ENDOCRINE SYSTEM

INTRODUCTION
All the physiological activities of the body are regulated by two major systems:
1. Nervous system
2. Endocrine system.
These two systems interact with one another and regulate the body functions.
Endocrine system functions by secreting some chemical substances called hormones.
ENDOCRINE GLANDS
Endocrine glands are the glands which synthesize and release the classical hormones into the
blood. Endocrine glands are also called ductless glands because the hormones secreted by
them are released directly into blood without any duct. Endocrine glands are distinct from
exocrine glands which release their secretions through ducts. Endocrine glands play an
important role in homeostasis and control of various other activities in the body through their
hormones. Hormones are transported by blood to target organs or tissues in different parts of
the body, where the actions are executed.

Major Endocrine Glands

Dr. Manish Kumar Sharma Page 1

 Hormones secreted by major Endocrine glands

Hormone secreted by Gonads

Hormones secreted by other organs

Dr. Manish Kumar Sharma Page 2

  Hormones
CHEMISTRY OF HORMONES
Hormones are chemical messengers, synthesized by endocrine glands. Based on
chemical nature, hormones are classified into three types :
1. Steroid hormones
2. Protein hormones
3. Derivatives of the amino acid called tyrosine.
STEROID HORMONES
Steroid hormones are the hormones synthesized from cholesterol or its derivatives.
Steroid hormones are secreted by adrenal cortex, gonads and placenta.
PROTEIN HORMONES
Protein hormones are large or small peptides. Protein hormones are secreted by
pituitary gland, parathyroid glands, pancreas and placenta (‘P’s). „
TYROSINE DERIVATIVES
Two types of hormones, namely thyroid hormones and adrenal medullary hormones
are derived from the amino acid tyrosine.

MECHANISM OF HORMONAL ACTION

Hormone does not act on the target cell directly. It combines with receptor to form
hormone-receptor complex. This complex executes the hormonal action by any one of
the following mechanisms:
1. By altering permeability of cell membrane
2. By activating intracellular enzyme
3. By acting on genes
BY ALTERING PERMEABILITY OF CELL MEMBRANE
Neurotransmitters in synapse or neuromuscular junction act by changing the
permeability of postsynaptic membrane. For example, in a neuromuscular junction,

Dr. Manish Kumar Sharma Page 3

 when an impulse (action potential) reaches the axon terminal of the motor nerve,
acetylcholine is released from the vesicles. Acetylcholine increases the permeability
of the postsynaptic membrane for sodium, by opening the ligand-gated sodium
channels. So, sodium ions enter the neuromuscular junction from ECF through the
channels and cause the development of endplate potential.
BY ACTIVATING INTRACELLULAR ENZYME
Protein hormones and the catecholamines act by activating the intracellular enzymes.
BY ACTING ON GENES
Thyroid and steroid hormones execute their function by acting on genes in the target
cells.

Situation of Hormonal receptors

Pituitary Gland
INTRODUCTION
Pituitary gland or hypophysis is a small endocrine gland with a diameter of 1 cm and weight
of 0.5 to 1 g. It is situated in a depression called ‘sella turcica’, present in the sphenoid bone
at the base of skull. It is connected with the hypothalamus by the pituitary stalk or
hypophyseal stalk.
DIVISIONS OF PITUITARY GLAND
Pituitary gland is divided into two divisions:
1. Anterior pituitary or adenohypophysis
2. Posterior pituitary or neurohypophysis.
ANTERIOR PITUITARY OR ADENOHYPOPHYSIS
Anterior pituitary is also known as the master gland because it regulates many other
endocrine glands through its hormones.

Dr. Manish Kumar Sharma Page 4

PARTS
Anterior pituitary consists of three parts :
1. Pars distalis
2. Pars tuberalis
3. Pars intermedia.

HISTOLOGY
Anterior pituitary has two types of cells, which have different staining properties:
1. Chromophobe cells
2. Chromophil cells.

HORMONES SECRETED BY ANTERIOR PITUITARY

Six hormones are secreted by the anterior pituitary:
1. Growth hormone (GH) or somatotropic hormone (STH)
2. Thyroid-stimulating hormone (TSH) or thyrotropic hormone
3. Adrenocorticotropic hormone (ACTH)
4. Follicle-stimulating hormone (FSH)
5. Luteinizing hormone (LH) in females or interstitial cell-stimulating hormone (ICSH) in
males
6. Prolactin.
GROWTH HORMONE
Source of Secretion Growth hormone is secreted by somatotropes which are the acidophilic
cells of anterior pituitary.

Dr. Manish Kumar Sharma Page 5

Basal level of GH concentration in blood of normal adult is up to 300 g/dL and in children, it
is up to 500 ng/ dL.
Actions of Growth Hormone
GH is responsible for the general growth of the body. Hypersecretion of GH causes enormous
growth of the body, leading to gigantism. Deficiency of GH in children causes stunted
growth, leading to dwarfism. GH is responsible for the growth of almost all tissues of the
body, which are capable of growing. It increases the size and number of cells by mitotic
division. GH also causes specific differentiation of certain types of cells like bone cells and
muscle cells.
GH also acts on the metabolism of all the three major types of foodstuffs in the body, viz.
proteins, lipids and carbohydrates.
1. On metabolism
GH increases the synthesis of proteins, mobilization of lipids and conservation of
carbohydrates.
2. On bones
In embryonic stage, GH is responsible for the differentiation and development of bone
cells. In later stages, GH increases the growth of the skeleton. It increases both the
length as well as the thickness of the bones.
Thyroid-stimulating Hormone (TSH)
TSH is necessary for the growth and secretory activity of the thyroid gland.
Adrenocorticotropic Hormone (ACTH)
ACTH is necessary for the structural integrity and the secretory activity of adrenal cortex.
Follicle-stimulating Hormone (FSH)
Follicle-stimulating hormone is a glycoprotein.
Actions of FSH
In males, FSH acts along with testosterone and accelerates the process of spermeogenesis.
In females , FSH: Causes the development of graafian follicle from primordial follicle.
Stimulates the theca cells of graafian follicle and causes secretion of estrogen.
Luteinizing Hormone (LH)
LH is a glycoprotein.
Actions of LH
In males, LH is known as interstitial cell-stimulating hormone (ICSH) because it stimulates
the interstitial cells of Leydig in testes. This hormone is essential for the secretion of
testosterone from Leydig cells.

Dr. Manish Kumar Sharma Page 6

In females, LH: Causes maturation of vesicular follicle into graafian follicle along with
follicle-stimulating hormone.
Is responsible for ovulation.
Is necessary for the formation of corpus luteum
Activates the secretory functions of corpus luteum.
Prolactin
Prolactin is necessary for the final preparation of mammary glands for the production and
secretion of milk.
POSTERIOR PITUITARY OR NEUROHYPOPHYSIS „
PARTS
Posterior pituitary consists of three parts:
1. Pars nervosa or infundibular process
2. Neural stalk or infundibular stem
3. Median eminence.
Pars tuberalis of anterior pituitary and the neural stalk of posterior pituitary together form the
hypophyseal stalk.
HORMONES OF POSTERIOR PITUITARY
Posterior pituitary hormones are:
1. Antidiuretic hormone (ADH) or vasopressin
2. Oxytocin.
Source of Secretion of Posterior Pituitary
Hormones Actually, the posterior pituitary does not secrete any hormone. ADH and oxytocin
are synthesized in the hypothalamus. From hypothalamus, these two hormones are
transported to the posterior pituitary through the nerve fibers of hypothalamo-hypophyseal
tract.
ANTIDIURETIC HORMONE
Actions Antidiuretic hormone has two actions:
1. Retention of water
2. Vasopressor action.
 Retention of water
Major function of ADH is retention of water by acting on kidneys. It increases the facultative
reabsorption of water from distal convoluted tubule and collecting duct in the kidneys.

Dr. Manish Kumar Sharma Page 7

  Vasopressor action
In large amount, ADH shows vasoconstrictor action. Particularly, causes constriction of the
arteries in all parts of the body. Due to vasoconstriction, the blood pressure increases.
OXYTOCIN
Actions in Females In females, oxytocin acts on mammary glands and uterus.
Action of oxytocin on mammary glands
Oxytocin causes ejection of milk from the mammary glands.
Action on uterus
Oxytocin acts on pregnant uterus and also non-pregnant uterus.
On pregnant uterus
Throughout the period of pregnancy, oxytocin secretion is inhibited by estrogen and
progesterone. At the end of pregnancy, the secretion of these two hormones decreases
suddenly and the secretion of oxytocin increases. Oxytocin causes contraction of uterus and
helps in the expulsion of fetus.
On non-pregnant uterus
The action of oxytocin on non-pregnant uterus is to facilitate the transport of sperms through
female genital tract up to the fallopian tube, by producing the uterine contraction during
sexual intercourse.
Action in Males
In males, the release of oxytocin increases during ejaculation. It facilitates release of sperm
into urethra by causing contraction of smooth muscle fibers in reproductive tract, particularly
vas deferens.
APPLIED PHYSIOLOGY – DISORDERS OF PITUITARY GLAND
HYPERACTIVITY OF ANTERIOR PITUITARY
1. Gigantism
Gigantism is the pituitary disorder characterized by excess growth of the body. The
subjects look like the giants with average height of about 7 to 8 feet.
2. Acromegaly
Acromegaly is the disorder characterized by the enlargement, thickening and
broadening of bones, particularly in the extremities of the body.
HYPOACTIVITY OF ANTERIOR PITUITARY
1. Dwarfism
Dwarfism is a pituitary disorder in children, characterized by the stunted growth.
2. Acromicria
Acromicria is a rare disease in adults characterized by the atrophy of the
extremities of the body.

Dr. Manish Kumar Sharma Page 8

 3. Simmond Disease
A major feature of Simmond disease is the rapidly developing senile decay. Thus,
a 30- years-old person looks like a 60-years-old person. The senile decay is
mainly due to deficiency of hormones from target glands of anterior pituitary, i.e.
the thyroid gland, adrenal cortex and the gonads.

Thyroid Gland
INTRODUCTION
Thyroid is an endocrine gland situated at the root of the neck on either side of the trachea. It
has two lobes, which are connected in the middle by an isthmus. It weighs about 20 to 40 g in
adults. Thyroid is larger in females than in males. The structure and the function of the
thyroid gland change in different stages of the sexual cycle in females. Its function increases
slightly during pregnancy and lactation and decreases during menopause.

HORMONES OF THYROID GLAND

Thyroid gland secretes three hormones:
1. Tetraiodothyronine or T4 (thyroxine)
2. Tri-iodothyronine or T3
3. Calcitonin.
T4 is otherwise known as thyroxine and it forms about 90% of the total secretion, whereas T3
is only 9% to 10%.
FUNCTIONS OF THYROID HORMONES
Thyroid hormones have two major effects on the body:
I. To increase basal metabolic rate
II. To stimulate growth in children.

Dr. Manish Kumar Sharma Page 9

 The actions of thyroid hormones are:
1. ACTION ON BASAL METABOLIC RATE (BMR)
Thyroxine increases the metabolic activities in most of the body tissues, except brain,
retina, spleen, testes and lungs. It increases BMR by increasing the oxygen
consumption of the tissues. The action that increases the BMR is called calorigenic
action. In hyperthyroidism, BMR increases by about 60% to 100% above the normal
level and in hypothyroidism it falls by 20% to 40% below the normal level.
2. ACTION ON PROTEIN METABOLISM
Thyroid hormone increases the synthesis of proteins in the cells.
3. ACTION ON CARBOHYDRATE METABOLISM
Thyroxine stimulates almost all processes involved in the metabolism of
carbohydrate.
Thyroxine: Increases the absorption of glucose from GI tract.
Increases the breakdown of glycogen into glucose.
4. ACTION ON FAT METABOLISM
Thyroxine decreases the fat storage by mobilizing it from adipose tissues and fat
depots. The mobilized fat is converted into free fatty acid and transported by blood.
Thus, thyroxine increases the free fatty acid level in blood.
5. ACTION ON PLASMA AND LIVER FATS
Even though there is an increase in the blood level of free fatty acids, thyroxine
specifically decreases the cholesterol, phospholipids and triglyceride levels in plasma.
So, in hyposecretion of thyroxine, the cholesterol level in plasma increases, resulting
in atherosclerosis.
6. ACTION ON VITAMIN METABOLISM
Thyroxine increases the formation of many enzymes. Since vitamins form essential
parts of the enzymes, it is believed that the vitamins may be utilized during the
formation of the enzymes. Hence, vitamin deficiency is possible during
hypersecretion of thyroxine.
7. ACTION ON BODY TEMPERATURE
Thyroid hormone increases the heat production in the body, by accelerating various
cellular metabolic processes and increasing BMR.

8. ACTION ON GROWTH
Increase in thyroxine secretion accelerates the growth of the body, especially in
growing children. Lack of thyroxine arrests the growth. Deficiency of thyroid
hormones during fetal life leads to mental retardation.
9. ACTION ON BODY WEIGHT
Thyroxine is essential for maintaining the body weight. Increase in thyroxine
secretion decreases the body weight and fat storage. Decrease in thyroxine secretion
increases the body weight because of fat deposition.
10. ACTION ON BLOOD
Thyroxine accelerates erythropoietic activity and increases blood volume.
11. ACTION ON CARDIOVASCULAR SYSTEM
Thyroxine increases the overall activity of cardiovascular system.
12. ACTION ON RESPIRATION
Thyroxine increases the rate and force of respiration.

Dr. Manish Kumar Sharma Page 10

 13. ACTION ON GASTROINTESTINAL TRACT
Generally, thyroxine increases the appetite and food intake. It also increases the
secretions and movements of GI tract. So, hypersecretion of thyroxine causes diarrhea
and the lack of thyroxine causes constipation.
14. ACTION ON CENTRAL NERVOUS SYSTEM
Thyroxine is very essential for the development and maintenance of normal
functioning of central nervous system (CNS).
15. ACTION ON SKELETAL MUSCLE
Thyroxine is essential for the normal activity of skeletal muscles.
16. ACTION ON SLEEP
Normal thyroxine level is necessary to maintain normal sleep pattern.
17. ACTION ON SEXUAL FUNCTION
Normal thyroxine level is essential for normal sexual function. In men,
hypothyroidism leads to complete loss of libido (sexual drive) and hyperthyroidism
leads to impotence. In women, hypothyroidism causes menorrhagia and
polymenorrhea. Hyperthyroidism in women leads to oligomenorrhea and sometimes
amenorrhea.
APPLIED PHYSIOLOGY – DISORDERS OF THYROID GLAND
HYPERTHYROIDISM
Increased secretion of thyroid hormones is called hyperthyroidism.
Hyperthyroidism is caused by:
1. Graves’ disease
2. Thyroid adenoma
Graves’ disease is an autoimmune disease and it is the most common cause of
hyperthyroidism.
Symptoms – irritability , muscle weakness, sleeping problems etc.
Thyroid adenoma Sometimes, a localized tumor develops in the thyroid tissue. It is known as
thyroid adenoma and it secretes large quantities of thyroid hormones. It is not associated with
autoimmunity.
Signs and Symptoms of Hyperthyroidism
1. Intolerance to heat as the body produces lot of heat due to increased basal metabolic rate
caused by excess of thyroxine
2. Increased sweating due to vasodilatation
3. Decreased body weight due to fat mobilization
4. Diarrhea due to increased motility of GI tract
5. Muscular weakness because of excess protein catabolism
6. Nervousness, extreme fatigue, inability to sleep, mild tremor in the hands.

Dr. Manish Kumar Sharma Page 11

HYPOTHYROIDISM
Decreased secretion of thyroid hormones is called hypothyroidism. Hypothyroidism leads to
myxedema in adults and cretinism in children.
Myxedema
Myxedema is the hypothyroidism in adults, characterized by generalized edematous
appearance.
Cretinism
Cretinism is the hypothyroidism in children, characterized by stunted growth.
Signs and Symptoms of Hypothyroidism:
1. Anemia
2. Fatigue and muscular sluggishness
3. Extreme somnolence with sleeping up to 14 to 16 hours per day
4. Menorrhagia and polymenorrhea
5. Decreased cardiovascular functions such as reduction in rate and force of contraction of the
heart, cardiac output and blood volume
6. Increase in body weight
7. Constipation
GOITER
Goiter means enlargement of the thyroid gland. It occurs both in hypothyroidism and
hyperthyroidism.

Parathyroid Glands
INTRODUCTION
Human beings have four parathyroid glands, which are situated on the posterior surface of
upper and lower poles of thyroid gland. Parathyroid glands are very small in size, measuring
about 6 mm long, 3 mm wide and 2 mm thick, with dark brown color.
Histology
Each parathyroid gland is made up of chief cells and oxyphil cells. Chief cells secrete
parathormone.
PARATHORMONE
Parathormone secreted by parathyroid gland is essential for the maintenance of blood calcium
level within a very narrow critical level.

Dr. Manish Kumar Sharma Page 12

Half-life and Plasma Level
Parathormone has a half-life of 10 minutes. Normal plasma level of PTH is about 1.5 to 5.5
ng/dL.
ACTIONS OF PARATHORMONE
PTH plays an important role in maintaining blood calcium level. It also controls blood
phosphate level.

Parathyroid glands on the posterior surface of thyroid

gland
ACTIONS OF PARATHORMONE ON BLOOD CALCIUM LEVEL
Primary action of PTH is to maintain the blood calcium level within the critical range of 9 to
11 mg/dL. The blood calcium level has to be maintained critically because, it is very
important for many of the activities in the body. PTH maintains blood calcium level by acting
on:
1. Bones
2. Kidney
3. Gastrointestinal tract
1. On Bones
Parathormone enhances the resorption of calcium from the bones (osteoclastic activity) by
acting on osteoblasts and osteoclasts of the bone.

Dr. Manish Kumar Sharma Page 13

2. On Kidney
PTH increases the reabsorption of calcium from the renal tubules along with magnesium ions
and hydrogen ions. It increases calcium reabsorption mainly from distal convoluted tubule
and proximal part of collecting duct.
PTH also increases the formation of 1,25- dihydroxycholecalciferol (activated form of
vitamin D) from 25-hydroxycholecalciferol in kidneys.
3. On Gastrointestinal tract
PTH increases the absorption of calcium ions from the GI tract indirectly. It increases the
formation of 1,25- dihydroxycholecalciferol in the kidneys. This vitamin, in turn increases
the absorption of calcium from GI tract. Thus, the activated vitamin D is very essential for the
absorption of calcium from the GI tract. And PTH is essential for the formation of activated
vitamin D.
APPLIED PHYSIOLOGY – DISORDERS OF PARATHYROID GLANDS
Disorders of parathyroid glands are of two types:
I. Hypoparathyroidism
II. Hyperparathyroidism
HYPOPARATHYROIDISM – HYPOCALCEMIA
Hyposecretion of PTH is called hypoparathyroidism. It leads to hypocalcemia (decrease in
blood calcium level).
Hypocalcemia causes neuromuscular hyperexcitability, resulting in hypocalcemic tetany.
Normally, tetany occurs when plasma calcium level falls below 6 mg/dL from its normal
value of 9.4 mg/dL.
Hypocalcemic Tetany
Tetany is an abnormal condition characterized by violent and painful muscular spasm (spasm
= involuntary muscular contraction), particularly in feet and hand. It is because of
hyperexcitability of nerves and skeletal muscles due to calcium deficiency.
HYPERPARATHYROIDISM – HYPERCALCEMIA
Hypersecretion of PTH is called hyperparathyroidism. It results in hypercalcemia.
Signs and symptoms of hypercalcemia
i. Depression of the nervous system
ii. Sluggishness of reflex activities
iii. Lack of appetite
iv. Constipation

Dr. Manish Kumar Sharma Page 14

CALCITONIN
Source of Secretion Calcitonin is secreted by the parafollicular cells or clear cells (C cells),
situated amongst the follicles in thyroid gland.
ACTIONS OF CALCITONIN
Calcitonin plays an important role in controlling the blood calcium level. It decreases the
blood calcium level and thereby counteracts parathormone. Calcitonin reduces the blood
calcium level by acting on bones, kidneys and intestine.
Calcitonin stimulates osteoblastic activity and facilitates the deposition of calcium on bones.
Calcitonin increases excretion of calcium through urine, by inhibiting the reabsorption from
the renal tubules.
Calcitonin prevents the absorption of calcium from intestine into the blood.
Pancreas
ISLETS OF LANGERHANS
Endocrine function of pancreas is performed by the islets of Langerhans. Human pancreas
contains about 1 to 2 million islets. Islets of Langerhans consist of four types of cells:
1. A cells or α-cells, which secrete glucagon
2. B cells or β-cells, which secrete insulin
3. D cells or δ-cells, which secrete somatostatin
4. F cells or PP cells, which secrete pancreatic polypeptide.

Dr. Manish Kumar Sharma Page 15

INSULIN
PLASMA LEVEL - Basal level of insulin in plasma is 10 µU/mL.
ACTIONS OF INSULIN
Insulin is the important hormone that is concerned with the regulation of carbohydrate
metabolism and blood glucose level. It is also concerned with the metabolism of proteins and
fats.
On Carbohydrate Metabolism
Insulin is the only antidiabetic hormone secreted in the body, i.e. it is the only hormone in the
body that reduces blood glucose level. Insulin reduces the blood glucose level by its
following actions on carbohydrate metabolism:
Increases transport and uptake of glucose by the cells
Promotes peripheral utilization of glucose
Promotes storage of glucose – glycogenesis (conversion of glucose into glycogen)
Inhibits glycogenolysis (the breakdown of glycogen into glucose in muscle and liver)
Inhibits gluconeogenesis (the formation of glucose from proteins)
On Protein Metabolism
Insulin facilitates the synthesis and storage of proteins and inhibits the cellular utilization of
proteins.
On Fat Metabolism
Insulin stimulates the synthesis of fat. It also increases the storage of fat in the adipose tissue.

On Growth
Along with growth hormone, insulin promotes growth of body by its anabolic action on
proteins. It enhances the transport of amino acids into the cell and synthesis of proteins in the
cells. It also has the protein-sparing effect, i.e. it causes conservation of proteins by
increasing the glucose utilization by the tissues.
GLUCAGON
ACTIONS OF GLUCAGON
Actions of glucagon are antagonistic to those of insulin. It increases the blood glucose level,
peripheral utilization of lipids and the conversion of proteins into glucose.

Dr. Manish Kumar Sharma Page 16

SOMATOSTATIN „
SOURCE OF SECRETION
Somatostatin is secreted from:
1. Hypothalamus
2. D cells (δ-cells) in islets of Langerhans of pancreas
3. D cells in stomach and upper part of small intestine„
ACTIONS OF SOMATOSTATIN
1. Somatostatin acts within islets of Langerhans and, inhibits β and α cells, i.e. it inhibits the
secretion of both glucagon and insulin
2. It decreases the motility of stomach, duodenum and gallbladder
3. It reduces the secretion of gastrointestinal hormones gastrin, CCK (Cholecystokinin).
4. Hypothalamic somatostatin inhibits the secretion of GH and TSH from anterior pituitary.
That is why, it is also called growth hormone-inhibitory hormone (GHIH).
APPLIED PHYSIOLOGY
HYPOACTIVITY – DIABETES MELLITUS
Diabetes mellitus is a metabolic disorder characterized by high blood glucose level,
associated with other manifestations.

Dr. Manish Kumar Sharma Page 17

Classification of Diabetes Mellitus
Type I Diabetes Mellitus
Type I diabetes mellitus is due to deficiency of insulin because of destruction of β-cells in
islets of Langerhans. This type of diabetes mellitus may occur at any age of life. But, it
usually occurs before 40 years of age and the persons affected by this require insulin
injection. So it is also called insulin-dependent diabetes mellitus (IDDM). When it develops
at infancy or childhood, it is called juvenile diabetes.
Type II Diabetes
Mellitus Type II diabetes mellitus is due to insulin resistance (failure of insulin receptors to
give response to insulin). So, the body is unable to use insulin. About 90% of diabetic
patients have type II diabetes mellitus. It usually occurs after 40 years. Only some forms of
Type II diabetes require insulin. In most cases, it can be controlled by oral hypoglycemic
drugs. So it is also called noninsulindependent diabetes mellitus (NIDDM).
Signs and Symptoms of Diabetes Mellitus
Glucosuria - Glucosuria is the loss of glucose in urine
Osmotic dieresis- Osmotic diuresis is the diuresis caused by osmotic effects. Excess glucose
in the renal tubules develops osmotic effect. Osmotic effect decreases the reabsorption of
water from renal tubules, resulting in diuresis. It leads to polyuria and polydipsia.
Polyuria - Excess urine formation with increase in the frequency of voiding urine is called
polyuria.
Polydipsia - Increase in water intake is called polydipsia.
Polyphagia - Polyphagia means the intake of excess food. It is very common in diabetes
mellitus.
Asthenia - Loss of strength is called asthenia.
Acidosis - During insulin deficiency, glucose cannot be utilized by the peripheral tissues for
energy. So, a large amount of fat is broken down to release energy. It causes the formation of
excess ketoacids, leading to acidosis.
HYPERACTIVITY – HYPERINSULINISM
Hyperinsulinism is the hypersecretion of insulin.
Signs and Symptoms of Hyperinsulinism
1. Hypoglycemia Blood glucose level falls below 50 mg/dL.
2. Manifestations of central nervous system
Initially, the activity of neurons increases, resulting in nervousness, tremor all over the body
and sweating. If not treated immediately, it leads to clonic convulsions and unconsciousness.
Slowly, the convulsions cease and coma occurs due to the damage of neurons.

Dr. Manish Kumar Sharma Page 18

Adrenal Cortex
IMPORTANCE OF ADRENAL GLANDS
Adrenal glands are called the ‘life-saving glands’ or ‘essential endocrine glands’. It is
because the absence of adrenocortical hormones causes death within 3 to 15 days and absence
of adrenomedullary hormones, decreases the resistance to mental and physical stress.
FUNCTIONAL ANATOMY OF ADRENAL GLANDS
There are two adrenal glands. Each gland is situated on the upper pole of each kidney.
Because of the situation, adrenal glands are otherwise called suprarenal glands. Each gland
weighs about 4 g.
PARTS OF ADRENAL GLAND
Adrenal gland is made of two distinct parts:
1. Adrenal cortex: Outer portion, constituting 80% of the gland
2. Adrenal medulla: Central portion, constituting 20% of the gland.
HISTOLOGY OF ADRENAL CORTEX
Adrenal cortex is formed by three layers of structure. Each layer is distinct from one another.
1. Outer zona glomerulosa
2. Middle zona fasciculata
3. Inner zona reticularis

HORMONES OF ADRENAL CORTEX

Adrenocortical hormones are steroids in nature, hence the name ‘corticosteroids’. Based on
their functions, corticosteroids are classified into three groups:

Dr. Manish Kumar Sharma Page 19

1. Mineralocorticoids
2. Glucocorticoids
3. Sex hormones
MINERALOCORTICOIDS
Mineralocorticoids are the corticosteroids that act on the minerals (electrolytes), particularly
sodium and potassium. Mineralocorticoids are:
1. Aldosterone
2. 11-deoxycorticosterone.
Mineralocorticoids (Aldosterone) - Life-saving Hormone, it maintains the osmolarity and
volume of ECF.
It increases:
1. Reabsorption of sodium from renal tubules
2. Excretion of potassium through renal tubules
3. Secretion of hydrogen into renal tubules.
GLUCOCORTICOIDS
Glucocorticoids act mainly on glucose metabolism. Glucocorticoids are:
1. Cortisol
2. Corticosterone
3. Cortisone
Glucocorticoids (Cortisol) - Life-protecting hormone because, it helps to withstand the stress
and trauma in life.
It offers high resistance to the body against stress.
Glucocorticoids increase the blood glucose level.
Promote the catabolism of proteins.
Maintenance of water balance.
Stimulate the bone resorption and inhibit bone formation.
Anti-inflammatory Effects
ADRENAL SEX HORMONES
Adrenal sex hormones are secreted mainly by zona reticularis. Zona fasciculata secretes small
quantities of sex hormones. Adrenal cortex secretes mainly the male sex hormones, which are
called androgens. But small quantity of estrogen and progesterone are also secreted by
adrenal cortex.

Dr. Manish Kumar Sharma Page 20

Androgens secreted by adrenal cortex:
1. Dehydroepiandrosterone
2. Androstenedione
3. Testosterone
APPLIED PHYSIOLOGY
HYPERACTIVITY OF ADRENAL CORTEX
Hypersecretion of adrenocortical hormones leads to the following conditions:
1. Cushing syndrome
2. Hyperaldosteronism
3. Adrenogenital syndrome.
CUSHING SYNDROME
Cushing syndrome is a disorder characterized by obesity.
Signs and Symptoms
Pot belly: Due to fat accumulation in upper abdomen
Reddish purple stripes on abdomen
Moon face: The edematous facial appearance due to fat accumulation and retention of water
and salt
Buffalo hump: Due to fat deposit on the back of neck and shoulder
HYPERALDOSTERONISM
Increased secretion of aldosterone is called hyperaldosteronism.
Causes and Types Depending upon the causes, hyperaldosteronism is classified into two
types:
i. Primary hyperaldosteronism
ii. Secondary hyperaldosteronism
Primary hyperaldosteronism is otherwise known as Conn syndrome. It develops due to
tumor in zona glomerulosa of adrenal cortex.
Secondary hyperaldosteronism occurs due to extra adrenal causes such as:
Congestive cardiac failure , Nephrosis , Toxemia of pregnancy , Cirrhosis of liver
Signs and Symptoms
i. Increase in ECF volume and blood volume
ii. Hypertension due to increase in ECF volume and blood volume
iii. Severe depletion of potassium, which causes renal damage. The kidneys fail to
produce concen trated urine. It leads to polyuria and polydipsia.

Dr. Manish Kumar Sharma Page 21

 HYPOACTIVITY OF ADRENAL CORTEX
Hyposecretion of adrenocortical hormones leads to the following conditions:
1. Addison disease or chronic adrenal insufficiency
2. Congenital adrenal hyperplasia.
ADDISON DISEASE OR CHRONIC ADRENAL INSUFFICIENCY
Addison disease is the failure of adrenal cortex to secrete corticosteroids.
Signs and Symptoms develop in Addison disease because of deficiency of both cortisol
and aldosterone.
Pigmentation of skin
Muscular weakness
Dehydration with loss of sodium
Hypotension
CONGENITAL ADRENAL HYPERPLASIA
Congenital adrenal hyperplasia is a congenital disorder, characterized by increase in size
of adrenal cortex.

Adrenal Medulla
Medulla is the inner part of adrenal gland and it forms 20% of the mass of adrenal gland.
It is made up of interlacing cords of cells known as chromaffin cells.
Types of chromaffin cells Adrenal medulla is formed by two types of chromaffin cells:
1. Adrenaline-secreting cells (90%)
2. Noradrenaline-secreting cells (10%)
HORMONES OF ADRENAL MEDULLA
Adrenal medullary hormones are the amines derived from catechol and so these hormones are
called catecholamines. Catecholamines secreted by adrenal medulla
1. Adrenaline or epinephrine
2. Noradrenaline or norepinephrine
3. Dopamine
Adrenaline , Noradrenaline (Emergency hormone, Fight or Flight hormone, Catecholamines)
Functions -
Adrenaline and noradrenaline have similar effect of sympathetic stimulation.
Adrenaline increases oxygen consumption and carbon dioxide removal. It increases basal
metabolic rate. So, it is said to be a calorigenic hormone

Dr. Manish Kumar Sharma Page 22

It increases overall activity of the heart.
It causes constriction of blood vessels throughout the body.
Adrenaline increases systolic blood pressure by increasing the force of contraction of the
heart and cardiac output.
Increases rate and force of respiration.
Catecholamines cause contraction of smooth muscles in the Gallbladder and Uterus
Catecholamines cause relaxation of smooth muscles in urinary bladder and Bronchioles.
Dopamine - Increase in heart rate and Increase in systolic blood pressure. Dopamine does not
affect diastolic blood pressure.

PINEAL GLAND „
Pineal gland or epiphysis is located in the diencephalic area of brain above the hypothalamus.
It is a small coneshaped structure with a length of about 10 mm.
Pineal gland has two types of cells:
1. Large epithelial cells called parenchymal cells
2. Neuroglial cells.
In adults, the pineal gland is calcified. But, the epithelial cells exist and secrete the hormonal
substance.
FUNCTIONS
Pineal gland has two functions:
1. It controls the sexual activities in animals by regulating the seasonal fertility. However, the
pineal gland plays little role in regulating the sexual functions in human being
2. It secretes the hormonal substance called melatonin
Hormone Function
Growth Hormone  GH is responsible for the growth of
almost all tissues of the body, which
are capable of growing.
 GH increases the synthesis of
proteins, mobilization of lipids and
conservation of carbohydrates.
 GH is responsible for the
differentiation and development of
bone cells.
Thyroid-stimulating Hormone (TSH)  TSH is necessary for the growth and
secretory activity of the thyroid gland.
 ACTH is necessary for the structural
integrity and the secretory activity of
Adrenocorticotropic Hormone (ACTH) adrenal cortex.

Dr. Manish Kumar Sharma Page 23

Follicle-stimulating Hormone (FSH)  In males, FSH acts along with
testosterone and accelerates the
process of spermeogenesis.
 In females FSH: Causes the
development of graafian follicle from
primordial follicle
 Stimulates the theca cells of graafian
follicle and causes secretion of
estrogen
Luteinizing Hormone (LH)  In males, LH is known as interstitial
cell-stimulating hormone (ICSH)
because it stimulates the interstitial
cells of Leydig in testes. This
hormone is essential for the secretion
of testosterone from Leydig cells.
 In females ,Causes maturation of
vesicular follicle into graafian follicle
along with follicle-stimulating
hormone.
 Is responsible for ovulation
 Is necessary for the formation of
corpus luteum
Prolactin  Prolactin is necessary for the final
preparation of mammary glands for
the production and secretion of milk.
Antidiuretic hormone (ADH)  Retention of water.
 Vasopressor action in arteries.
OXYTOCIN  Oxytocin causes ejection of milk
from the mammary glands.
 Oxytocin causes contraction of uterus
and helps in the expulsion of fetus.
Thyroxine  To increase basal metabolic rate
 To stimulate growth in children.
 Thyroxine increases the overall
activity of cardiovascular system.
 Thyroxine increases the rate and force
of respiration indirectly.
 Thyroxine is very essential for the
development and maintenance of
normal functioning of central nervous
system (CNS).
 Normal thyroxine level is essential
for normal sexual function.
Parathormone (PTH)  PTH plays an important role in
maintaining blood calcium level. It
also controls blood phosphate level.
 PTH maintains blood calcium level
by acting on:
1. Bones
2. Kidney 3. Gastrointestinal tract.

Dr. Manish Kumar Sharma Page 24

  Parathormone enhances the
reabsorption of calcium from the
bones, renel tubules, GI tract.
Calcitonin  Maintains blood calcium level by
deposition of calcium in bones.

Insulin  Insulin reduces the blood glucose

level by actions on carbohydrate
metabolism.
Glucagon  It increases the blood glucose level,
peripheral utilization of lipids and the
conversion of proteins into glucose.
Somatostatin  It inhibits the secretion of both
glucagon and insulin.
 It decreases the motility of stomach,
duodenum and gallbladder
 Hypothalamic somatostatin inhibits
the secretion of GH and TSH from
anterior pituitary.
Mineralocorticoids (Aldosterone)  Life-saving Hormone, it maintains the
osmolarity and volume of ECF.
 It increases:
1. Reabsorption of sodium from renal tubules
2. Excretion of potassium through renal
tubules
3. Secretion of hydrogen into renal tubules.
Glucocorticoids (Cortisol)  Life-protecting hormone because, it
helps to withstand the stress and
trauma in life.
 It offers high resistance to the body
against stress.
 Glucocorticoids increase the blood
glucose level.
 Promote the catabolism of proteins.
 Maintenance of water balance.
 Stimulate the bone resorption and
inhibit bone formation.
 Anti-inflammatory Effects

Adrenaline , Noradrenaline (Emergency  Adrenaline and noradrenaline have

hormone, Fight or Flight hormone, similar effect of sympathetic
Catecholamines) stimulation.
 Adrenaline increases oxygen
consumption and carbon dioxide
removal. It increases basal metabolic
rate. So, it is said to be a calorigenic
hormone

Dr. Manish Kumar Sharma Page 25

  It increases overall activity of the
heart.
 It causes constriction of blood vessels
throughout the body.
 Adrenaline increases systolic blood
pressure by increasing the force of
contraction of the heart and cardiac
output.
 Increases rate and force of respiration.
 Catecholamines cause contraction of
smooth muscles in the Gallbladder
and Uterus
 Catecholamines cause relaxation of
smooth muscles in urinary bladder
and Bronchioles.
Melatonin  At night, in the absence of light, the
pineal gland secretes the hormone
melatonin.
 Melatonin regulates the body’s sleep
patterns in both circadian (daily) and
seasonal patterns.
 In the morning, when light hits the
eye, photo receptors in the retina send
signals to the pineal gland, which
then decreases melatonin production
and we wake up.
 In humans, it inhibits the onset of
puberty by inhibiting the gonads.

Gland Hypoactivity Hyperactivity

Anterior pituitary Dwarfism Gigantism
Acromicria Acromegaly
Simmond disease
Posterior pituitary Diabetes insipidus Syndrome of inappropriate
hypersecretion of ADH
Thyroid Hypothyroidism leads to Goiter in Hyperthyroidism –
myxedema in adults and Toxic Goiter
cretinism in children.
Goiter in Hypothyroidism –
Non-toxic Goiter
Parathyroid Hypoparathyroidism – Hyperparathyroidism –
hypocalcemia and tetany hypercalcemia
Pancreas Diabetes mellitus/ Hyperinsulinism/
hyperglycemia hypoglycemia
Adrenal cortex Addison disease Cushing syndrome (obesity)
Hyperaldosteronism

Dr. Manish Kumar Sharma Page 26