Endocrinology is concerned with the study of the biosynthesis, storage, chemistry, and physiological function ofhormones and with the cells of the endocrine glands and tissues that secrete them.
The endocrine system consists of several glands, all and in different parts of the body, that secrete hormones directly into the blood rather than into a duct system. Hormones have many different functions and modes of action; one hormone may have several effects on different target organs, and, conversely, one target organ may be affected by more than one hormone.
In the original 1902 definition by Bayliss and Starling (see below), they specified that, to be classified as a hormone, a chemical must be produced by an organ, be released (in small amounts) into the blood, and be transported by the blood to a distant organ to exert its specific function. This definition holds for most “classical” hormones, but there are also paracrine mechanisms (chemical communication between cells within a tissue or organ), autocrine signals (a chemical that acts on the same cell), and intracrine signals (a chemical that acts within the same cell). Aneuroendocrine signal is a “classical” hormone that is released into the blood by a neurosecretory neuron (see article on neuroendocrinology).
Hormones act by binding to specific receptors in the target organ. As Baulieu notes, a receptor has at least two basic constituents:
Endocrinology as a profession
Although every organ system secretes and responds to hormones (including the brain, lungs, heart, intestine, skin, and the kidney), the clinical specialty of endocrinology focuses primarily on the endocrine organs, meaning the organs whose primary function is hormone secretion. These organs include the pituitary, thyroid, adrenals, ovaries, testes, and pancreas.
An endocrinologist is a doctor who specializes in treating disorders of the endocrine system, such as diabetes,hyperthyroidism, and many others (see list of diseases below).
The medical specialty of endocrinology involves the diagnostic evaluation of a wide variety of symptoms and variations and the long-term management of disorders of deficiency or excess of one or more hormones.
The diagnosis and treatment of endocrine diseases are guided by laboratory tests to a greater extent than for most specialties. Many diseases are investigated through excitation/stimulation or inhibition/suppression testing. This might involve injection with a stimulating agent to test the function of an endocrine organ. Blood is then sampled to assess the changes of the relevant hormones or metabolites. An endocrinologist needs extensive knowledge of clinical chemistry and biochemistry to understand the uses and limitations of the investigations.
A second important aspect of the practice of endocrinology is distinguishing human variation from disease. Atypical patterns of physical development and abnormal test results must be assessed as indicative of disease or not.Diagnostic imaging of endocrine organs may reveal incidental findings called incidentalomas, which may or may not represent disease.
Endocrinology involves caring for the person biology as well as the nucleus the enzymes as well as the disease. Most endocrine disorders are chronic diseases that need life-long care. Some of the most common endocrine diseases include diabetes mellitus, hypothyroidism and the metabolic syndrome. Care of diabetes, obesity and other chronic diseases necessitates understanding the patient at the personal and social level as well as the molecular, and the physician–patient relationship can be an important therapeutic process.
Apart from treating patients, many endocrinologists are involved in clinical science and medical research, teaching, and hospital management.
There are roughly 4,000 endocrinologists in the United States.Endocrinologists are specialists of internal medicine orpediatrics. Reproductive endocrinologists deal primarily with problems of fertility and menstrual function—often training first in obstetrics. Most qualify as an internist, pediatrician, or gynecologist for a few years before specializing, depending on the local training system. In the U.S. and Canada, training for board certification in internal medicine, pediatrics, or gynecology after medical school is called residency. Further formal training to subspecialize in adult, pediatric, or reproductive endocrinology is called a fellowship. Typical training for a North American endocrinologist involves 4 years of college, 4 years of medical school, 3 years of residency, and 2 years of fellowship. Adult endocrinologists are board certified by the American Board of Internal Medicine (ABIM) in Endocrinology, Diabetes and Metabolism.
In North America the principal professional organizations of endocrinologists include The Endocrine Society, the American Association of Clinical Endocrinologists, the American Diabetes Association, the Lawson Wilkins Pediatric Endocrine Society, and the American Thyroid Association.
In the United Kingdom, the Society for Endocrinologyand the British Society for Paediatric Endocrinology and Diabetesare the main professional organisations. The European Society for Paediatric Endocrinology is the largest international professional association dedicated solely to paediatric endocrinology. There are numerous similar associations around the world.
Because endocrinology encompasses so many conditions and diseases, there are many organizations that provide education to patients and the public. The Hormone Foundation is the public education affiliate of The Endocrine Society and provides information on all endocrine-related conditions. Other educational organizations that focus on one or more endocrine-related conditions include the American Diabetes Association, National Osteoporosis Foundation, Human Growth Foundation, American Menopause Foundation, Inc., and Thyroid Foundation of America.
ENDOCRINE DESEASETypes of endocrine diseaseBroadly speaking, endocrine disorders may be subdivided into three groups:
List of endocrine diseasesAdrenal disorders