Endocrine System and Metabolism: Quick Physiology Review (Quick Review Notes)
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Think of the hypothalamus as the pituitary's older sibling—it not only controls the actions of the pituitary but it secretes at least nine hormones to the pituitary's seven.
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Attached to the hypothalamus, the pituitary gland is a pea-sized, reddish-gray body that stores hormones from the hypothalamus and releases them into the bloodstream. The pituitary consists of an anterior lobe and a posterior lobe, each of which have distinct functions. The anterior lobe or adenophyophosis secretes hormones that regulate a wide variety of bodily functions. There are five anterior pituitary cells that secrete seven hormones:. Secrete human growth hormone hGH , aka somatotropin, which stimulates tissues to secrete hormones that stimulate body growth and regulate metabolism.
They stimulate the secretion of estrogen and progesterone, maturation of egg cells in the ovaries, and stimulate sperm production and secretion of testosterone in the testes. Secrete prolactin PRL , which initiates milk production in the mammary glands. Secrete adrenocorticotropic hormone ACTH , which stimulates the adrenal cortex to secrete glucocorticoids like cortisol.
Also secretes melanocyte-stimulating hormone MSH. Secrete thyroid-stimulating hormone TSH , which controls secretions of the thyroid gland.
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This table represents the types of hormones secreted by the cells of the anterior pituitary. Target Area. Human-growth hormone hGH. Stimulates tissue growth in the liver, muscles, bones, as well as protein synthesis, tissue repair, and elevation of blood glucose levels.
Stimulates development of oocytes immature egg cells and secretion of estrogen in females; stimulates sperm production in the testes in males. Luteinizing hormone LH. Stimulates secretion of estrogen and progesterone, including during ovulation, in females; stimulates testes to produce testosterone in males. When in excess, can cause darkening of the skin; may influence brain activity its exact role unknown—there is very little MSH in humans.
While the anterior lobe shoulders most of the work in producing hormones, the posterior lobe stores and releases only two: oxytocin and antidiuretic hormone ADH , or vasopressin. Secretes in response to uterine distention and stimulation of the nipples. Stimulates smooth muscle contractions of the uterus during childbirth, as well as milk ejection in the mammary glands. Secretes in response to dehydration, blood loss, pain, stress; inhibitors of ADH secretion include high blood volume and alcohol.
Decreases urine volume to conserve water, decreases water loss through sweating, raises blood pressure by constricting arterioles.
Even though it's very small, the pituitary gland isn't free from ailment—nothing is completely foolproof, after all. Most disorders of the pituitary glands are tumors, which are common in adults. In fact, they're almost always benign in nature! There are two types of pituitary tumors—secretory and non-secretory.
A secretory tumor produces too much of a hormone, while a non-secretory tumor does not. Regardless, if the tumor is big enough, it can hinder normal pituitary function. These tumors can be removed, or monitored and controlled with medication. Problems caused by tumors fall into certain categories:. Hyposecretion: Too little of a hormone is produced, interfering in normal function. Hypersecretion: Too much of a hormone is produced, interfering in normal function.
Mass effects: The tumor presses on the pituitary or other areas of the brain, causing pain, vision issues, or other problems. While the pituitary and hypothalamus can run into the above issues, on the whole they work a balancing act on your body. So the next time you're feeling juuuust right , you can thank the pituitary, hypothalamus, and all the other organs of the endocrine system. Plasma calcium in the fluorosis patients was generally in the normal range, but urinary calcium concentrations were lower than those of controls; dietary calcium intakes were considered to be adequate.
Vitamin D deficiency was not found. Elevated calcitonin was found in some but not all cases of skeletal fluorosis in a series of epidemiologic studies reviewed by Teotia et al. Huang et al. Calcitonin concentrations do not seem to have been routinely measured in cases of skeletal fluorosis, but elevated calcitonin does seem to be present when looked for.
The effect has been noted at fluoride intakes as low as 3. No animal studies have reported calcitonin concentrations after fluoride exposure. In humans, four small parathyroid glands are normally situated on the posterior surface of the thyroid. These glands produce PTH, a simple peptide hormone, which is the principal regulator of extracellular calcium Bringhurst et al.
The major mechanisms by which this effect occurs include the mobilization of calcium phosphate from the bone matrix, primarily from increased osteoclastic activity; in the kidney, increased reabsorption of calcium, decreased reabsorption of phosphate, and increased activation of vitamin D; and increased intestinal absorption of calcium Bringhurst et al.
PTH is also important for skeletal homeostasis bone remodeling. Regulation of PTH secretion is inversely related to the concentration of ionized calcium Bringhurst et al. Healthy individuals secrete PTH throughout the day pulses per hour ; blood concentrations of PTH also exhibit a diurnal pattern, with peak values after midnight and minimum values in late morning el-Hajj. Calcitonin inhibits bone resorption by acting directly on the osteoclast, but it appears to play only a small role in regulating bone turnover in adults Raisz et al. Elevated calcitonin concentrations are often present in certain types of malignancy, especially medullary thyroid carcinoma carcinoma arising from the thyroid parafollicular cells; Bringhurst et al.
One source suggests that subtle alterations in calcitonin production or response may play a role in metabolic bone disease Raisz et al. It is important to note that assays of PTH have varied over the years Bringhurst et al. Fuleihan et al. Circadian patterns of PTH concentrations differ in men and women Calvo et al. The diurnal fluctuations might be important for urinary calcium conservation el-Hajj Fuleihan et al. Alterations in PTH rhythms might contribute to or be associated with osteoporosis el-Hajj Fuleihan et al.
Fluoride ion has been shown to be a potent inhibitor of PTH secretion in bovine and human parathyroid cells in vitro Chen et al. No single mechanism is clearly responsible for inhibiting PTH secretion, suggesting that several mechanisms might be involved in its regulation. A number of animal studies of the effects of fluoride on parathyroid function are summarized below for more details, see Appendix E , Table E Administration of NaF as a lavage was found to elicit hyperparathyroidism in rats Yates et al.
Levy et al. More recently, increased serum inorganic fluoride due to use of the anesthetic isoflurane was associated with decreased ionized calcium and increased PTH and osteocalcin in cynomolgus monkeys Hotchkiss et al. The overactivity of the. Chavassieux et al. Because of wide variation, the increased serum PTH is not considered statistically significant, but mean serum PTH in both groups at 45 days was at least twice as high as at the beginning of the experiment.
This study and those of Faccini and Care and Hotchkiss et al. However, two other studies with low-calcium situations found an altered parathyroid response. Fluoride-treated animals with adequate dietary calcium showed only slightly increased osteoblastic activity after 2 months but elevated serum alkaline phosphatase activity and increased average width of trabecular bone after 1 year.
In an earlier study, Rosenquist et al. At 35 weeks, average serum immunoreactive PTH was reduced, but not significantly, in the fluoride-treated rats. At 51 weeks, calcium-deficient rats without fluoride showed elevated PTH the normal response , whereas calcium-deficient rats with fluoride showed very slightly less PTH than calcium-sufficient, fluoride-treated rats.
All groups had normal serum calcium concentrations. However, a better interpretation of the data is that the normal increase in PTH in response to a dietary calcium deficiency did not occur in the fluoride-treated animals. Elevated osteocalcin and alkaline phosphatase are considered markers for bone turnover Raisz et al. These animals were adults when the calcium deficiency was imposed, and the effect of fluoride treatment on animals with a preexisting calcium deficiency was not examined.
Substantially wider standard deviations were observed for all fluoride-treated and calcium-deficient groups than in the controls no fluoride, calcium sufficiency , suggesting variable responses in the animals. Dunipace et al. Fluoride reportedly had no effect on various clinical parameters monitored in normal, calcium-deficient, or malnourished animals; however, the papers showed results only for combinations of fluoride treatment groups, and calcium-related parameters such as PTH and calcitonin concentrations were not measured.
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The combination of general malnutrition and calcium deficiency was not examined. PTH was not measured. Tiwari et al. Although the authors did not measure PTH or examine bone histomorphometry, they did demonstrate specific changes in gene transcription in the duodenal mucosa, including decreased transcription of the genes for the vitamin D receptor and calbindin D 9 k a vitamin-D regulated protein that enhances calcium uptake and altered decreased at 9 weeks transcription of the gene for the calcium-sensing receptor which senses changes in extracellular calcium concentrations and regulates serum calcium concentrations by influencing PTH secretion.
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Excess fluoride continued to produce alterations in gene expression even when calcium was restored to the diet. The changes in gene expression are thought to result in decreased absorption of calcium from the gut. Clinical, occupational, and population studies of the effects of fluoride on human parathyroid function are summarized below for more detail, see Appendix E , Table E In one study with healthy subjects, a single oral. The fall in serum calcium was attributed to increased mineralization of bone in response to the fluoride dose.
The mean PTH concentration at 3 weeks was elevated slightly over the initial pretreatment values, and the standard deviation was considerably larger, suggesting that a few individuals might have had significant increases. In a follow-up letter, Gill et al. Stamp et al. In the short-term 8-day study, two groups of patients were identified with respect to stability of serum calcium and phosphorus concentrations Stamp et al. In the group with more stable serum calcium, NaF inhibited intestinal calcium and phosphorus absorption and reduced calcium balance; this inhibition is not explainable by the formation of calcium-fluoride complexes and might be due to inhibition by fluoride of some step s in active transport Stamp et al.