Autoimmune Endocrine Diseases

Hormone Imbalances in Endocrine Disease

Thyroidgland - nih.gov
Thyroidgland - nih.gov
This article describes the autoimmune endocrine disorders and their effects on hormone levels.

Autoimmune endocrine disorders are diseases of the endocrine glands caused by an immune system defect known as autoimmunity. In autoimmunity, the immune system errs in its response and targets the body's tissues and cells. Most autoimmune endocrine disorders target single organs, for instance the adrenal gland is targeted in Addison's disease and the pancreas's Islet of Langerhans is affected in type I diabetes.

In patients with multiple autoimmune endocrine disorders and in patients with autoimmune polyglandular syndromes, two or more glands are affected. Autoimmune endocrine disorders include: Hashimoto's thyroiditis, Graves' disease, Addison's disease (adrenal gland insufficiency), autoimmune hypophysitis (pituitary gland insufficiency), autoimmune oophritis (ovarian insufficiency), insulin dependent (type 1) diabetes mellitus (IDDM), autoimmune hypoparathyroidism, testicular insufficiency, and premature ovarian failure.

Multiple Endocrine Disorders

Patients with organ specific autoimmune endocrine disorders such as type I diabetes or Graves' disease are more likely to develop a second autoimmune endocrine disorder than other people. Some of these people may have two co-existing glandular disorders and others may go on to develop one of the autoimmune polyglandular syndromes.

Autoimmune thyroid disorders are the most common autoimmune endocrine disorder, and they are also the disorder most likely to occur in people with other autoimmune endocrine disorders. For instance, it's not unusual for people with Addison's disease or type I diabetes to develop Hashimoto's thyroiditis years later. Even in the absence of autoimmune thyroid disease, a large number of patients with other endocrine disorders have high titers of thyroid antibodies.

Symptoms in Autoimmune Endocrine Disease

The body's endocrine glands produce hormones that help regulate various functions including growth, metabolism, and reproduction. Autoimmune disorders usually damage endocrine glands thereby causing hormone deficiencies. The exception is Graves' disease, a disorder of excess thyroid hormone production. Symptoms of endocrine disease vary depending on the particular gland affected. In type I diabetes, destruction of the pancreas results in diminished insulin production. Without adequate levels of insulin blood glucose levels rise.

Overall, deficiencies and excesses of hormones affect all of the bodily symptoms and consequently they cause a wide range of symptoms. Most people affected will have several predominant symptoms that can change over time rather than all symptoms associated with the disorder. Similar to most other autoimmune conditions, symptoms in endocrine conditions wax and wane, with periods of remission frequently alternating with periods of variable symptoms. Autoimmune endocrine disorders such as hypothyroidism, Addison's disease and premature ovarian failure are associated with fertility problems causing a condition of autoimmune infertility.

Treatment

Treatment primarily consists of correcting the hormonal imbalance and suppressing the immune system with corticosteroids and other immunosuppressant agents. Because symptoms wax and wane, regular monitoring of hormone levels is necessary. Because of the high incidence of autoimmune thyroid disease in patients with other endocrine disorders, patients with other endocrine disorders should have routine screening tests for thyroid function and thyroid antibodies regularly.

Source: Robert Volpe, Autoimmune Endocrinopathies, 1999.

Elaine at NYC Best of Reference Library Awards, Lisa Moore

Elaine Moore - I'm a retired medical technologist and medical writer with more than 30 years experience working in hospital laboratories. Currently, I ...

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Comments

Dec 17, 2008 12:45 PM
Guest :
Would a lo b12,low vitamin d, insulin resistance and stomach pain point to an endocrine issue?
Dec 19, 2008 9:45 AM
Elaine Moore :
Hi,
Endocrinologists typically people with diabetes and insulin resistance since the pancreas is an endocrine gland. About 1/2 of the population are showing Vitamin D deficiency...so now that we're testing more people it appears that this condition is pretty widespread. Vitamin B12 deficiency can have several causes--read my article on it. Either an internist or an endo could help you figure out the cause and manage treatment. Best, Elaine
May 14, 2011 5:38 AM
Guest :
The article was very informative. I am a mom of an 11 year old boy. In Oct., of 2010 he was diagnosed with AutoImmune Addison's Disease. He's currently taking hydrocortisone & florinef to regulate these hormones. I was recently informed that his DHEA levels are extremely low, but there's not a lot of research backing whether or not to supplement. What is your opinion on this? Also, he does have TPO antibodies, but the Endo tells me that the thyroid is functioning normally. I have read several articles stating that when you have thyroid antibodies, the lab work is not accurate, and that the thyroid levels can fluctuate between hyper and hypo. It seems as though some doctors believe you should treat for thyroid disease even if lab work comes back normal, while others have more of a wait and see approach. The concerns me because I don't know which way to go for my son. He has been suffering with extreme anxiety and depression for about two months, and is exhibiting a lot of OCD symptoms. He has completely lost interest in all of the things he used to love. The psychiatrist has written a prescription for Zoloft and some other anti-anxiety drug, but as a mother I feel as though we need to get to the underlying medical issues. I'm sorry this is so long, but I feel completely alone, and can't seem to find a doctor who seems to know what to do for him. Most we've seen don't even return phone calls. Thanks for any answers you may provide. Signed, Desperate for My Son
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