condition can help reduce weight gain related to hormonal imbalance.

Pregnancy

Pregnancy results in changing hormone levels to nourish a growing fetus. These include changing levels of the hormones progesterone, estrogen, and testosterone. While the hormone levels may be different, they are not necessarily unbalanced during pregnancy.

However, some hormones that increase during pregnancy can affect how a woman’s body uses insulin. This can lead to insulin resistance and diabetes during pregnancy.

Hair loss

Male pattern hair loss has links to reduced androgen hormones, such as testosterone. For this reason, doctors also call male pattern hair loss androgenetic alopecia. This condition causes hair loss in the front and crown of the head.

However, not all males experience androgenetic alopecia even though their hormone levels change as they age. Doctors interpret this to mean that some men are genetically predisposed to hair loss.

Tests

Testing for hormonal imbalances depends largely on what condition your doctor may think is causing your condition. Some of the tests a doctor may use include:

• Blood testing: Doctors can test for certain hormones, such as estrogen, testosterone, or thyroid hormone.
• Imaging: Doctors imaging studies, such as ultrasound, X-ray, or magnetic resonance imaging (MRI) tests to identify cysts or tumors that could cause the body to produce excess amounts of hormones.
• Urine testing: Doctors use urine tests to measure levels of hormones related specifically to the menstrual cycle, such as follicle-stimulating hormone (FSH).

Some at-home testing kit companies may offer products that allow a person to take a test at home. These could include urine or blood tests. A person should ensure the company is reputable and uses certified laboratories to evaluate testing samples.

Causes

Everyone will experience natural periods of hormonal imbalance or fluctuations at particular points in their lives. But hormonal imbalances can also occur when the endocrine glands are not functioning properly.

Endocrine glands are specialized cells that produce, store, and release hormones into the blood. There are several endocrine glands located throughout the body that control different organs, including the:

• adrenal glands
• gonads (testis and ovaries)
• pineal gland
• pituitary gland
• hypothalamus gland
• thyroid and parathyroid glands
• pancreatic islets

Several medical conditions can impact the endocrine glands. Certain lifestyle habits and environmental factors can also play a role in hormonal imbalances.

Medical conditions

Medical conditions that can affect hormone production may but are not limited to:

• diabetes, in which the body does not produce enough of the hormone insulin
• hyperthyroidism and hypothyroidism, which are the overactivity and underactivity of the thyroid gland
• Addison’s disease, in which the adrenal glands do not produce enough hormones
• Cushing’s syndrome, in which the adrenal glands produce too many corticosteroids
• acromegaly, which is the overproduction of growth hormones
• hyperglycemia, which is the overproduction of glucagon
• hypoglycemia, which is when the body produces more insulin than there is glucose in the blood
• solitary thyroid nodules
• pituitary tumors
• benign tumors and cysts (fluid-filled sacks) that affect the endocrine glands
• congenital adrenal hyperplasia (low levels of cortisol)
• cancers that involve endocrine glands
• chemotherapy and radiation therapy
• iodine deficiency (goiters)
• hereditary pancreatitis
• Turner syndrome, in which females are born with only one functioning X chromosome
• Prader-Willi syndrome
• anorexia
• pituitary gland injury with bleeding and congenital genetic abnormalities in a pregnant person and their fetus

Additional causes

Other causes of hormonal imbalance may include:

• chronic stress
• poor diet and nutrition
• having overweight
• hormonal replacement or birth control medications
• misuse of anabolic steroid medications
• exposure to toxins, pollutants, and endocrine-disrupting chemicals, including pesticides and herbicides

Females naturally experience several periods of hormonal imbalance throughout their lifetime, including:

• puberty
• menstruation
• pregnancy, childbirth, and breastfeeding
• perimenopause, menopause, and postmenopause

Females are likely to develop different hormonal imbalance disorders than males because they have different endocrine organs and cycles.

Causes of hormonal imbalance in women include:

• polycystic ovary syndrome (PCOS)
• hormone replacement or birth control medications
• primary ovarian insufficiency (POI)
• ovarian cancer

Males also experience natural periods of hormonal imbalance during their lifetime, including:

• puberty
• aging
• stress

Men may develop different hormonal imbalances than women because they have different endocrine organs and cycles.

Medical conditions causing hormonal imbalances in men include, but are not limited to:

• congenital problems or other underlying medical conditions
• prostate cancer, which develops with the aid of androgens or male sex hormones
• hypogonadism, which is the production of testosterone
• testicular injury
• radiation or chemotherapy
• hormone disorders, such as a pituitary tumor
• diseases, such as type 2 diabetes, HIV, and AIDS
• genetic conditions, such as Klinefelter syndrome, hemochromatosis, or Kallmann syndrome

How to fix a hormonal imbalance

Treatment for hormonal imbalances may vary depending on the cause. Every person may require different types of treatment for hormonal imbalances.

Treatments for females

Treatment options for females with hormone imbalances include:

• Hormone or birth control. For those who are not trying to get pregnant, medications containing forms of estrogen and progesterone can help regulate irregular menstrual cycles and symptoms. Birth control is available as a pill, ring, patch, shot, or intrauterine device (IUD).
• Vaginal estrogen. People experiencing vaginal dryness associated with changes in estrogen levels can apply creams containing estrogen directly to vaginal tissues to reduce symptoms. They can also use estrogen tablets and rings to relieve vaginal dryness.
• Hormone replacement medications. Medications are available to temporarily reduce severe symptoms associated with menopause, such as hot flashes or night sweats.
• Eflornithine (Vaniqa). This prescription cream may slow excessive facial hair growth in women.
• Anti-androgen medications. Medications that block the predominately male-sex hormone androgen can help limit severe acne and excessive hair growth or loss.
• Clomiphene (Clomid) and letrozole (Femara). These medications help stimulate ovulation in people with PCOS who are trying to become pregnant. Doctors may also give those with PCOS and infertility injections of gonadotropins to help increase the chances of pregnancy.
• Assisted reproductive technology. In vitro fertilization (IVF) may be used to help those with PCOS complications get pregnant.

Treatments for males

Treatment options for males with hormonal imbalances include:

• Testosterone medications. Gels and patches containing testosterone can help reduce symptoms of hypogonadism and other conditions that cause low testosterone levels, such as delayed or stunted puberty.

Other treatments

Treatment options for hormonal imbalances include:

• Metformin. A medication for PCOS and diabetes, metformin can help lower both androgens and blood sugar levels.
• Levothyroxine. Medications containing levothyroxine, such as Synthroid and Levothroid, can help improve symptoms of hypothyroidism.

RECALL OF METFORMIN EXTENDED RELEASE

Metformin extended-release tablets should be taken with care and under the advice of a doctor. In May 2020, the Food and Drug Administration (FDA) recommended that some makers of metformin extended-release remove some of their tablets from the U.S. market. Further, in June 2021, Viona Pharmaceuticals, a maker of extended-release Metformin pulled their tablets from pharmacy shelves.

Each concern was because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release Metformin tablets. If you currently take this drug, call your healthcare provider. They will advise whether you should continue to take your medication or if you need a new prescription.

Natural remedies

People have used natural supplements to treat hormonal imbalances for thousands of years.

However, clinical studies have not proven that any natural remedies can treat hormonal imbalances and their causes.

Supplements

Natural supplements commonly used to reduce symptoms of hormonal imbalances include:

• black cohosh, dong quai, red clover, and evening primrose oil for hot flashes caused by menopause
• ginseng for irritability, anxiousness, and sleep disturbances caused by menopause
• ginseng, and maca for ED

Before taking any natural or herbal treatment, a person should check with their doctor to ensure safety and avoid interaction side effects when taking with other medications.

Lifestyle changes

Lifestyle changes that may help reduce the likelihood and symptoms of hormonal imbalances include:

• maintaining a moderate body weight
• eating a nutritious and balanced diet
• exercising regularly
• practicing good personal hygiene, focusing on washing areas with a lot of natural oils, such as the face, neck, back, and chest
• using OTC acne washes, rinses, and medicated creams or gels for minor to moderate acne
• avoiding triggers that cause hot flashes, such as warm weather and spicy, rich, or hot foods and drinks
• reducing and managing stress
• practicing yoga, meditation, or guided visualization
• limiting sugary foods and refined carbohydrates
• avoiding packaged foods
• replacing older non-stick pans with ceramic pans
• using glass containers to store and heat foods and drinks
• restricting the use of cleaning products that contain toxic chemicals, such as bleach
• buying fruits and vegetables free from pesticides or ripening chemicals
• avoiding microwaving foods and drinks in plastic containers

Outlook

Most people will experience at least one or two periods of hormonal imbalance during their lifetime.

Hormonal imbalances are more common during puberty, menstruation, pregnancy, menopause, and aging. But some people experience continual, irregular hormonal imbalances.

Medical conditions that affect or involve the endocrine system or glands can lead to a hormone imbalance. However, external factors, such as stress or hormone medications, can also be a cause.

A person should speak to a doctor about long-term unexplained symptoms, especially those that cause pain, discomfort, or interfere with everyday activities.

An overview of insulin

Insulin is a type of hormone. The role of insulin in the body is to allow glucose in the blood to enter cells, providing them with the energy to function. A lack of effective insulin plays a key role in the development of diabetes.

Hormones are chemical messengers that instruct certain cells or tissues to act in a certain way that supports a particular function in the body.

Insulin is essential for staying alive.

In this article, we look at how the body produces insulin and what happens when not enough of it circulates, as well as the different types that a person can use to supplement insulin.

What is insulin?

Insulin is a chemical messenger that allows cells to absorb glucose, a sugar, from the blood.

The pancreas is an organ behind the stomach that is the main source of insulin in the body. Clusters of cells in the pancreas called islets produce the hormone and determine the amount based on blood glucose levels in the body.

The higher the level of glucose, the more insulin goes into production to balance sugar levels in the blood.

Insulin also assists in breaking down fats or proteins for energy.

A delicate balance of insulin regulates blood sugar and many processes in the body. If insulin levels are too low or high, excessively high or low blood sugar can start to cause symptoms. If a state of low or high blood sugar continues, serious health problems might start to develop.

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Insulin problems

In some people, the immune system attacks the islets, and they cease to produce insulin or do not produce enough.

When this occurs, blood glucose stays in the blood and cells cannot absorb them to convert the sugars into energy.

This is the onset of type 1 diabetes, and a person with this version of diabetes will need regular shots of insulin to survive.

In some people, especially those who are overweight, obese, or inactive, insulin is not effective in transporting glucose into the cells and unable to fulfill its actions. The inability of insulin to exert its effect on tissues is called insulin resistance.

Type 2 diabetes will develop when the islets cannot produce enough insulin to overcome insulin resistance.

Since the early 20th century, doctors have been able to isolate insulin and provide it in an injectable form to supplement the hormone for people who cannot produce it themselves or have increased insulin resistance.

Types of insulin

A person can take different types of insulin based on how long they need the effects of the supplementary hormone to last.

People categorize these types based on several different factors:

• speed of onset, or how quickly a person taking insulin can expect the effects to start.
• peak, or the speed at which the insulin reaches its greatest impact
• duration, or the time it takes for the insulin to wear off
• concentration, which in the United States is 100 units per milliliter (U100)
• the route of delivery, or whether the insulin requires injection under the skin,into a vein, or into the lungs by inhalation.

People most often deliver insulin into the subcutaneous tissue, or the fatty tissue located near the surface of the skin.

Three main groups of insulin are available.

Fast-acting insulin

The body absorbs this type into the bloodstream from the subcutaneous tissue extremely quickly.

People use fast-acting insulin to correct hyperglycemia, or high blood sugar, as well as control blood sugar spikes after eating.

This type includes:

• Rapid-acting insulin analogs: These take between 5 and 15 minutes to have an effect. However, the size of the dose impacts the duration of the effect. Assuming that rapid-acting insulin analogs last for 4 hours is a safe general rule. Examples: Aspart (Novolog), Lispro (Humalog).
• Regular human insulin: The onset of regular human insulin is between 30 minutes and an hour, and its effects on blood sugar last around 8 hours. A larger dose speeds up the onset but also delay the peak effect of regular human insulin. Examples: Humulin R, Novolin R

Intermediate-acting insulin

This type enters the bloodstream at a slower rate but has a longer-lasting effect. It is most effective at managing blood sugar overnight, as well as between meals.

Options for intermediate-acting insulin include:

• NPH human insulin: This takes between 1 and 2 hours to onset, and reaches its peak within 4 to 6 hours. It can last over 12 hours in some cases. A very small dose will bring forward the peak effect, and a high dose will increase the time NPH takes to reach its peak and the overall duration of its effect. Examples: Humulin N, Novolin N.
• Pre-mixed insulin: This is a mixture of NPH with a fast-acting insulin, and its effects are a combination of the intermediate- and rapid-acting insulins. The mixtures can be in various combinations from 50:50 to 75:25 or 70:30. An example includes Novolog 70/30.

Long-acting insulin

While long-acting insulin is slow to reach the bloodstream and has a relatively low peak, it has a stabilizing “plateau” effect on blood sugar that can last for most of the day. Glargine (Lantus) is an example.

It is useful overnight, between meals, and during fasts.

Long-acting insulin analogs are the only available type, and these have an onset of between 1.5 and 2 hours. While different brands have different durations, they range between 12 and 24 hours in total.

Takeaway

Insulin is a vital hormone that controls how cells and tissues absorb energy as well as the breakdown of fats and proteins.

Clusters of cells in the pancreas called islets secrete this hormone. When cells in the body respond less to its instructions, insulin resistance is increasing.

In some people, the immune system attacks the islets, halting insulin production and leading to type 1 diabetes. Type 2 diabetes occurs when insulin resistance coexists with a lack of compensatory increase in insulin production.

People can take insulin shots to counteract the effects of insulin resistance. There are fast, intermediate, and long-acting insulins that a person would take depending on how quickly they need to see a drop in blood sugar and the duration for which a person needs to control blood sugar.

What do growth hormone injections do?

• Why use human growth hormone (HGH)?
• In children
• In adults
• Injections
• Risks and side effects
• Other uses

If the body does not produce enough human growth hormone (HGH), a person may need to have growth hormone injections. Side effects of HGH injections include headaches, joint discomfort, and muscle aches.

Several glands in the body produce hormones, but health experts consider the pituitary to be the master control gland. Not only does it control other glands, but it also makes the hormone that triggers growth.

The pituitary gland is in the brain below the hypothalamus. It secretes hormones in response to chemical messages from the hypothalamus.

The human growth hormone (HGH) helps to influence height, as well as build bones and muscles in the body. It is crucial for processes involved in normal human growth and development.

Genetic factors can lead to a lack of growth hormone in children. Damage to the pituitary gland is a common cause of a deficiency in adults.

In this article, we look at the reasons to use HGH, the function of growth hormones, and possible side effects.

Why use human growth hormone?

HGH is essential to growth, especially in children, but it is also involved in many other processes in the body, including bone density, muscle mass, and mood.

Different hormones control various body functions and processes, including growth and development, metabolism, sexual function and reproduction, and mood.

It helps process protein and increases fat breakdown to help provide the energy needed for tissue growth.

Growth hormone levels can change through the day, and physical activity plays a part.

Exercise and similar activities can cause the levels to rise naturally. Sleep, stress, and low blood sugar levels also increase growth hormone levels.

Even small changes in HGH levels affect the body.

Too little or too much growth hormone can cause significant growth problems. Too little HGH is one of the main causes of short stature and conditions such as dwarfism.

Some people use HGH because they believe it will build muscle, improve performance, or slow aging. However, the existing evidence does not support the use of HGH for these purposes.

In children

Children with low levels of lack of growth hormone may or may not be smaller at birth. Growth problems may appear in time, for example, if they are smaller than their classmates and growing less than 2 inches a year.

Some children are unable to produce growth hormone when they are born and continue to have low levels throughout their life.

Symptoms of growth hormone deficiency in children are:

• looking much younger than other children their age
• having a chubby body build
• impaired hair growth
• delayed puberty
• short stature

In some children, a lack of growth hormone is part of a genetic condition, but sometimes the cause of the deficiency is unknown.

In adults

In adults, a lack of growth hormone is often due to damage to the pituitary gland, which may be permanent. The damage could have occurred in childhood or adulthood.

Other causes include:

• radiation therapy
• a head injury
• infections, such as meningitis

Problems in the pituitary with producing growth hormone are commonly due to a pituitary tumor.

The pituitary can be damaged by the tumor itself or by treatment such as surgery and radiotherapy.

In adults, a lack of HGH can cause a number of different problems including:

• anxiety and depression
• increased fat around the waist
• increased risk of heart disease and stroke
• weak heart
• weak muscles and bones
• tiredness
• reduced ability to think
• other conditions

Growth hormone deficiency can also be a combination of one or more hormone deficiencies.

Some medical conditions may also benefit HGH treatment.

These include:

• Turner’s syndrome: Women with this condition generally have underdeveloped female sexual characteristics.
• Prader-Willi syndrome: A genetic disorder causes weak muscle tone, feeding difficulties, poor growth, and delayed development.
• Noonan syndrome: This genetic disorder interferes with the proper development of various part of the body.
• Chronic kidney disease in children: HGH is not a treatment option for adults with CKD.

Injections

The most common treatment in both adults and children is growth hormone therapy using lab-developed HGH injections.

Doses occur several times per week or on a daily basis depending on how severe the deficiency is. Manufacturers designed the growth hormone to mimic the behavior of natural growth hormone in the body. It will be prescribed by a doctor.

HGH treatments can be self-administered or given by a doctor. Treatments are often given for several years. Patients will see their doctor every month or so to check their condition.

Blood tests will be carried out to see if extra growth hormone is needed and if treatments should be increased, decreased, or stopped. Cholesterol levels, blood sugar levels, and bone density will also be checked to see if they are healthy.

Taking growth hormone can affect the body’s response to insulin, which controls blood sugar levels. Growth hormone deficiency can also lead to high cholesterol and brittle bones if it is not treated.

Specific treatment for growth hormone deficiency depends on the person.

Doctors base this treatment on certain factors, such as:

• age
• overall health and medical history
• extent of the condition
• tolerance for specific treatment
• treatment expectations
• patient’s choice

The earlier the lack of growth hormone is treated in children, the better chance they have to grow to a near normal adult height.

Children can gain as many as 4 inches or more over the first 3 years of treatment. Another 3 inches or more can grow during the next 2 years.

Many adults have to take HGH treatment for the remainder of their life.

Anyone taking HGH will undergo regular monitoring to assess the safety and effectiveness of the hormone.

The goal of growth hormone treatments in adults and children is to restore energy, metabolism, and enhance body development or shape. It can help to reduce total body fat, especially around the belly.

HGH injections can also help to improve bone density and muscle mass, increase capacity for exercise, and reduce the risk of heart disease in those who lack growth hormone.

Many people experience an increase in overall quality of life.

Risks and side effects

Most people tolerate HGH injection treatments well with few problems.

However, possible side effects include:

• muscle aches
• joint discomfort
• headaches
• swelling of the hands and feet

Those who experience these symptoms or other problems should talk to their doctor. They can change the dose if necessary to help remedy the symptoms.

HGH injections are not recommended for people who have:

• tumors
• cancer
• serious illness
• severe breathing problems
• multiple injuries
• complications from open heart or abdominal surgery

HGH can affect insulin usage in the body, so people with diabetes should monitor their blood sugar levels carefully.

Other treatments may be required depending on the cause of the HGH deficiency.

Surgery or radiation may be necessary to treat a tumor in the pituitary. Pituitary hormones may also have to be taken to correct a gland that is not working properly.

Too much human growth hormone

If the levels of HGH are too high in adults, they may experience:

• muscle or joint pain
• fluid retention, leading to swelling
• carpal tunnel syndrome

Long-term use of HGH injections can cause a condition called acromegaly.

Adults cannot grow taller by using the synthetic growth hormone. High doses will thicken the person’s bones instead of lengthening them.

People with acromegaly will experience an overgrowth of bones, particularly in the hands, feet, and face.

The skin area can also be affected and may turn thick, coarse, and hairy. The excess HGH levels can also lead to high blood pressure and heart disease.

Other uses

HGH injections have also become popular for nonmedical usage. Bodybuildersgro and athletes sometimes use them in an effort to get larger muscles, more energy, and increased stamina.

They are considered performance-enhancing drugs and are banned in professional sports.

HGH injections are also advertised as an anti-aging or weight loss treatment.

Many people aim to help increase their energy as well as fight the decrease in muscle and bone mass that happens with aging.

The Endocrine Society does not recommend HGH injections for adults or children unless they have a growth hormone deficiency.

Not enough evidence is available to prove that HGH injections can slow down the aging process, and studies show it does not improve athletic performance. Adverse effects often occur, especially fluid retention.

Using them for any nonmedical reason is illegal in the United States.

HGH injections are designed for adults or children who have a lack of growth hormone and should only be prescribed by a doctor.

Children and adults with low levels of growth hormone should ensure they have plenty of sleep, a balanced diet, regular exercise, and that they follow medical advice.

What to know about hypopituitarism?

Hypopituitarism is a rare disorder of the endocrine system, which is responsible for hormone production. The condition develops when the pituitary gland does not make enough hormones.

Hypopituitarism may appear suddenly or take many years to develop, depending on the cause. People with this condition often require lifelong treatment.

This article explains hypopituitarism, how it develops, the symptoms it causes, and how to manage it.

Hypopituitarism is where the pituitary gland does not produce enough hormones. The pituitary gland is a small organ at the base of the brain. Its hormones help control how the body makes other crucial hormones.

A typical functioning pituitary gland produces adequate amounts of the following hormones:

• Adrenocorticotropic hormone (ACTH): This hormone tells the adrenal glands to make cortisol, which helps the body cope with stress and inflammation.
• Prolactin: This hormone stimulates milk production in people who are nursing. It also affects fertility and sexual function in both males and females.
• Luteinizing hormone (LH) and follicle-stimulating hormone (FSH): These control the production of sex hormones and the release of eggs from ovaries. They play essential roles in puberty, menstruation, and fertility.
• Growth hormone (GH): This stimulates bone, muscle, and tissue growth in children and adolescents. In adults, GH also helps control body composition, muscle and bone strength, metabolism, and heart function.
• Thyroid-stimulating hormone (TSH): This triggers thyroid hormone production in the thyroid gland. These regulate metabolism, body temperature, growth, and development.
• Oxytocin: The pituitary gland releases this hormone during childbirth, nursing, and sexual activity. Oxytocin helps with bonding, social behavior, empathy, and stress relief.

A shortage of these hormones affects the levels that the thyroid, adrenal glands, testes, and ovaries usually produce. These glands rely on pituitary hormones to function.

Symptoms

The symptoms of hypopituitarism depend on the particular hormone in low supply, as well as other factors, including:

• the cause of the low pituitary hormone levels
• age of onset
• how quickly a person has a reduction in hormones

For example, as the thyroid has links to body temperature control, a person with low levels of TSH might feel particularly sensitive to cold. A child with low GH levels might experience difficulties with growth.

Symptoms can also include:

• stomach pain
• appetite loss
• nausea and vomiting
• constipation
• increased thirst
• more frequent urination
• fatigue
• weakness
• anemia
• dizziness
• headaches
• unexpected weight changes
• aching muscles

Symptoms in different populations

As hypopituitarism may reduce levels of sex hormones and GH, it may affect different features of general and sexual development. These might look different in males, females, and children.

Hypopituitarism can cause difficulties with growth, especially height and sexual development.

Symptoms in females

Symptoms in females may include:

• reduced armpit or pubic hair
• low libido
• infertility
• nursing difficulties
• irregular or absent periods

Symptoms in males

For males, symptoms may include:

• loss of face, armpit, or pubic hair
• low libido
• infertility
• erectile dysfunction

Causes

Hypopituitarism results from damage to the pituitary gland. This damage needs to have occurred to 75% of the pituitary gland to affect pituitary hormone levels.

This can be due to many reasons, including:

• pituitary gland tumors, or those that grow nearby — even if they are not cancerous, which is often the case
• pituitary apoplexy, which refers to bleeding pituitary tumors
• treatment with radiation therapy, which destroys pituitary gland tissue
• surgery on or near the pituitary gland
• traumatic brain injury
• extreme blood loss during childbirth
• infections, including meningitis and tuberculosis
• conditions present at birth, such as Prader-Willi syndrome
• pituitary gland inflammation, known as hypophysitis
• conditions that move to the pituitary gland from elsewhere, such as histiocytosis, hemochromatosis, or lymphoma.

It is not always clear what causes hypopituitarism. This is known as “idiopathic hypopituitarism.”

Diagnosis

A doctor will perform various examinations to diagnose hypopituitarism, such as:

• Physical exam: This includes checking the skin and testing how blood pressure responds to lying down, sitting down, and standing up.
• Blood tests: This may involve checking cortisol levels in the morning when levels are highest. Doctors test for testosterone levels at the same time of day. Using different tests, they may also test for TSH, GH, LH, FSH, and prolactin levels.
• Stimulation tests: These involve injecting a medication to increase blood levels of pituitary hormones to test how they improve. High levels of one hormone but not others may suggest low pituitary activity. For example, if GH does not respond well to the test, it shows that the pituitary is not making enough of it.
• MRI scan: This can help a doctor identify physical damage to the pituitary and show any tumors on or near the gland that might be causing hypopituitarism.

Treatment

Treating the underlying cause of hypopituitarism is central to preventing further damage. However, treatment is often lifelong, as it is not possible to reverse the effects of the disorder.

Treatment includes:

Surgery

This often involves removing a tumor or lesion from the gland. These cause hypopituitarism in around 61% of people with the disorder. People will often still need to supplement hormone levels for life afterward. However, surgery sometimes improves how the gland works.

However, there is a 10–25% risk of hypopituitarism after tumor removal from the pituitary.

Hormone replacement therapy

This depends on the hormone that’s lacking. Replacement hormones act in place of hormones that the pituitary would produce rather than increasing the gland’s ability to produce more. Doctors supplement hormones with patches, injections, or oral medications. These might include:

• a synthetic form of ADH called DDAVP
• synthetic thyroxine, which replaces the thyroid hormone
• testosterone for males
• estrogen for females
• cortisol for people with adrenal insufficiency

However, supplementation of GH is less common, except in children with GH deficiency.

Ongoing care

Regular checkups will be necessary for life. It can also help to wear a medical information bracelet or pendant that informs potential caregivers about the condition during emergencies.

A doctor will also advise on what to do in scenarios of sickness or stress. According to a 2021 study, hypopituitarism increases the risk of mental health disorders, such as depression and anxiety. Managing these, as well as periods of symptoms or medication side effects, can help people with hypopituitarism improve their quality of life.

Outlook

According to the Endocrine Society, people with hypopituitarism may not have a lower life span, provided they continue to take their prescribed medications.

A 2017 review of 12 studies that included data on over 23,000 individuals found that hypopituitarism may have links to a lower age of mortality. The review concluded that the risk of lower life expectancy might be higher in the following groups of people with hypopituitarism:

• females
• anyone who received a diagnosis at a younger age
• those who also have craniopharyngioma, a rare type of brain tumor
• individuals who have received radiation therapy
• those who have undergone brain surgery
• individuals with a type of diabetes known as diabetes insipidus
• those with low testosterone, or hypogonadism

Summary

Hypopituitarism refers to low levels of pituitary hormones. The condition often occurs due to a tumor but can develop suddenly or slowly due to a wide range of injuries and health issues. Hypopituitarism also affects hormone levels from other glands, which can lead to sexual or developmental issues and other symptoms.

A doctor diagnoses this condition using physical examination, blood tests, and MRI scans. Treatment is usually lifelong. It typically involves treating the underlying cause of hypopituitarism with surgery while supplementing levels of the low hormone.

Some people with hypopituitarism may have a reduced life expectancy. However, taking suitable medications and attending regular checkups can help improve lifespan.

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