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Endocrine system
Dr. A.R. Joshi
Professor of Physiology
Control systems of body
 Nervous control
Quick action,short duration
 Hormonal control
Slow action,long duration
Hormone
A chemical messenger,protein/polypeptide
or steroid,secreted by ductless gland,directly
poured in blood and acts on target organ.
Types of hormones
 General
 Local
Paracrine
Autocrine
Thyroid hormones
 T 3
 T 4
 Thyrocalcitonin
Actions of T 3 and T 4
 Metabolic actions-
General cellular
Carbohydrate
Protein
Fat
Cholesterol
Actions of T 3 and T 4…cont
 Systemic actions-
CVS
RS
GIT
Bone marrow
Reproductive
CNS
Regulation of T 3 and T 4
 TSH from ant pituitary
 Blood iodine level
 Climatic temperature
Hyperthyroidism
 Intolerance to warmth
 Weight loss
 Exophtholmos
 Tremors
 Tachyrrhythmia
 Secondary diabetes
 Intolerance to cold
 Weight gain
 Non pitting oedema
 Bradycardia
 Atrophy of gonads
 Sluggish mental activity
Myxoedema
Cretinism
 Delayed mile-stones
 Stunted growth
 Mental retardation
 Repeated infections
 T 3 and T 4 levels
 TSH levels
 Radioactive iodine uptake
 Serum cholesterol
 Specific tests
Thyroid function tests
Mechanism of action of insulin
 Acts on membrane receptor
 Stimulates protein kinase enzyme
 Makes Glut4 protein available
 Carrier mediated diffusion of glucose
 Glucose moves inside the cell
 Blood glucose level reduced
Carbohydrate metabolism
 Glucose made available inside cell
 Glycogenesis stimulated
 Glycogenolysis inhibited
 Gluconeogenesis inhibited
Protein metabolism
 Amino-acids move inside the cell
 Protein synthesis stimulated
 Cellular growth stimulated
 Tissue repair stimulated
 Catabolism prevented
Fat metabolism
 Lipogenesis stimulated
 Lipolysis inhibited
Regulation of insulin
 Regulated by blood glucose level
 Increase in blood glucose increases
insulin secretion
 Secretion occurs in 2 phases
Rapid phase
Delayed phase
Hormonal regulation of BGL
Insulin group
 Insulin decreases blood
glucose level
Anti-insulin group
 Glucagon
 T3 and T4
 Glucocorticoids
 Catecholamines
 Growth hormone
( They increase blood
glucose level )
Diabetes mellitus
 Juvenile DM
 Maturity onset DM
IDDM (Type 1 )
NIDDM (Type 2 )
 Secondary DM
Metabolism in DM
 Hyperglycemia and glycosuria
 Increased catabolism
 Lipolysis stimulated
 FFA are burned by beta oxidation
 Ketone bodies formed
 Ketoacidosis and coma
Detection of DM
 Urine examination
 Blood glucose level
Fasting
P P
P G ( OGTT )
 G T T
 Glycated Hb
Management of DM
 Diet
 Exercise
 Drugs
Insulin injections
Oral anti-diabetic drugs
Adrenal hormones
Adrenal cortex
 Aldosterone
 Gluco-coticoids
 Sex hormones
Adrenal medulla
 Adrenaline
 Nor-adrenaline
 Dopamine
Gluco-corticoids
 Metabolic actions
Increase in BSL,AA & FFA
 Systemic actions
CVS,RS,Bone marrow,GIT,Renal,
Musculo-skeletal & CNS
Pharmacological actions….
 Anti-inflammatory
 Anti-allergic
 Anti-stress
 Immuno-suppressive
Side effects of gluco-corticoids
 Reduced immunity
 Secondary DM
 Hypertension
 Hyperacidity
 Osteoporosis
 Retaintion of salt and water
Actions of catecholamines
 Increase in HR and BP
 Broncho-dialatation
 Decreased GIT motility & secretions
 Relaxation of bladder
 Rise in BSL & FFA level
 Pupillary dilatation
 CNS stimulation
Uses of adrenaline
 Sudden cardiac arrest
 Acute bronchial asthma
 Anaphylactic shock
Role of dopamine
 Relation with schizophrenia
 Relation with parkinsonism
 Drug of choice in hypovolemic shock
 Relation with vomiting center
Polycystic ovary syndrome
( Hyper androgenic anovulation )
 Incidence – 5% to 10%
 Age – 18 to 44 years
PCOS……symptomatology
 Irregular or no menstruation
 Excess body or facial hairs
 Acne
 Pelvic pain
 Infertility
PCOS……aetiology
 Familial tendency
 Sedentary life style
 High faty,salty & rich carbohydrate diet
 Associated obesity
 Associated type 2 DM
PCOS……diagnostic triad
 No ovulation
 High androgen level
 Ovarian cysts
PCOS…….. management
 Lifestyle modifications
 Physical exercise to reduce weight
 Diet restrictions
 OCP for regularization of cycles
 Metformin
 Anti-androgen drugs
Infertility…….. causes
Males
 Mumps
 Undescended testis
 STDs
 Exposure to high
temperature
 Heavy metal toxicity
 Systemic illnesses
 Endocrinal abnormalities
Females
 Anovulation
 TB of endometrium
 Tubal block
 Uterine abnormalities
 Mumps
 STDs
 Systemic illnesses
 Endocrinal abnormalities
Infertility…..investigations
 Semen examination
 Endometrial biopsy
 Hystero-salpingo-graphy
 USG
 Laproscopic examination
 Special tests
Infertility…..management
 Treat the basic cause
 Drugs to stimulate gamatogenesis
 Surgical procedures
 Artificial insemination from sperm bank
 Invitro-fertilization
 Surrogate mother
Role of ayurveda….
 Early prediction by study of prakruti
 Measures to modify membrane
responses
 Long term medication without side
effects
 Modification of hypothalamo-
hypophysial-gonadal axis
For assistance in Clinical
Physiology
 Dr. A.R. Joshi
Professor of Physiology
(mobile :+919423523322)
email: aniruddharj@hotmail.com

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