Drugs and the endocrine system

Abstract

The endocrine system regulates many aspects of important physiological processes in the body. Our body produces hormones from different glands and these hormones are kept in balance by various regulatory feedback mechanisms. Autoimmune problems, tumors, metabolic dysregulation and genetic predisposition may disrupt normal regulation of hormones causing excessive production, hormone deficiency or resistance of target organs to hormones. Three hormones, i.e., thyroid hormones, insulin and glucocorticoids are at issue more often compared to the rest of the hormones in the endocrine system. In hyperthyroidism, various antithyroid drugs are used, which target the different stages in thyroid hormone synthesis and release. In hypothyroidism, thyroxine is used in replacement therapy. Diabetes mellitus is an increasing problem worldwide where high blood glucose level is attributed to the deficiency of insulin (Type 1 diabetes) or insulin resistance (Type 2 diabetes.) Type 1 diabetes is managed with human insulin or insulin analogues. In Type 2 diabetes, where there is insulin resistance and relative insulin deficiency, insulin secretagogues and insulin sensitizers are used. Newer agents target the incretin hormones which play an important role in the regulation of insulin, glucose and satiety. The adrenal glands which produce the glucocorticoids and mineralocorticoids regulate many metabolic processes and are important in inflammatory and immune responses. Synthetic glucocorticoids are used clinically in a wide variety of clinical conditions not related to hormone deficiencies due to its potent anti-inflammatory and immunosuppressant effects. However, the use of glucocorticoids therapeutically is associated with many adverse effects, among them impaired response to infection and Cushings syndrome.