ENDO 101: Everything You (Should) Want to Know About Endocrinology

By Mary Green

Chances are that if you’re reading this article, you’re in a medical office reception area or a doctor’s exam room. And odds are better than even that you are there to be seen by an endocrinologist, a physician who specializes in the diagnosis and treatment of a wide range of conditions affecting the endocrine system including diabetes, thyroid disorders, growth hormone deficiency, infertility, cholesterol problems, hypertension, obesity and more.

The word endocrinology is from the Greek words endon, meaning “within” and krīnō, meaning “to separate” and is a branch of medicine that deals with the endocrine system’s glands, the actions of their hormones (a chemical substance, formed in endocrine glands, that controls and regulates the function of specifically receptive organs or tissues when transported to them by body fluids) and the metabolic consequences. The endocrine system’s glands and organs secrete hormones that regulate a number of vital functions of our body. Although every organ system in the body secretes or responds to hormones, endocrinology focuses primarily on the endocrine glands whose primary function is hormone secretion. These include the hypothalamus, pineal, pituitary, thyroid, parathyroid, adrenals, pancreas, testes and ovaries.

Hormones have many different functions and modes of action and often affect different parts of the body in different ways. For example, the male sex hormone testosterone is responsible for sex drive, but also impacts muscle size and encourages the growth of pubic, facial or body hair. There are up to 40 different hormones circulating in your blood at any time. Once released into the bloodstream, a hormone circulates throughout the body until it reaches its specific target -- or targets -- to perform its function. These targets can be either other endocrine glands or other organs and tissues in the body.

While all these glands normally coordinate with each other exceptionally well in order to regulate various metabolic processes, hormonal function is a balancing act of sorts. Too much or too little of one hormone can have an impact on the release of other hormones. If this hormonal imbalance occurs, some of your body’s systems do not work properly. In order to bring the hormones back to their normal levels, your body has built-in mechanisms to keep track and respond to any changes by means of a complex, but highly efficient, feedback system that links some endocrine glands with others. Normal balance is maintained by the body by “feeding” some of its hormones (and sometimes other hormones) from the target back to the original endocrine gland. This “tells” the endocrine gland to release more or less of the hormone.

When this system goes awry and there appears to be a problem, a patient is usually referred by his/her primary care physician to an endocrinologist, who is an expert in treating frequently complex (and often chronic) conditions which can involve several different systems within the body.

Endocrinologists perform diagnostic tests to evaluate the problem, determine a course of treatment and counsel patients on lifestyle changes that can improve the medical condition(s). This type of specialist needs extensive knowledge of clinical chemistry and biochemistry to understand the physiology and chemical processes underlying endocrine disorders. Many endocrinologists also are involved in clinical research to gain a better understanding of endocrine disease and to assist in the development of better treatment options. Some endocrinologists treat a range of endocrine disorders, while others choose to specialize in a single category such as diabetes, infertility or thyroid.

While certain disorders are clearly within the domain of endocrinologists, others can involve the endocrinology system even though they don’t originate there. In these cases, the endocrinologist may work with an internist, primary care physician or a specialist in another discipline to coordinate the patient’s follow-up care.

In order to become an endocrinologist, one must first complete medical school, advanced training during three to four years of a residency program, and a minimum of two years’, but often three years’, further sub-specialization in a fellowship before seeking required certification from the American Board of Internal Medicine.

Because endocrinology encompasses so many conditions and diseases, there is great demand from patients for information. For that reason, the American Association of Clinical Endocrinology (www.aace.com) and its educational, scientific and charitable arm, the American College of Endocrinology, have created an in-depth patient information website which features educational materials covering a broad range of endocrine conditions: a “Find an Endocrinologist” feature where the public can locate endocrinologists by geographic region and/or specialty; valuable tips on how to charge of your health; and online issues of this magazine. Visit www.empoweryourhealth.org to learn more about endocrine conditions or www.aace.com to learn more about endocrinologists and AACE, the largest association of clinical endocrinologists in the world, with 6,500 members in the U.S. and abroad.