What do the terms "endocrine" and "hormone" mean?
The endocrine glands of the body include the pituitary, thyroid, parathyroid, adrenal, pineal, and thymus glands. The pancreas, ovaries, and testes also act as endocrine glands. The endocrine system is a controlling system of the body. It controls cell activities by releasing chemical messengers called hormones into the bloodstream.
What are estrogen and testosterone?
Estrogens and testosterone are important hormones and are both normally present in females and males. In females, estrogen works together with other hormones such as progesterone and testosterone to control puberty, monthly periods, healthy reproduction, and bone health. Estrogens, produced mainly by the ovaries in females, are necessary for the growth (in girls and young women) and the maintenance (in adulthood) of normal healthy bone.
In males,testosterone is the main male sex hormone produced mostly by the testes. Testosterone is responsible for normal development of sex organs, normal puberty, and fertility in males. For males, normal testosterone and estrogen levels are necessary for the growth and maintenance of muscle and bone mass.
What is the role of hormonal balance in the promotion of healthy bones in youth?
Peak bone mass, defined as the maximum bone density an individual will ever have, is reached between 16 and 25 years of age. Hormonal balance is one of the factors necessary to reach peak bone mass. Low levels of hormones (estrogen and/or testosterone) during youth and young adulthood are associated with lower peak bone mass.
What is the role of hormonal balance in the promotion of healthy bones in adulthood?
In adulthood, after peak bone mass is reached, low estrogen levels in women can increase the rate of bone breakdown and cause bone loss. In men, any condition or disease causing low levels of testosterone or estrogen may also result in bone loss.
When you have a hormonal or an endocrine disorder it is crucial to consult with your healthcare provider to get the medical treatment necessary to control your condition and optimize your bone health.
The following conditions associated with endocrine/hormonal disorders (listed alphabetically) may increase the risk for osteoporosis:
What is amennorhea?
Amenorrhea is the absence of menstrual cycles. There are some reasons to stop having menstrual periods during the premenopausal years such as during pregnancy and the use of certain medications prescribed by healthcare providers. However, there are a number of medical conditions that can also cause amenorrhea in premenopausal women. For example, the athletic female triad is a syndrome consisting of disordered eating, excessive exercise, and amenorrhea that results in bone loss. Bone density is lower in athletes with amenorrhea in comparison to athletes with regular menstrual cycles. Some of the other common causes of amenorrhea include the use of certain medications and some medical conditions such as thyroid disease, polycystic ovarian syndrome, and pituitary disorders.
How does amennorhea affect bone health?
Amenorrhea that is not related to pregnancy can often lead to lower bone density, particularly if it is related to lower estrogen levels. In all cases, it is important to consult with a doctor or healthcare provider to determine the cause for amenorrhea. Early detection and treatment of disorders that can cause amenorrhea may help reduce the risk for osteoporosis.
What is Cushing's disease?
In Cushing's disease, the body produces an excess of cortisol, a steroid hormone. Cushing's disease is caused by the presence of a non-cancerous (benign) tumor on the pituitary gland.
How does Cushing's syndrome affect bone health?
This overproduction of cortisol can produce the same problems for bones as that caused by the use of steroid medications.
What is diabetes?
Diabetes is a condition characterized by high blood glucose levels resulting from the body's inability to use blood glucose for energy. In Type 1 diabetes, the pancreas no longer makes insulin and therefore blood glucose cannot enter the cells to be used for energy. In Type 2 diabetes, either the pancreas does not make enough insulin or the body is not able to use insulin properly.
How does Type 1 diabetes affect bone health?
Type I diabetes appears to be a significant risk factor for osteoporosis. In Type 1 diabetics, the cells that form bone do not seem to work as well as those in the general population, perhaps due to the absence of the bone forming effects of insulin. This may be one of the reasons why low bone mass occurs. Further research is needed to better understand the complex relationship between Type 1 diabetes and osteoporosis.
How does Type 2 diabetes affect bone health?
People with Type 2 diabetes usually have normal or even increased bone mass compared with those without diabetics. The higher body weight typical of individuals with Type 2 diabetes may account for the normal or increased bone mass. However, evidence suggests that despite normal bone mass, people with Type 2 diabetes tend to have a higher risk for fracture than non-diabetics. Much of the increased risk for fracture is due to a higher risk for falls. To begin with, many women with Type 2 diabetes are overweight and inactive. These two factors tend to lessen coordination and balance making it more likely for a person to fall. People with Type 2 diabetes often have complications such as impaired vision, peripheral nerve damage, or foot problems, all of which can contribute to a fall. Finally, some people with Type 2 diabetes (especially if their blood glucose is poorly controlled) find that they frequently have to get out of bed during the night to use the bathroom. Walking around in the dark in a sleepy state, especially without proper lighting, can greatly increase the risk of falls.
How can people with Type 1 and Type 2 diabetes protect their bones?
There are many actions that individuals with diabetes can take to help protect their bones:
What are the parathyroid glands and what do they do?
The parathyroid glands are four small endocrine glands (the size of peas) that are located at the base of the neck next to the thyroid gland. Although they are neighbors and both part of the endocrine system, the thyroid and parathyroid glands are otherwise not related. The parathyroid glands produce parathyroid hormone that is largely responsible for maintaining normal levels of calcium in the blood.
What is hyperparathyroidism?
Hyperparathyroidism is overactivity of one or more of the parathyroid glands. In hyperparathyroidism, too much parathyroid hormone is produced. In primary hyperparathyroidism, excessive levels may be the result of a tumor (that is usually benign). A surgical procedure to remove the benign tumor is often required.
How does hyperparathyroidism affect bone health?
Hyperparathyroidism can result in bone loss and higher calcium levels in the blood. Primary hyperparathyroidism may lead to a lower bone mass at some skeletal sites while bone mass at other skeletal sites will be preserved. A recent study found that there was an increased risk for fractures (broken bones) at the spine, forearm, and lower extremities in people with primary hyperparathyroidism. The increased fracture risk can happen more than several years before having surgery to remove the parathyroid gland. After parathyroid surgery, fracture risk stabilizes and there is no additional fracture risk associated with the disease.
What is hyperprolactinemia?
Hyperprolactinemia is a condition characterized by an overproduction of prolactin, the hormone responsible for milk production in a woman's breasts. Often women with hyperprolactinemia experience a milky discharge from their breasts and amennorhea, the stopping of their menstrual periods.
How does hyperprolactinemia affect bone health?
Increased prolactin levels can lead to decreased bone density when compared with healthy individuals of the same age. It is important to consult a healthcare provider to diagnose and treat hyperprolactinemia. Treatment with certain medications typically results in the return of normal ovarian function and lowers the risk for osteoporosis.
What is Klinefelter syndrome?
Kleinfelter syndrome is the most common sex chromosome variation in males. It is estimated to occur in 1 out of 500 men. The disease is caused by an extra X, or female, sex chromosome. The extra X chromosome interferes with the development of male characteristics. Men with Klinefelter syndrome often have low testosterone levels. Characteristics of Klinefelter syndrome vary from person to person.
The low testosterone levels associated with Klinefelter syndrome increase the risk for developing osteoporosis. The lower the testosterone level, the lower the bone density.
What is thyroid hormone?
Thyroid hormone is a hormone secreted into the bloodstream by the thyroid gland located in the front of the neck. The purpose of thyroid hormone is to regulate the body's metabolism. It can affect heart rate, body weight, energy level, muscle strength, skin condition, mental state, intestinal function, bone health, and menstrual cycles in females.
How does thyroid disease affect bone health?Too much thyroid hormone can increase bone loss and increase the risk for osteoporosis. There are different conditions that result in excess thyroid hormone:
How can people with thyroid disease protect their bones?
What is Turner syndrome?<
Turner syndrome is a chromosomal condition that only affects girls and women. It occurs when one of the two X chromosomes normally found in females is missing or incomplete. Almost all people with Turner syndrome have short stature and loss of ovarian function resulting in low estrogen levels. No real causes have been found for this condition. It appears to randomly occur and affects 1 out of 2500 females live births worldwide.
How does Turner syndrome affect bone health?There is a high incidence of osteoporosis in women with Turner syndrome. The main cause of osteoporosis appears to be low levels of estrogen but there may also be defects in bone structure and strength. Children with Turner syndrome do not tend to have the increases in bone mass normally seen at puberty. Women with Turner syndrome tend to have lower bone mass than their peers.