An Overview of Endocrine Issues and Autoimmune Diseases

Endocrine disorders are diseases and conditions that affect your endocrine system. The endocrine system includes your glands, which secrete hormones that have effects on other organs in the body.

Your key endocrine glands include:

• Thyroid gland
• Pituitary gland
• Pineal gland
• Pancreas
• Ovaries
• Testes
• Parathyroid
• Hypothalamus
• Adrenals

Some of the most common endocrine disorders include a number of thyroid-related conditions, including:

• Hypothyroidism
• Hyperthyroidism
• Hashimoto's Thyroiditis
• Graves' disease
• Thyroid cancer
• Goiter
• Thyroiditis
• Thyroid nodules

Some other common endocrine disorders include:

• Adrenal disorders
• Diabetes
• Osteoporosis
• Pituitary disorders
• Polycystic ovary syndrome

Endocrine disorders have a number of causes, including:

• Some sort of dysfunction in the gland itself, which can be due to genetics, injury, or infection
• Benign or cancerous tumors or growths on the gland
• Autoimmune disease, where antibodies attack the gland
• A problem with the communications between endocrine glands, or a failure of one gland to stimulate another as needed
• A genetic disorder, such as multiple endocrine neoplasia (MEN) or congenital hypothyroidism

Endocrine disorders are commonly diagnosed via a combination of clinical evaluation of symptoms and medical history, blood tests, and in some cases, imaging tests, and biopsies.

Typically, endocrine disorders cause a deficiency or excess of hormone, so testing for the presence or lack of sufficient hormones, and the body's ability to produce them when challenged to, is a key step in diagnosis.

For example, testing for adrenal disorders can include measurement of levels of the key adrenal hormone cortisol, as well as challenge tests that measure the body's ability to produce cortisol when stimulated. Diabetes testing looks at glucose levels at a moment in time, over a longer period (such as with the Hemoglobin A1C test), and may also look at the body's ability to respond to glucose, such as in the glucose challenge test. Polycystic ovary syndrome involves a combination of blood tests to evaluate estrogen and testosterone levels, along with imaging tests to detect ovarian cysts.

Endocrine disorders of the thyroid gland are typically diagnosed by clinical examination and blood tests, and in some cases, imaging tests and thyroid biopsy.

The immune system is complex, and its job is to protect us from diseases and defend against infections, including bacteria, viruses, and pathogens.

With autoimmune disease, the immune system is confused, and goes on the attack against healthy cells, organs, tissue, and glands in the body as if they were infections or pathogens. Autoimmune disease is sometimes referred to as “friendly fire” by the immune system against our own body.

Some of the better-known autoimmune diseases include Hashimoto’s thyroiditis, Graves’ disease, multiple sclerosis, rheumatoid arthritis, lupus, and alopecia.

The causes of most autoimmune diseases are not well-known or understood. But experts do know that a combination of factors—genetics, toxic exposures, stress, pregnancy, nutritional deficiencies, and others—serve as a trigger in some people and can result in any one of around 80 different conditions that are considered autoimmune in nature.

Autoimmune diseases can be complicated to diagnose, because in some cases, early symptoms may be vague and general, such as fatigue, muscle aches and pain, and brain fog. But the most common sign in most autoimmune conditions is inflammation, and that can cause pain, swelling, and when external, redness.

Other symptoms really depend on the target of the autoimmune disease. For autoimmune thyroid disease, symptoms such as fatigue and weight changes reflect changes in thyroid function. Multiple sclerosis, which attacks the communication between muscles, can result in difficulties with coordination and walking. Rheumatoid arthritis, which attacks the joints, can cause pain and swelling in the joints, and reduced function.

Autoimmune disease diagnosis and treatment depends on the disease. The diagnosis process typically includes a clinical examination, family history, and blood tests as a starting point. Blood tests may measure key functions of organs that are targeted, but the key measures typically are evaluations of antibody levels, and markers and measures of inflammation and inflammatory responses in the body.

In some cases, imaging tests may be performed, such as x-rays to assess joint damage in rheumatoid arthritis, or an MRI to look for brain lesions in multiple sclerosis. In some cases, biopsies may be needed to differentiate benign from cancerous lesions, cysts, nodules, or masses, or may help further detect antibodies that are not evident from blood test but are present in organs or glands.

Treatment of autoimmune diseases frequently targets reduction of the inflammation, relief of related symptoms, and rebalancing of any affected hormones. In the cases of the more debilitating autoimmune diseases, modulation of the immune system to slow the rate of permanent damage to organs and tissues may be an important part of treatment.