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What can go wrong?

Hormones affect systems all over the body. They control the development of male and female sexual characteristics, fertility, growth, the rate at which the body uses energy, its ability to digest food, to utilise glucose, to respond to stress, to maintain fluid/water balance and to maintain a proper blood pressure. Endocrine abnormalities usually result in the production of either too much of a specific hormone or too little. Some of the conditions that cause dysfunction have been given names, such as Cushing’s syndrome (associated with excess cortisol) because when they occur they cause a typical set of symptoms and complications.

Endocrine gland dysfunction may be due to either a problem with the gland itself, a problem “upstream” in the feedback system, and/or due to a lack of response by the target tissues. There may be decreased hormone production related to trauma, disease, infection, crowding of the hormone-producing cells by a tumour, or due to an inherited gene mutation that affects the quantity, quality, or use of a hormone. Decreased production may also be due to failure of the “upstream” gland to produce its hormone(s). Increased production may also be related to a problem upstream (such as the pituitary producing too much ACTH, leading to the production of too much cortisol), hyperplasia or tumour of the hormone-producing cells, lack of tissue response, medication use or an inherited condition.

Tumours are generally small and usually benign. Most of them are located inside the affected gland and produce a single type of hormone. Rarely they may be cancerous and also rarely they may be located elsewhere in the body. A tumour may cause symptoms because of the excess hormone it is producing, because its growth crowds out and decreases the production of other hormones in the gland, or because its physical size presses against surrounding nerves and structures.

Most inherited conditions are rare and are usually related to deficient or dysfunctional production of a single hormone or to the hormone production of a particular gland (for example, congenital hypothyroidism). However, there are genetically-caused conditions that affect the glands themselves. Two that have been identified as affecting several endocrine glands are MEN-1 and MEN-2 (multiple endocrine neoplasia, types 1 and 2). These conditions are related to alterations in specific genes, and they increase the lifetime risk that those affected will develop tumours in one or more of their endocrine glands.

Last Review Date: July 1, 2018