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- 1. Effects of abnormal level of: Presented By: Abdulwassay Ahmad khursheed • Gonadal hormones • Aldosterone • Rennin-angiotensin • Thyroid hormone • Cortisol • Serotonin
- 2. Gonadal Hormones Gonadal Hormones consists of: • Testosterone • Estrogen • Progesterone Gonadal Hormones are produced by male and female gonads and perform function of Reproduction and Development of secondary sex characteristics in males and females.
- 3. 1. Testosterone • Testosterone is the main male sex hormone. • Both males and females have testosterone, but males naturally have higher testosterone levels. • Testosterone production occurs in the testes in males and ovaries in females. • A small amount of Testosterone is also produced by adrenal glands in both genders. • In males between the ages of 19 and 39 range between 300 and 1000 ng/dL. • Females usually have lower testosterone levels than males. Healthy testosterone levels in females range from 9-55 ng/dL.
- 4. Causes of high levels of Testosterones • Puberty • Testosterone Replacement Therapy (TRT) • Polycystic Ovary Syndrome (PCOS) • Hyperthyroidism • Tumors • Steroid Abuse • Adrenal Hyperplasia • Certain Medications
- 5. Effects of High levels of Testosterone • Acne and Facial hair • Deep voice • Male pattern baldness • Increased muscle mass • Decreased breast tisssue • Aggressive behavior • Low Sperm count • Heart problems (Polycythemia) • Insomnia • Prostate enlargement which may cause difficulty passing urine, it can also cause prostate cancer.
- 6. Causes of low levels of Testosterones Congenital • Testicular agenesis • Klinefelter‘s Syndrome (47XXY) • Untreated Cryptorchidism • Kallman’s syndrome Acquired • Bilateral Orchitis ( inflammation of testes) • Irradiation • Cytotoxic drugs
- 7. Effects of Low levels of Testosterone • Decreased Libido • Loss of Muscle Mass and Strength • Increased Body Fat • Depression • Gynecomastia • Fatigue and Decreased Energy Levels • Decreased sperm count • Decreased Bone Density • Reduced Cognitive (Higher level brain) Function • Erectile Dysfunction • Irregular Menstrual Cycles
- 8. 2. Estrogen: • Estrogen is a steroid hormone associated with the female reproductive organs and is responsible for developing female sexual characteristics • In women primary site of production are ovaries • In men estrogen is produced By aromatization of testosterone by aromatase which is found in various tissues throughout the body, including adipose tissue, the brain, bone, and skin. Additionally, small amounts of estrogen are produced directly by the testes in men • 30 to 400 pg/mL for premenopausal women,0 to 30 pg/mL for postmenopausal women, 10 to 50 pg/mL for men
- 9. Causes of Low levels of estrogen • Primary ovarian insufficiency • Age • Eating disorders • Genetic conditions • Autoimmune diseases • Treatments impacting your ovaries • Hypothalamic amenorrhea
- 10. Effects of Low levels of estrogen • Dry skin. • Tender breasts. • Weak or brittle bones. • Trouble concentrating. • Moodiness and irritability. • Vaginal dryness or atrophy. • Hot flashes and night sweats. • Irregular periods or no periods (amenorrhea). • Weight gain, especially in your belly. • Headaches before or during your period. • Decreased sex drive. • Feeling fatigued and having trouble sleeping (insomnia).
- 11. Causes of High levels of estrogen • Medications • Body fat • Stress • Alcohol • Liver problems • Synthetic xenoestrogens
- 12. Effects of high levels of estrogen • Infertility. • Erectile dysfunction • A condition called gynecomastia, where the breasts become enlarged • Irregular Menstrual cycle (unpredictable timing, light or heavy bleeding) • Dense breast tissue
- 13. Cont. High estrogen levels are associated with a variety of conditions. Estrogen doesn’t necessarily cause these conditions. Instead, estrogen may worsen a condition or symptom you already have, including: • Breast cancer • Ovarian cancer • Endometriosis pain. • Insulin resistance • Polycystic ovarian syndrome (PCOS) • Uterine cancer (endometrial cancer). • Tumors on your ovaries and adrenal glands.
- 14. 3. Progestrone • Progesterone is an endogenous steroid hormone that is commonly produced by the the gonads, as well as the adrenal cortex. • It prepares endometrium for conception and supports pregnancy. • 0.1 to 0.7 ng/mL in the follicular stage of the menstrual cycle, 2 to 25 ng/mL in the luteal stage of the menstrual cycle, 10 to 44 ng/mL during the first trimester of pregnancy, 19.5 to 82.5 ng/mL during the second trimester of pregnancy.
- 15. Causes of low level of Progesterone • Anovulation • Polycystic ovary syndrome (PCOS) • High stress • Hypothyroidism • Hyperprolactinemia • Low cholesterol • Perimenopause • Over-exercising or extreme dieting
- 16. Effects of low level of Progesterone • Irregular menstrual periods • Headaches • Difficulty conceiving • Mood changes, anxiety or depression. • Trouble sleeping • Hot flashes • Bloating or weight gain Some symptoms of low progesterone in pregnant Women are: • Spotting (light vaginal bleeding) • Low blood sugar • Breast tenderness. • Fatigue • Miscarriage
- 17. Causes of High level of Progesterone • Hormone Replacement • Hormone Contraceptives • Pregnancy • Ovarian Cysts • Congenital Adrenal Hyperplasia
- 18. Effects of high levels of Progesterone • Headache • Nausea or vomiting • Diarrhea or constipation • Fatigue • Breast tenderness • Muscle or joint pain • Mood swings • Vaginal discharge Molar Pregnancy Another condition associated with high progesterone is a molar pregnancy. This happens when the embryo doesn't form correctly and the placenta grows into a noncancerous tumor.
- 19. Aldosterone • Main function of aldosterone is to increase in retaining water and Sodium and excrete Potassium from body. • The levels of aldosterone varies depending on the time of day, physical activity, body position change, and others, the negative and positive predictive values of one random aldosterone level are limited but a normal and well hydrated individual has average 3 – 25 micrograms per 24 hours (mcg/24 hrs).
- 20. Causes of high levels of Aldosterone • Having higher-than-normal aldosterone levels is usually considered hyperaldosteronism. The main cause of hyperaldosteronism is primary aldosteronism, also known as Conn’s syndrome. This condition is usually caused by a benign (noncancerous) tumor on one of your adrenal glands, which causes the gland to overproduce aldosterone.
- 21. Effects of high levels of Aldosterone • High aldosterone levels cause elevated sodium levels (hypernatremia) and low potassium levels (hypokalemia), often resulting in an electrolyte imbalance • High blood pressure (hypertension) • Headache • Muscle weakness, especially if potassium levels are very low • Extreme thirst and frequent urination
- 22. Causes of low levels of Aldosterone • Addison’s disease: This rare condition, also known as primary adrenal insufficiency, is an autoimmune disease in which your immune system attacks the outer portion of your adrenal glands (the cortex), where aldosterone and the hormone cortisol are made. This results in low levels of both aldosterone and cortisol. • Congenital adrenal hyperplasia (CAH): CAH describes a group of genetic disorders affecting your adrenal glands. People with CAH are born with deficiencies of certain enzymes that are necessary for the production of hormones your adrenal glands make. • Certain health conditions: People with diabetes, kidney disease, lead poisoning or severe illness can develop hypoaldosteronism. • Certain medications: Non-steroidal anti-inflammatory drugs (NSAIDs), heparin or medications used to treat heart failure can cause hypoaldosteronism.
- 23. Effects of low levels of Aldosterone • Low blood pressure(hypotension) • Muscle weakness • Nausea • Heart palpitations • Irregular heartbeat (arrhythmia)
- 24. Renin-Angiotensin-Aldosterone system (RAAS) • When your blood pressure falls, your kidneys release the enzyme renin into your bloodstream. • Renin splits angiotensinogen, a protein your liver makes and releases, into pieces. One piece is the hormone angiotensin I. • Angiotensin I, which is inactive (doesn’t cause any effects), flows through your bloodstream and is split into pieces by angiotensin- converting enzyme (ACE) in your lungs and kidneys. One of those pieces is angiotensin II, an active hormone.
- 25. Cont. • Angiotensin II causes the muscular walls of small arteries (arterioles) to constrict (narrow), which increases blood pressure. • Angiotensin II also triggers your adrenal glands to release aldosterone and your pituitary gland to release antidiuretic hormone (ADH, or vasopressin). • Together, aldosterone and ADH cause your kidneys to retain sodium. Aldosterone also causes your kidneys to release (excrete) potassium through your urine. • The increase in sodium in your bloodstream causes water retention. This increases blood volume and blood pressure, thus completing the renin-angiotensin-aldosterone system.
- 27. Effects of high levels of Renin-Angiotensin • High Blood Pressure • Cardiovascular disease Congestive heart failure Stroke Vascular diseases • Kidney failure • Metabolic disease Hypokalemia Hypernatremia Edema
- 28. Effect of abnormal level of thyroid hormones
- 29. Overview The endocrine system is a complex network of glands that produce hormones that regulate many important bodily functions. When these hormones are out of balance, it can lead to various health problems. So, in this lecture we will discuss the effect of abnormal levels of different hormones Including: • Thyroid Hormones • Cortisol • Serotonin • Gonadal Hormones • Aldosterone • Rennin-angiotensin system Abnormal levels of various hormones in the body can significantly affect physiological functions.
- 30. Effect of abnormal level of thyroid hormones 1. Thyroid Hormones (T3 and T4) • The thyroid gland is a vital endocrine (hormone-producing) gland. It plays a major role in chemical reactions in the body (our metabolism), as well as our growth and development. • The thyroid gland's main function is to produce thyroid hormones, which regulate your metabolism • The two main hormones your thyroid releases — thyroxine (T4) and triiodothyronine (T3) — collectively make up thyroid hormone. • These hormones (T3, T4) regulate metabolism, heart rate, and body temperature.
- 31. Abnormal level of these hormones causes. 1. Hyperthyroidism. 2. Hypothyroidism. Hyperthyroidism (High Level): Hyperthyroidism, also known as an overactive thyroid, is a condition that occurs when your thyroid gland produces too much thyroid hormone. This can cause your metabolism to speed up, leading to several symptoms that can affect your entire body. Unintended weight loss, even though you may be eating more Rapid heartbeat (tachycardia) or irregular heartbeat Fatigue and muscle weakness Skin that feels warm and moist
- 32. • Causes. • Thyroid hyperplasia (Grave Diseases) • Hyperfunctional multinodular goiter • Hyperfunctional thyroid adenoma • Other causes include, • Excessive iodine intake. • Pregnancy and medication containing thyroid hormones.
- 33. Graves Diseases. • Most common cause of hyperthyroidism. It is an autoimmune disease. • It occurs when autoantibodies (Thyroid Stimulating Immunoglobins) are directed against the TSH receptor and mimic action of TSH leads to T3 and T4 release. It also leads to goiter. • Graves Ophthalmopathy • It is associated with grave diseases when the immune system attacks orbital preadipocyte fibroblast resembles TSHR causing eye protrusion.
- 34. Effects of hyperthyroidism C.V.S Tachycardia Increase cardiac output Hypertension G.I.T Hypermotility and malabsorption Diarrhea Body weight Loss of body weight and muscle weakness.
- 35. Hypothyroidism (Low Level) Hypothyroidism, also known as an underactive thyroid, is a condition that occurs when your thyroid gland doesn't produce enough thyroid hormone. This can slow down your metabolism, leading to several symptoms that can affect your entire body. Fatigue: This is the most common symptom of hypothyroidism. Weight gain: Even though you may not be eating more, you may gain weight because your metabolism has slowed down. Sensitivity to cold: People with hypothyroidism often feel cold, even in warm weather. Muscle aches and weakness: Hypothyroidism can cause muscle aches, weakness, and stiffness.
- 36. Causes. Causes include primary and secondary Hypothyroidism. Primary Hypothyroidism. Primary hypothyroidism vast majority of cases worldwide. It includes • Autoimmune thyroiditis ( Hashimoto thyroiditis). • Dietary Iodine deficiency. • Genetic mutation (PAX8, FOXE1, TSH receptor mutation). • Thyroid surgery. • Drugs (lithium, iodides, sulfonylureas). • Secondary Hypothyroidism. • It is caused by TSH deficiency (pituitary failure) and TRH deficiency (Hypothalamic failure).
- 37. Cortisol Cortisol is a steroid hormone, also referred to as the "stress hormone", that is produced in the adrenal glands. It plays a critical role in the body's stress response, helping to regulate a variety of essential functions including • Metabolism, Immune response, Blood pressure regulation, Brain Function • Its level is controlled by Corticotropin-releasing hormone (CRH) in the hypothalamus and Adrenocorticotropic hormone (ACTH) in the pituitary gland. • High levels of ACTH detected in the adrenal gland stimulate the secretion of cortisol.
- 38. High cortisol (chronic stress): This can lead to weight gain, high blood pressure, anxiety, depression, and difficulty sleeping. Cushing Syndrome Too much cortisol over a prolonged time leads to a condition called Cushing Syndrome. Causes include: 1. Administration of exogenous glucocorticoids. 2. Primary hypothalamic-pituitary disorder. 3. Adrenal adenoma or carcinoma. • Primary ACTH hypersecretion accounts for 70% with women (4:1) ratio. • Ectopic ACTH secretion accounts for 10%. • Primary adrenal neoplasm for 10% and carcinoma in 5% cases.
- 39. Addison Diseases Addison's disease, also known as primary adrenal insufficiency, occurs when the adrenal glands do not produce enough cortisol and sometimes aldosterone. • It is an autoimmune disease associated with the destruction of 90% of the adrenal cortex. • Other causes include tuberculosis, fungal infection, and HIV. • Secondary causes include hypothalamic and pituitary (tumor, infarction, infection) disorders leading to diminished ACTH production. Clinical symptoms Clinical symptoms include: • Weakness, fatigue. , Anorexia • Hyperkalemia, hypotension due to adrenaline insufficiency. • Darkening of skin. • Low blood sugar. • Weight loss and decreased appetite.
- 40. Serotonin • Serotonin, often called the "feel-good" chemical, is a complex molecule that acts as both a neurotransmitter and a hormone in the human body. It's produced in the intestines and central nervous system and plays a role in a wide range of bodily functions • It plays an important role in the body influencing learning, happiness, mood, and memory. • Low and high serotonin levels can cause physical and psychological changes in the body.
- 41. Causes Low serotonin levels. • Genetic causes • Inadequate intake of tryptophan. • Medical conditions( anxiety, depression, insomnia ) • Certain medications like antidepressants, antipsychotics, etc. • Effects • Mood disorder, sleep disturbance, appetite changes, constipation, and impaired learning, memory, and decision-making.
- 42. High serotonin level Excessive accumulation of serotonin in the body creates the symptoms of serotonin syndrome. Certain medication increases serotonin levels; • SSRI and SNRI • Tricyclic antidepressant • MAOI (Antidepression) • Symptoms • Insomnia, restlessness, HBP, rapid heart rate, • Diarrhea, excess sweating, etc.
Editor's Notes
- Gonads are glands that produce hormones that are involved in reproduction and other functions of the body.
- Development of Male Reproductive Tissues: Testosterone is crucial for the development of male reproductive organs such as the testes and the prostate gland during fetal development. Promotion of Secondary Sexual Characteristics: During puberty, testosterone levels surge, leading to the development of secondary sexual characteristics in males such as increased muscle mass, facial and body hair growth, deepening of the voice, and enlargement of the Adam’s apple. Muscle and Bone Health: Testosterone plays a key role in maintaining muscle mass and strength. It stimulates protein synthesis, leading to muscle growth. Additionally, testosterone contributes to bone density and helps maintain bone strength. Sperm Production: Testosterone is essential for the production of sperm (spermatogenesis) in the testes. It stimulates the Sertoli cells in the testes, which support the development of sperm cells. Libido (Sex Drive): Testosterone influences sexual desire and arousal in both men and women. Higher levels of testosterone are associated with increased libido. Mood Regulation: Testosterone can influence mood and behavior. Low testosterone levels have been linked to symptoms such as irritability, fatigue, and depression in men. Cognitive Function: Testosterone may also play a role in cognitive function, including memory, spatial abilities, and verbal fluency, although the exact mechanisms are still being studied. Metabolic Health: Testosterone helps regulate metabolism, including fat metabolism. Low levels of testosterone have been associated with increased body fat and insulin resistance. Cardiovascular Health: Testosterone may have a protective effect on cardiovascular health, including reducing the risk of heart disease. However, the relationship between testosterone levels and cardiovascular health is complex and not fully understood.
- Polycystic Ovary Syndrome (PCOS): Polycystic ovary syndrome (PCOS) is a common hormonal condition that affects women of reproductive age. It usually starts during adolescence, but symptoms may fluctuate over time. PCOS can cause hormonal imbalances, irregular periods, excess androgen levels and cysts in the ovaries. Irregular periods, usually with a lack of ovulation, can make it difficult to become pregnant. PCOS is a leading cause of infertility. PCOS is a chronic condition and cannot be cured. However, some symptoms can be improved through lifestyle changes, medications and fertility treatments Puberty: During puberty, both males and females experience a surge in testosterone levels, which is essential for the development of secondary sexual characteristics. Testosterone Replacement Therapy (TRT): In some cases, individuals may undergo TRT to supplement low testosterone levels. However, improper dosage or administration can lead to elevated testosterone levels. Tumors: Tumors in the testes, ovaries, adrenal glands, or pituitary gland can result in excess testosterone production. Steroid Abuse: Anabolic steroids, often abused by athletes and bodybuilders, can significantly increase testosterone levels. However, this is often accompanied by various health risks and side effects. Adrenal Hyperplasia: This condition involves the overgrowth or enlargement of the adrenal glands, which can lead to excessive production of androgens, including testosterone. Certain Medications: Some medications, such as corticosteroids and certain antidepressants, can interfere with hormone regulation and lead to increased testosterone levels as a side effect.
- Testicular agenesis: A rare 46,XY disorder of gonadal development characterized by congenital complete absence of testicular tissue in an individual with an otherwise normal male phenotype and normal karyotype. Cryptorchidism: A condition in which one or both of the testes fail to descend from the abdomen into the scrotum. Orchitis: Orchitis is an inflammation of one or both testicles. Bacterial or viral infections can cause orchitis, or the cause can be unknown. Kallmann’s Syndrome: It is a congenital disorder. This hormonal disorder is due to underdevelopment of specific neurons, or nerves, in the brain that signal the hypothalamus. Without these neurons, the hypothalamus cannot properly stimulate the production and release of certain hormones by the pituitary gland. In normal development, the hypothalamus secretes bursts of gonadotropin-releasing hormone (GnRH) at puberty. These bursts of GnRH trigger the pituitary gland to produce hormones that in turn prompt the release of male and female sex hormones by the gonads (testicles and ovaries) and the development of sperm and egg cells. In Kallmann syndrome, the hypothalamus fails to secrete these bursts of GnRH in utero, during infancy, and at puberty.
- Low levels of testosterone increases the risk of Alzheimer's disease. Gynecomastia involves increase in breast tissue in men.
- Estrogen regulates important processes in your skeletal, cardiovascular, and central nervous systems that impact your overall health. Estrogen affects: Cholesterol levels. Blood sugar levels. Bone and muscle mass. Circulation and blood flow. Collagen production and moisture in your skin. Brain function, including your ability to focus. While men have significantly lower levels of estrogen compared to women, it still plays important roles in male physiology, such as regulating bone density, lipid metabolism, and sexual function.
- Primary ovarian insufficiency: also called premature ovarian insufficiency, premature menopause, and premature ovarian failure, is the partial or total loss of reproductive and hormonal function of the ovaries before age 40 because of follicular dysfunction or early loss of eggs. Age Estrogen levels decrease during menopause. At this point, the primary form of estrogen in your body switches from estradiol (produced primarily in your ovaries) to estrone (produced primarily in body fat). Eating disorders Eating disorders like anorexia and bulimia can deprive your body of the nutrients it needs to keep your hormone levels balanced. Genetic conditions. Turner syndrome and Fragile X syndrome both cause low estrogen. Autoimmune diseases. Autoimmune diseases that attack your ovaries can prevent them from making enough estrogen. Treatments impacting your ovaries. Cancer treatments, like radiation and chemotherapy, may damage your ovaries. The injury may prevent your ovaries from secreting normal levels of estrogen. Having one or both ovaries removed (oophorectomy) as part of treatment can also cause low estrogen. Conditions affecting your pituitary gland. Your pituitary gland secretes hormones that tell your ovaries to start making estrogen. Your body may produce low estrogen levels if your pituitary gland doesn't release enough of these hormones. Hypothalamic amenorrhea. If your body is stressed (ex., excessive exercise) and not getting enough nourishment, you can develop hypothalamic amenorrhea. With hypothalamic amenorrhea, your brain doesn’t release enough of the hormone that activates estrogen production in your ovaries. As a result, your periods stop entirely. Athletes assigned female at birth are particularly susceptible.
- Medications: Hormone therapy to boost low estrogen levels may cause your levels to become too high at first. It may take some time to get the dosage right. (high-dose oral contraceptives/birth control pills) Body fat: Fat tissue (adipose tissue) secretes estrogen. Having a high percentage of body fat can lead to high estrogen levels. Stress: Your body produces the hormone cortisol in response to stress. Producing high amounts of cortisol in response to stress can deplete your body’s ability to produce progesterone. The estrogen in your body is left unchecked by progesterone. Alcohol: Drinking too much alcohol can increase your estrogen levels and reduce your body’s ability to break down (metabolize) estrogen. Liver problems: Your liver breaks down estrogen and eliminates it from your body. If your liver’s not functioning correctly, too much estrogen can accumulate. Too few digestive enzymes, too much bad gut bacteria (dysbiosis), low magnesium levels and too little fiber in your diet can prevent your liver from removing excess estrogen. Synthetic xenoestrogens: Synthetic xenoestrogens are chemicals found in the environment that act like estrogen once they’re inside your body. They can increase your estrogen levels. Xenoestrogens include bisphenol A (BPA) and phthalates. Both of these chemicals are used in various plastics. Xenoestrogens can also be found in pesticides, household cleaning products and some soaps and shampoos.
- Anovulation: Ovulation doesn’t occur (your ovary doesn’t release an egg). Polycystic ovary syndrome (PCOS): A hormone imbalance that causes missed periods and unpredictable ovulation. PCOS can also cause small cysts to develop on your ovaries. High stress: Cortisol is your stress hormone, and too much of it can interfere with your body’s ability to make progesterone. Hypothyroidism: A slow or underactive thyroid. It makes it harder for your body to make progesterone. Hyperprolactinemia: Your body makes too much prolactin, the hormone responsible for lactation. Prolactin disrupts other sex hormones like progesterone, leading to irregular cycles or loss of your menstrual period. Low cholesterol: Low levels of cholesterol can cause low progesterone. Perimenopause: The time just before menopause when your hormone levels decline. Over-exercising or extreme dieting: This can increase cortisol levels and put stress on your body. It also deprives your body of key nutrients needed to sustain healthy hormone levels.
- Contraceptives are medications used for preventing pregnancy, It mainly contains progesterone which prevents follicle maturation and ovulation
- Having lower-than-normal aldosterone levels is usually considered hypoaldosteronism, which is a condition characterized by a lack of (deficiency) or impaired function of aldosterone. Low levels of aldosterone result in low sodium levels (hyponatremia), elevated potassium levels (hyperkalemia) and a condition in which your body produces too much acid (metabolic acidosis).