George Trachte ENDO/REPRO

Spring 2016
Summary of Introduction to Endocrine Hormones
1. Hormone biochemistry dictates how they are produced, stored and released
2. Hormone receptor complexes mediate the physiological responses via secondary messenger
systems (peptide hormones) or via transcription (steroids)
3. The endocrine system is organized in a hierarchy.
When the Anterior pituitary is involved, the hierarchy involves the hypothalamus and usually
a tertiary endocrine gland in the periphery that produces a final hormone. This is called a
hypothalamic-pituitary endocrine axis.
Hypothalamic neuron projections into the Posterior pituitary release hormones directly into
circulation and this is the FINAL hormone of action
4. Hypothalamic and pituitary hormones are proteins. Tertiary endocrine hormones can be either
proteins (e.g., insulin) , steroids (e.g., glucocorticoids) or amino acid (e.g., thyroid hormones) based.
5. Specific and nonspecific carrier proteins bind most hormones.
This increases total serum concentrations (free hormone + carrier bound hormone) of
insoluble hormones (e.g., steroid & thyroid hormones) and
protects hormones from metabolism and excretion.
6. Response rates to protein hormone binding to receptor are generally rapid (minutes) and to steroid
hormones is slow (hours).
7. Hormone removal from circulation involves liver and/or kidney metabolism and bile or urinary
excretion.
8. Hypothalamic hormone secretion is pulsatile and is influenced by circadian rhythm.
9. One hormone may influence the response of another hormone. Hormones may be permissive,
additive, synergistic or antagonistic.
10. The purpose of these systems is to maintain homeostasis including regulating: metabolic rate;
electrolyte and fluid balance; fuel sources; growth; reproduction; etc.
Summary of Mammosomatotrophic Endocrine Axes
1. Growth Hormone Axis involves stimulatory and inhibitory hypothalamic hormones
2. Growth hormone action also involves IGF-1
3. GH and IGF-1 negatively feedback on the GH axis
4. Hyposecretion of GH can be treated with GH and/or IGF-1 analogs
5. Clinical diagnosis of hyposecretion requires a stimulatory test of GnRH-arginine co-stimulation or
insulin tolerance test
6. Hypersecretion of GH can be medically treated with dopamine agonists or somatostatin analogs.
Newer treatments include GH receptor antagonists
7. Prolactin endocrine axis involves hypothesized stimulatory and definitive inhibitory hypothalamic
regulation. Inhibitory stimulation is dominant.
8. Prolactin action in reproduction is in breast development during pregnancy and milk production. It
also has a role in immunity.
9. Hypersecretion of prolactin can be due to dopamine inhibitor based drugs or pituitary tumors
10. D2 receptors are often present on prolactin secreting tumors so dopamine agonists are effective
treatments (bromocriptine)
Summary of Thyroid Physiology
1. Thyroid hormone axis involves stimulatory hypothalamic and anterior pituitary hormones
2. There are two thyroid hormones. T3 is biologically more active. T4 has a longer half life. T4 is
converted to T3 in cells by deiodinases.
3. Thyroid hormones are required for normal development of the brain and for growth. Thyroid
hormones are key homeostatic regulators of metabolism.
4. Hyposecretion of thyroid hormones causes sloth-like sluggishness.
5. Hypersecretion of thyroid hormones causes roadrunner-like symptoms.
6. Clinical diagnosis of thyroid function includes resting levels of TSH and thyroid hormones.
7. Levothyroxine is usually used to treat hyposecretion (3rd most prescribed generic drug in 2014;
Synthroid was the 2nd most prescribed non-generic).
8. The Thioamide drugs, Methimazole (Carbimazole) and Propylthiouracil are frequently used to treat
thyroid hormone hypersecretion due to Graves disease. Methimazole and PTU inhibit Thyroid
Peroxidase. PTU also inhibits Iodinase I
9. Methimazole (Carbimazole) is preferred, except with pregnancy in which PTU is preferred.

10. Radioactive iodine destroys the thyroid gland hence is used to treat hyperthyroidism that does not
involve Graves disease.

Dopamine (-)

(-)

(-)

(aka somatotropin)

(+)