Several endocrine, or hormonal, diseases and conditions occur due to insufficient production of necessary hormones, including hypothyroidism, type 1 diabetes mellitus and Addison’s disease. Replacement of the deficient hormones serves as a mainstay of treatment for these disorders. Restoration of normal hormone levels typically reverses the deleterious metabolic effects of hormone insufficiency on the body.
Insulin
Loss of the beta cells of the pancreas, which produce insulin, results in type 1 diabetes mellitus, a primary hormone deficiency disorder. The American Diabetes Association reports that 5 to 10 percent of diabetic children and adults in the United States have type 1 diabetes. Insulin replacement is the cornerstone of type 1 diabetes treatment. Different insulin formulations have a variable onset of action and duration of activity, including rapid, short, intermediate and long-acting insulins. Premixed insulins contain a specific ratio of two different forms of insulin. Insulin is administered beneath the skin with a series of shots throughout the day or via an insulin pump, which delivers the hormone continuously.
Thyroid Hormone
Inadequate secretion of hormones by the thyroid gland characterizes hypothyroidism. This disorder most commonly occurs due to misguided immune system destruction of the thyroid gland. Other possible causes include surgical removal of all or part of the thyroid and destruction of the gland due to medications or radiation treatments. Hypothyroidism is treated with oral levothyroxine, a man-made thyroid replacement hormone. Different brands of levothyroxine may demonstrate varying activity in the body. The American College of Clinical Endocrinologists recommends taking the same brand of thyroid hormone throughout treatment. Reassessment of the medication dose may be required when switching to a new brand of levothyroxine.
Glucocorticoids and Mineralocorticoids
The adrenal glands produce several hormones including glucocorticoids and mineralocorticoids. The primary adrenal glucocorticoid is cortisol, and the primary mineralocorticoid is aldosterone. Adrenal insufficiency, or Addison’s disease, typically causes a deficiency in both of these hormones, notes the National Institute of Diabetes and Digestive and Kidney Diseases. Cortisol replacement involves treatment with a man-made glucocorticoid such as dexamethasone, prednisone or hydrocortisone. Fludrocortisone acetate serves as a replacement for aldosterone. These hormone replacement medications are taken by mouth.
Testosterone
Male testosterone deficiency, or hypogonadism, can occur due to genetic disorders, damage to the testicles, HIV/AIDS and aging. Insufficient testosterone production by the testicles can lead to an array of systemic effects, including decreased muscle and bone mass, increased body fat, decreased energy level, loss of sexual interest and erectile dysfunction. The American Association of Clinical Endocrinologists estimates that approximately 4 to 5 million adult males in the United States have a testosterone deficiency. Testosterone replacement drugs can correct the metabolic effects of testosterone deficiency. These medications are available as skin patches, topical gels, injections and a gum-like substance left in the mouth.
References
- American Diabetes Association: Diabetes Basics, Type 1
- American Diabetes Association: Insulin Basics
- American Association of Clinical Endocrinologists: Medical Guidelines for Clinical Practice for the Evaluation and Treatment of Hyperthyroidism And Hypothyroidism
- National Institute of Diabetes and Digestive and Kidney Diseases: Adrenal Insufficiency and Addison’s Disease
- American Association of Clinical Endocrinologists: Current Challenges and Future Opportunities in the Treatment of Testosterone Deficiency in Men
