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Glossary

Getting a diagnosis and dealing with tests can be a very trying time. Here are some words you'll want to know.

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Abnormal: Not normal. Deviating from the usual structure, position, condition, or behavior. In referring to a growth, abnormal may mean that it is cancerous or premalignant (likely to become cancer ).

See the entire definition of Abnormal

Acanthosis nigricans: Asymptomatic, brown to black skin, with a velvety texture. Pedunculated skin tags often are present. The most common sites are the axillae, neck, and groin. If the patient is obese, the eruption may clear with weight loss or correction of the underlying endocrine disorder. Local treatment is not effective.

More on Acanthosis nigricans.

Acromegaly: Excessive growth caused by overproduction of growth hormone by the pituitary gland.  This is a condition that usually affects middle aged people. It is characterized by gradual, marked enlargement of the bones of the face, jaw and extremities. The excessive growth occurs first in the hands and feet, as soft tissue begins to swell.

Apart from these symptoms, the metabolic abnormalities associated with GH (Growth Hormone) that warrant effective GH lowering therapy. Acromegaly affects mostly middle-aged adults. Untreated, the disease can lead to severe illness and death. Acromegaly is the Greek word for "extremities" and "enlargement."

Acromegaly/ Gigantism is a very rare (annual incidence: 3/1.000.000) and serious chronic condition related to a permanent hypersecretion of growth hormone (GH) by the pituitary gland, generally of tumoral origin. The syndrome results from a chronic exposure to GH (Growth Hormone) leading to the classic clinical features.

This causes an excessive production of Insulin-like Growth Factor 1 (IGF-1), a hormone secreted from the liver and other tissues. Excessive production of IGF-1 and GH translates into uncontrolled growth of various organs, and debilitating symptoms. Control of the GH and IGF-1 levels by Sandostatin® LAR results in normalizing such excessive growth and symptoms. Medical treatment has an important role to play in the management of patients with acromegaly. It is a life long treatment, with few, mild side effects.

Read an article on acromegaly.

Symptoms of acromegaly.

Read an article on Gigantism

ACTH: Adrenocorticotropic Hormone. ACTH is a normal by-product of the anterior pituitary gland. It acts by controlling the secretion of the adrenal hormone, cortisol. Produced by the pituitary gland. A pituitary tumor often causes too little ACTH to be produced. Symptoms of ACTH deficiency include weakness, fatigue and gastrointestinal disturbances.

Ectopic ACTH Syndrome

To cure the overproduction of cortisol caused by ectopic ACTH syndrome, it is necessary to eliminate all of the cancerous tissue that is secreting ACTH. The choice of cancer treatment--surgery, radiotherapy, chemotherapy, immunotherapy, or a combination of these treatments--depends on the type of cancer and how far it has spread. Since ACTH-secreting tumors (for example, small cell lung cancer) may be very small or widespread at the time of diagnosis, cortisol-inhibiting drugs, like mitotane, are an important part of treatment. In some cases, if pituitary surgery is not successful, surgical removal of the adrenal glands (bilateral adrenalectomy) may take the place of drug therapy.  Read more about treatments for Ectopic ACTH Syndrome.

Addison's Disease (Adrenal insufficiency): Caused by low levels of cortisonelike hormones produced by the adrenal glands. The cause is usually unknown, but may be a complications of tuberculosis, cancer, pituitary disease of cortisone drugs.

Adenoma: Benign tumor of glandular cells. May cause hormone secretion by the affected gland.

Adrenal: Pertaining to one or both of these endocrine glands located on top of the kidneys. These glands secrete many hormones, including epinephrine (adrenaline), norepinephrine, and the corticosteroid, and play an important part in the body's endocrine system.

The adrenal is made up of an outer wall (the cortex) and an inner portion (the medulla).

A closer look at the adrenal glands, including an illustration.

Adrenal cortex: Outer layer of the adrenal gland, it secretes various hormones including cortisone, estrogen, testosterone, cortisol, androgen, aldosterone and progesterone.

Adrenalectomy: Surgical removal of the adrenal glands is a final measure for halting excess cortisol production This is used only when all other measures fail in individuals with pituitary tumors.

Adrenal gland tumor: A benign tumor, or adenoma, that usually results in the excess production of adrenal gland hormones.

Sometimes, an abnormality of the adrenal glands, most often an adrenal tumor, causes Cushing's syndrome. The average age of onset is about 40 years. Most of these cases involve non-cancerous tumors of adrenal tissue, called adrenal adenomas, which release excess cortisol into the blood. adrenal glands. In Primary Pigmented Micronodular Adrenal Disease and the familial Carney's complex, surgical removal of the adrenal glands is required.

Adrenal insufficiency: See Addison's Disease. Adrenal insufficiency is a life threatening chronic illness. An active and vigorous lifestyle with normal life expectancy is possible as long as the prescribed medications are taken regularly and adjusted when indicated. As with most chronic diseases, adrenal insufficiency demands that the patients take responsibility and develop self-management skills and techniques.

Read an article on Adrenal insufficiency

Adrenal medulla: Middle part of the adrenal gland, it secretes epinephrine (adrenalin) and norepinephrine.

Adrenocortical carcinomas, or adrenal cancers: These are the least common cause of Cushing's syndrome. Cancer cells secrete excess levels of several adrenal cortical hormones, including cortisol and adrenal androgens. Adrenocortical carcinomas usually cause very high hormone levels and rapid development of symptoms.

Adrenocortical hyperplasia: Increase in the number of cells of the adrenal cortex. It secretes cortisol, androgens and aldosterone. Increased production of any or all of these hormones may result in a variety of disorders, such as Cushing's syndrome and hypertension.

Adrenocorticotropic-hormone deficiency: Not enough ACTH is produced by the pituitary gland.

Adrenoleukodystrophy: Disturbance in brain substance caused by abnormal function of the adrenal gland.

Agglutination: Clumping or gathering together of cells (usually red blood cells) into a mass. Normally each cell exists separately.

Aldosterone: Adrenal hormone that affects the body's handling of sodium, chloride, and potassium.

Read an article on Aldosterone testing

Amenorrhea: Cessation of menstrual periods.

Analytical Chemical Analysis: Separates, determines and analyzes the quantity of any specific chemical or substance.

Anesthesia: A combination of drugs administered by a variety of techniques and routes by trained professionals that provide sedation, amnesia, analgesia, and immobility adequate for accomplishment of the surgical objectives with minimal discomfort, and without injury, to the patient.

Some operations require that the patient remain immobile, anesthetic, and amnesic for many hours at a time. From a variety of anesthetic options for any given procedure, the surgeon and anesthesiologist selects those that in patients demographically (diagnosis, age, neurologic condition) similar to the one being operated on, most reliably produce safe, effective, uncomplicated anesthesia in as non-invasively as possible.

Androgens: Male sex hormones such as testosterone and DHEA. These hormones are produced in higher amounts by men, but are also produced by women in their ovaries and adrenal glands.

Anovulation: Lack of ovulation. There may be anovulatory periods -- in which there is menstruation, but no egg has been released.

Anterior: Toward the front or in front of.

Apheresis: The process of apheresis involves removal of whole blood from a patient or donor. Within an instrument that is essentially designed as a centrifuge, the components of whole blood are separated. One of the separated portions is then withdrawn and the remaining components are retransfused into the patient or donor.

Ascites: An abnormal pooling of fluid in the abdominal cavity; the fluid contains large amounts of protein and other cells. Ascites is usually noticed when more than 1 pint (500 ml) of fluid has collected. The condition may lead to general abdominal swelling, dilution of the blood, or less urinary output. The most common cause is liver disease (cirrhosis). However, ascites can be caused by cancer, kidney disease, congestive heart failure, or other diseases. the fluid can be removed with a needle (paracentesis). This relieves pain and improves breathing and organ function.

Assay: Determination of the amount of a particular constituent of a mixture or the biological or pharmacological potency of a drug.

Atomic Absorption Spectroscopy: Measures trace elements, such as calcium, magnesium or copper, in body fluids.

Autoimmune Premature Ovarian Failure: Premature ovarian failure due to a autoimmune disorder, including other autoimmune disorders such as lupus, rheumatoid arthritis, etc., or an autoimmune reaction to your ovaries, endometrial lining, FSH, etc.

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Barrett's esophagus: Barrett's esophagus is caused by gastroesophageal reflux disease, which allows the stomach's contents to damage the cells lining the lower esophagus.

Benign: Tumor or growth that is neither cancerous nor located where it might impair normal function. It is not progressive or recurrent. Benign also means harmless. A benign tumor does not invade surrounding tissue or spread to other parts of the body. A benign tumor may grow but it stays put (in the same place).

BLA, Bilateral Adrenalectomy: Surgical removal of both the adrenal glands.

Blood tests: Blood tests can determine relative levels of cortisol and ACTH. Because these hormones are secreted episodically, your doctor will likely request that measurements be done on two or three separate days. The relative levels of cortisol and ACTH can help differentiate between the different causes of Cushing's syndrome.

Blood Pressure: Constant force placed on the walls of the arteries.

BMD: Is often used as an acronym for bone mineral density in discussions about osteoporosis

Bone Density Testing: Tests using low-dose radiation x-rays to determine the density of bones. It is used to detect osteopenia and/or osteoporosis.

Brain Stem: Portion of the brain that connects the hemispheres with the spinal cord. Consists of medulla oblongata, pons, and midbrain.

Bromocriptine (Parlodel®): Prescription medication that reduces prolactin levels and/or shrinks pituitary tumors. Used to treat hyperprolactinemia and pituitary tumors.

Buffalo Hump: is an accumulation of fat on the back of the neck and upper back. This condition can occur with oversecretion of cortisone by the adrenal gland, a condition called Cushing's syndrome.

Read more about the Buffalo Hump.

Talk about this terrible symptom with others who understand.

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Cabergoline (Dostinex®) Treatment of choice for prolactinomas which are generally responsive to pharmacological treatment.

Read an article on Dostinex.

CAH (Congenital Adrenal Hyperplasia): Congenital adrenal hyperplasia refers to a group of inherited disorders relating to the adrenal glands, characterized by a deficiency in the hormones cortisol and aldosterone and an overproduction of androgen.

Read more about Congenital Adrenal Hyperplasia (CAH)

Calcitonin: A hormone produced by the parathyroid, thyroid and thymus glands and responsible for increasing the amount of calcium and phosphate deposited on bones.

Catheter: Hollow tube used to introduce fluids into the body of drain fluids from the body.

Catheterization: Passage of a tubular, flexible, surgical instrument called a catheter into a cavity of the body.

Central Serous Retinopathy (CSR): A condition which causes temporary or permanent impairment of vision. The symptoms are loss of sensitivity in dim light, usually in an oval shaped gray or brown area, blurring or distortion of the visual image. It is a result of the detachment of most of the layers of the retina (the back of the eye) from its supporting tissue as a result of the buildup of fluid. The buildup of fluid appears to be due to one or more small breaks in the retinal pigment epithelium.

Cholesterol: A waxy, fat-like substance contained in every cell in the body and in many foods. Some cholesterol in the blood is necessary - but a high level can lead to heart disease. Drugs like Lipitor are often used to help control high cholesterol.

Chromophobe adenoma: Tumor of the anterior portion of the pituitary gland.

Chronic: Term used to describe long-lasting diseases or conditions. Usually, a chronic disease will last in some form for the remainder of the patient's life.

Congenital Adrenal Hyperplasia (CAH): Congenital adrenal hyperplasia refers to a group of inherited disorders relating to the adrenal glands, characterized by a deficiency in the hormones cortisol and aldosterone and an overproduction of androgen.

Read more about Congenital Adrenal Hyperplasia (CAH)

Corticosteroids: Hormones produced by the cortex of the adrenal glands; also, a class of such hormones used as medications. They are used in inflammatory conditions for their anti-inflammatory effects. They have a rapid onset of action, and profoundly affect many parts of the immune system as well as most other body systems. Corticosteroids are a cornerstone of treating most types of vasculitis, and are often used in combination with other immunosuppressive medications. See also Cortisol and Prednisone.

Cortisol: A hormone which produced by the adrenal gland (cortex) to control blood sugar. The production of cortisol is triggered by the pituitary hormone ACTH. Cortisol is a glucocorticoid which stimulates an increase in blood glucose. Cortisol will also stimulate the release of amino acids from muscle tissue and fatty acids from adipose tissue. The amino acids are then converted in the liver to glucose (for use by the brain). The fatty acids can be used by skeletal muscles for energy (rather than glucose) thereby freeing up glucose for selective utilization by the brain. Cortisol levels are often measured to evaluate the function of the pituitary or adrenal glands. Some of the cortisol is metabolized by the liver to produce 17 hydroxycorticosteroids, which is then excreted in the urine.

The primary stress hormone. Cortisol is the major natural GLUCOCORTICOID (GC) in humans.

Synthetic cortisol, also known as hydrocortisone, is used as a drug mainly to fight allergies and inflammation.

Physiology
The amount of cortisol present in the serum undergoes diurnal variation, with the highest levels present in the early morning, and lower levels in the evening, several hours after the onset of sleep. Information about the light/dark cycle is transmitted from the retina to the paired suprachiasmatic nuclei in the hypothalamus. Changed patterns of the serum cortisol levels have been observed in connection with abnormal ACTH levels, clinical depression, psychological stress, and such physiological stressors as hypoglycemia, illness, fever, trauma, surgery, fear, pain, physical exertion or extremes of temperature. There is also significant individual variation, although a given person tends to have consistent rhythms.

Cortisol also inhibits the secretion of corticotropin releasing hormone (CRH), resulting in feedback inhibition of ACTH secretion. Some researchers believe that this normal feedback system may break down when animals are exposed to chronic stress.

In normal release, cortisol has widespread actions which help restore homeostasis after stress. It acts as a physiological antagonist to insulin by promoting gluconeogenesis, breakdown of lipids, and proteins, and mobilization of extrahepatic amino acids and ketone bodies. This leads to increased blood glucose concentrations, resulting in increased glycogen formation in the liver (Freeman, 2002). It also increases blood pressure. In addition, immune and inflammatory cells have their responses to stress attenuated by cortisol, and the hormone thus lowers the activity of the immune system. Bone formation is also lowered by cortisol.

These normal endogenous functions are the basis for the physiological consequences of chronic stress - prolonged cortisol secretion causes muscle wastage, hyperglycemia, and suppresses immune / inflammatory responses. The same consequences arise from long-term use of glucocorticoid drugs.

Also, long-term exposure to cortisol results in damage to cells in the hippocampus. This damage results in impaired learning. However, short-term exposure of cortisol helps to create memories; this is the proposed mechanism for storage of flash bulb memories.

Pharmacology
As an oral or injectable drug, cortisol is also known as hydrocortisone. It is used as an immunosuppressive drug, given by injection in the treatment of severe allergic reactions such as anaphylaxis and angioedema, in place of prednisolone in patients who need steroid treatment but cannot take oral medication, and peri-operatively in patients on long-term steroid treatment to prevent an Addisonian crisis.

It is given by topical application for its anti-inflammatory effect in allergic rashes, eczema and certain other inflammatory conditions. It may also be injected into inflamed joints resulting from diseases such as gout.

Compared to prednisolone, hydrocortisone is about 1/4th the strength. Dexamethasone is about 40 times stronger than hydrocortisone. For side effects, see corticosteroid and prednisolone.

A certain amount of cortisol is necessary for life. Without cortisol even a small amount of stress will kill you. Addison's disease is a disease which causes low cortisol levels, and which is treated by cortisol replacement therapy.

Cortisol...

• helps maintain blood pressure and cardiovascular function;
• helps slow the immune system's inflammatory response;
• helps balance the effects of insulin in breaking down sugar for energy; and
• helps regulate the metabolism of proteins, carbohydrates, and fats.

Read more about urinary cortisol testing

Craniopharyngioma: A benign pituitary tumor.

Chromophobe: Chromophobe adenoma; pituitary adenoma; undifferentiated cell adenoma; an adenoma of the hypophysis composed of cells for which there is no overt evidence or hormone production, but which produce hypopituitarism and visual disturbances by compression of adjacent structures; approximately one third of these tumors have cells with abundant mitochondria (oncocytes) that are somewhat larger than the monocytic null cells.

Condition: The term "condition" has a number of biomedical meanings including the following:

1. An unhealthy state, such as in "this is a progressive condition."
2. A state of fitness, such as "getting into condition."
3. Something that is essential to the occurrence of something else; essentially a "precondition."
4. As a verb: to cause a change in something so that a response that was previously associated with a certain stimulus becomes associated with another stimulus; to condition a person, as in behavioral conditioning.

CRH Stimulation Test:  See under Tests

CSR:  See Central Serous Retinopathy

CT Scan (CAT Scan): Procedure in which an extremely narrow X-ray beam passes through a cross-section of the body or brain. It is picked up by an electronic instrument called a SCINTILLATOR rather than being exposed on X-ray film. Scintillator reads the density that tissue X-rays pass through. A computer prints out the densities as an illustration of the cross-section.

Cushing's Disease/ Cushing's Syndrome: Cushing's is a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol. Your adrenal glands, which are right above your kidneys, release cortisol when they receive a chemical message from your pituitary gland. The message comes in the form of adrenocorticotrophic hormone (ACTH), which travels through the bloodstream.

Cushing's Disease Is the result of a pituitary tumor which causesthe emergence of secondary male characteristics (like hair growth, acne, etc.), and ovarian failure. Other symptoms usually include high blood pressure and water retention.

Cushing's Syndrome: Causes the same symptoms, but is a disorder marked by overproduction of adrenal hormones, which can cause a drop in LH and FSH.

An estimated 10 to 15 of every million people are affected each year. Cushing's is an increased concentration of glucocorticoid hormone (ACTH) in the bloodstream that is being produced by an adrenal gland tumor (adenoma). Ectopic Cushing syndrome refers to the production of ACTH in a location other than the pituitary gland or adrenalgland. Examples of ectopic sites include thymoma, medullary carcinoma of the thyroid, pheochromocytoma, islet cell tumors of the pancreas, and oat cell carcinoma of the lung.

Symptoms include weight gain, central obesity, moon face, weakness, fatigue, backache, headache, increased thirst, increased urination, impotence, mental status changes, and muscle atrophy.

Treatment varies with cause. If an ACTH secreting tumor is involved then it must be removed surgically.

More about Cushing's.

Talk about Cushing's with people who understand.

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Danazol: A drug used in the treatment of endometriosis.

Depression: See articles From NIMH and from Troya.

Dexamethasone-CRH Test: See under Tests.

DEXA scan: Dual-Energy X-ray Absorbtiometry. It is the most accurate form of bone density checking.

DHEA (dehydroepiandrosterone) : DHEA is a male hormone (androgen) which is converted into estrogen and testosterone.  It is mainly produced by the adrenal gland. Considered a "building-block hormone," one from which the other sex hormones are made. It may help prevent osteoporosis, heart disease and Alzheimer's.

Diabetes Insipidus: Diabetes insipidus is a condition that results from insufficient production of the antidiuretic hormone by the hypothalamus, the portion of the brain that stimulates the pituitary gland. Normally, the antidiuretic hormone controls the kidneys' output of urine. Diabetes insipidus causes excessive thirst and excessive production of very diluted urine.

More information on Diabetes insipidus

Diagnosis: Identification of a disease or disorder by a physician or other qualified medical personnel.

Dostinex (cabergoline): Treatment of choice for prolactinomas which are  generally responsive to pharmacological treatment. Read the article on Dostinex.

Dysmenorrhoea: Painful menstrual periods.

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Ectopic ACTH production: Adrenocorticotropic hormone (ACTH) at some site other than the pituitary gland. Some benign or malignant (cancerous) tumors that arise outside the pituitary can produce ACTH. This condition is known as Ectopic ACTH Syndrome. Lung tumors cause over 50 percent of these cases. Men are affected 3 times more frequently than women. The most common forms of ACTH-producing tumors are oat cell, or small cell lung cancer, which accounts for about 25 percent of all lung cancer cases, and carcinoid tumors. Other less common types of tumors that can produce ACTH are thymomas, pancreatic islet cell tumors, and medullary carcinomas of the thyroid.

Read about treatments for Ectopic ACTH Syndrome

Empty Sella Syndrome: Empty sella syndrome is common in women who are overweight or have high blood pressure. Characterized by an enlarged bony structure (sella turcica) that houses the pituitary gland at the base of the brain, the disorders sometimes results in high fluid pressure inside the skull. The pituitary gland is usually normal size or small.

More on Empty Sella

Endocrinologist, Endocrinology: A doctor specifically trained in diagnosis and treatment of the system of organs that secretes hormones into the blood. The endocrine organs are the anterior and posterior pituitary glands, thyroid and parathyroid glands, pancreas, adrenal glands, ovaries (in women) and testicles (in men).

View an image of the body and the placement of the various endocrine glands.

Endometriosis: A condition where active endometrium is implanted outside the uterus.

Endometrium: The lining of the uterus shed with each menstrual period.

Estrogen (Oestrogen): Female hormones produced by ovary and responsible for regulating certain reproductive functions. Estrogen is responsible for stabilizing moods and plays a role in lubrication. Estrogen is involved in breast development and may help some types of breast cancer to grow.

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Familial Cushing's Syndrome: Most cases of Cushing's syndrome are not inherited. Rarely, however, some individuals have special causes of Cushing's syndrome due to an inherited tendency to develop tumors of one or more endocrine glands.

In Primary Pigmented Micronodular Adrenal Disease, children or young adults develop small cortisol-producing tumors of the adrenal glands.

Flutamide: A new drug for hirsuitism.

Dr. Dean on Flutamide.

• Other options for hair removal
• Vanqua, a new cream to remove excess hair.
• Read or post messages about Hirsuitism with others who understand.

FSH (Follicle Stimulating Hormone): A hormone secreted from the anterior pituitary gland. In the woman, FSH stimulates production of ovarian follicles ("eggs") and estradiol (another reproductive hormone) during the first half of the menstrual cycle. In men FSH stimulates the testes to produce sperm.

Normal values:

• Male: 4 to 25 U/L
• Female:
  • premenopausal: 4 to 30 U/L
  • midcycle peak: 10 to 90 U/L
  • pregnancy: low to undetectable
  • postmenopausal: 40 to 250 U/L

Note: U/L = units per liter

FESS: Image-guided Functional Endoscopic Sinus Surgery (FESS). ENT surgeons are taking a new route to treat common problems like sinusitis, nasal obstruction, nasal allergy and polyps.

FESS is performed with the aid of nasal endoscopes that leave no post-operative scarring on the face. FESS techniques are also extending the boundaries of the ENT speciality to crossover to other disciplines. Surgeries include endoscopic dacryocystorhinostomy (performed usually by ophthalmologists for blockage of the flow of tears), cerebrospinal fluid leak and removal of pituitary tumours (neurosurgery domain).

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Galactorrhea: Breast milk flow, usually clear or milky, not associated with childbirth or breast-feeding. It may be a symptom of a pituitary gland tumor or high prolactin levels.

Gamma Knife: This is a more focused radiation treatment than conventional radiation, which reduces the risk of hypopituitarism. It provides a large dose of radiation to a tumor so that when the tumor cells divide, they die. As this method depends on the rate of cell division, symptoms may persist long after the radiation treatment.

Read an article on Gamma Knife treatments.

Gigantism/Acromegaly is a very rare disease (annual incidence: 3/1.000.000). The syndrome results from a chronic exposure to GH (Growth Hormone) leading to the classic clinical features that the diagnosis seems to be easy.

Read an article on Giantism

Gland: Any organ or tissue that releases a substance to be used elsewhere in the body; endocrine glands release hormones directly into the bloodstream.

Gonadotrophins: A collective term for follicle stimulating hormone (FSH) and lutenizing hormone (LH).

Gonadotropin Releasing Hormone (GnRH): The "master hormone" in the reproductive system, since it signals the pituitary gland to release two other hormones crucial in ovulation - FSH and LH

GnRH: A neuroendocrine peptide which stimulates the secretion of the pituitary LH, which in turn stimulates the production of estrogen by the ovary or testosterone by the testes. The most widely prescribed drugs which modulate the GnRH receptor are peptide agonists, such as, Lupron(R) and Zoladex(R), with estimated combined sales in excess of $2.5 billion worldwide (2003). These compounds are administered as injectable depots which act by first stimulating then eventually inhibiting the secretion of pituitary LH and consequently, estrogen or testosterone production. GnRH peptide agonists have proven clinically useful in the treatment hormone dependent diseases such as endometriosis, uterine fibroids, prostate cancer and breast cancer, as well as being used for assisted-reproductive therapy. Despite a multitude of potential applications, deleterious consequences of GnRH agonist therapy, especially permanent bone loss in women's health diseases, have limited the useful duration of treatment.

Gonadatropin Releasing Hormone Stimulating Test: Indication: To evaluate patients who present with low LH and sex steroids. The test may also be used to diagnose patients with delayed puberty.

Growth Hormone: Growth of cells, fat metabolism, improved mood, increased energy levels. See also Hgh (Human growth hormone)

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Hematologist, Hematology: A doctor who specializes in diseases of the blood and blood-forming organs.

hGH: Human Growth Hormone (hGH) is produced in the pituitary gland of humans, and the hormone is secreted throughout a person's lifetime. It promotes growth in children and plays an important role in adult metabolism.

More about HgH

Hirsutism: If this is mild, cosmetic methods may be all that are required. These included plucking, bleaching, waxing, depilatory creams which dissolve the hair, or shaving. Many people are worried that shaving will make the hair grow more rapidly, but there is no evidence for this. The disadvantage of these methods is that they are temporary, although they are relatively inexpensive. Electrolysis has a more permanent effect, but takes time (the hair follicles are destroyed one by one), and is therefore more expensive. If the hair growth is more extensive, then medical treatment may be considered. Although different types of treatment are available, the most common used drugs are the antiandrogens (spironolactone or cyproterone acetate). These are not curative, but reduce the rate of hair growth and the coarseness of the hair. They may take three to six months to work, and the effect gradually wears off once the drug is stopped. However many people find that it is very reassuring that the hair growth can be controlled.

Read the article on Hirsuitism

• Options for hair removal
• Vanqua, a new cream to remove excess hair.
• Read or post messages about Hirsuitism with others who understand.

Hormonal Disorders: The endocrine system consists of a group of glands and organs that secrete hormones into the bloodstream. (see illustration) The major glands are the pituitary gland (controlled by the hypothalamus), the thyroid gland, the parathyroid glands, the islets of the pancreas (which produce insulin), the adrenal glands, the testes in males, and the ovaries in females. Hormones secreted by these glands control physical growth, sexual function, metabolism, and other functions. Many of the endocrine disorders that affect adults also affect children but may produce different symptoms.

Hormone: A specific protein substance, secreted by an endocrine gland into the bloodstream, to regulate the functions of tissues and organs elsewhere in the body where it acts to modify their structure of function.

HPA (hypothalamic-pituitary-adrenal) axis

HRT (Hormone Replacement Therapy): Usually used during menopause, it contains estrogen and progestogen. Hormone therapy with tamoxifen can act on cells all over the body and may increase your chance of getting cancer of the uterus. If you are taking tamoxifen, you should go to your doctor for a pelvic exam every year, and you should report any vaginal bleeding other than your menstrual period to your doctor as soon as possible.

Continuous combined HRT: A therapy for women past menopause who want a period-free HRT

• Sequential HRT: A one pill, once a day HRT containing estrogen and progestogen. This type of therapy induces regular periods.
• Unopposed HRT: HRT containing estrogen only. Often called ERT.

HRT: COMMON SIDE EFFECTS: Fluid retention, bloating, weight gain, Breast tenderness Vaginal discharge, Headaches/Migraines, Nausea, Acne, Depression not attributable to other factors, Dizziness, shortness of breath

HRT: SERIOUS SIDE EFFECTS: Thrombophlebitis, High blood pressure, Thyroid problems, Fibroid tumors, Cancer, Gallstones, Hyperplasia, Hypoglycemia

Human growth hormone (hGH ): Human Growth Hormone (hGH) is produced in the pituitary gland of humans, and the hormone is secreted throughout a person's lifetime. It promotes growth in children and plays an important role in adult metabolism.

More about hGH

Hypercortisolemia: Hypercortisolemia is simply the overproduction of cortisol.

Basically, what happens with people who have hypercortisolemia is that they have the inability to shut off the stress response so they are constantly responding to stress differently than other people.

In addition to diseases like Cushing's, high stress responses can come from many different sources such as traumatic events, busy lifestyles, or physically, emotionally, or spiritually threatening situations. Stress responses are real, and are typically out of the control of the person experiencing them.

More about the HPA (hypothalamic-pituitary-adrenal) axis

Hyperprolactinemia: Is a condition marked by excessive prolactin production -- which can suppress the production of LH and FSH and thus cause amenorrhea. It is often treated by taking bromocriptine (Parlodel®)

Hyperthyroidism: An autoimmune disorder in which the thyroid gland overproduces thyroid hormone. It can cause some symptoms that overlap with those of menopause, including palpitations.

Hypoalderostonism: Deficiency of aldosterone secreted by the outer layer of the adrenal glands. May result from Addison's disease, salt-losing syndrome and toxema of pregnancy.

More about Hyperaldosteronism

Hypocalcemia: Abnormally low level of calcium in the blood. May be associated with Cushing's disease, kidney failure, pancreatitis or peritonitis.

Hypoglycemia: Hypoglycemia, or low blood sugar, occurs when blood levels of glucose drop too low to fuel the body's activity.

More about Hypoglycemia

Hypopituitarism: Inadequate pituitary function. It is also called an underactive pituitary gland, is a condition that affects the anterior lobe of the pituitary gland -- usually resulting in a partial or complete loss of functioning of that lobe. The resulting symptoms depend on which hormones are no longer being produced by the gland. Because the pituitary gland affects the other endocrine organs, effects of hypopituitarism may be gradual or sudden and dramatic.

In children, hypopituitarism may be caused by a benign pituitary tumor (craniopharyngioma), an injury, or an infection, or it may have no identifiable cause (idiopathic hypopituitarism). Rarely, hypopituitarism (and diabetes insipidus) occurs as part of Hand-Schüller-Christian disease, which affects small areas of bone and lungs and the function of the pituitary gland.

If the pituitary gland malfunctions before puberty, growth is delayed, sexual characteristics do not develop, and the thyroid and adrenal glands function inadequately. After puberty, pituitary malfunction can cause decreased sex drive, impotence, and shrinking of the testes.

See the list of symptoms

Hypothalamus Gland: The part of the brain in charge of the entire endocrine system; responsible for releasing GnRH (gonadotropin-releasing hormone)

An image of the Hypothalamus Gland

Hypothalamic Obesity: Damage to the hypothalamus (VMH) and termed "hypothalamic obesity", is characterized by weight gain that is unresponsive to diet, exercise, and pharmacotherapy. VMH damage leads to increased weight gain. Severe obesity after VMH damage due to brain tumors or cranial irradiation were treated for 6 months to 1 year. Obese children and adults exhibit a syndrome of Primary Insulin Hypersecretion; for which a specific etiology, pathogenesis, diagnosis, and pharmacotherapy are now identified.

Hypothyroidism: An autoimmune disorder in which the thyroid gland under produces insufficient thyroid hormone. Can cause symptoms that overlap with menopausal symptoms -- such as fatigue, weight gain, skipped periods, etc.

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Iatrogenic: Induced by a physician.

Idiopathic: No known cause.

Image-guided Functional Endoscopic Sinus Surgery: See FESS

Insulin resistance: The condition in which normal amounts of insulin are inadequate to produce a normal insulin response from fat, muscle and liver cells. Insulin resistance in fat cells results in hydrolysis of stored triglycerides, which elevates free fatty acids in the blood plasma. Insulin resistance in muscle reduces glucose uptake whereas insulin resistance in liver reduces glucose storage, with both effects serving to elevate blood glucose. High plasma levels of insulin and glucose due to insulin resistance often leads to the metabolic syndrome and type 2 diabetes.

Isolated luteinizing hormone deficiency: Only one pituitary hormone, the luteinizing hormone, is missing.

IGF-1: (also known as Serum IGF-1 or Somatomedin C) is a polypeptide hormone. It belongs to a family of peptides whose levels are regulated by growth hormone (GH) through receptors. IGF-1 is secreted mainly by the liver and has potent growth stimulating activity. Its mitogenic activity has caused interest in its possible role in cancer growth but its present clinical use is for the diagnosis of human growth disorders. Less than 5% of IGF-1 is free and the rest is bound to IGF-binding proteins (IGFBP). The major one in circulation is IGFBP-3.

Read more about Serum IGF-1 or Somatomedin C

~J ~

JAMA: The Journal of the American Medical Association. JAMA began publication in 1883. It now bills itself as "the world's best-read medical journal". However one defines "best-read", JAMA clearly ranks as one of the two leading general medical journals published in the United States. (The other is the New England Journal of Medicine.)

JAMA is published by the American Medical Association (AMA) and reports American Medical Association policy, "as appropriate." However, according to JAMA, articles in it "do not reflect the official policy of the American Medical Association...." and JAMA has the objective of " maintaining editorial independence, objectivity, and responsibility."

The mission of JAMA is lofty: "To promote the science and art of medicine and the betterment of the public health."

JAMA carries original, generally well-documented, peer-reviewed medical articles on a diversity of clinical as well as laboratory topics. It has become a publication that is timely, credible and, as medical journals go, important.

~K ~

Kidney: One of two bean-shaped organs that filter wastes from the blood and discharge these waste products in urine. The kidneys are located on either side at the level of the 12th ribs toward the back. The kidneys send urine to the bladder through tubes called ureters.

~ L ~

Laparoscopic adrenalectomy: Laparoscopic adrenalectomy uses a thin, telescope-like instrument called a laparoscope, which is inserted through a small incision in the flank (fleshy area between the ribs and hip). The laparoscope is connected to a tiny video camera - smaller than a dime - which projects a view of the operative site onto video monitors located in the operating room. The abdomen is inflated with carbon dioxide, a gas, to allow your surgeon a better view of the operative area. Two or three additional small incisions are made near the laparoscope through which the surgeon inserts specialized surgical instruments. The surgeon manipulates these instruments to perform the adrenalectomy. Following the procedure, the small incisions are closed with sutures and covered with surgical tape. After a few months, they are barely visible.

Read more about laparoscopic adrenalectomy

Lipitor: A statin drug, which aids in the lowering of cholesterol. More information is available at http://www.lipitor.com/.

Read the article on Lipitor

Luteinizing Hormone (LH): Pituitary hormone that causes a follicle to rupture and an egg to be released (ovulation); the surge of LH that does this is called the LH surge. In men LH stimulates the testes to produce Testosterone.

~M ~

The Magnetic Stereotaxis System (MSS): MSS was developed by a team of American neurosurgeons, is touted as a safer, less invasive and more effective way to biopsy brain tumors. Other applications may include diagnosing and treating cardiovascular conditions, such as coronary artery disease, cardiac arrhythmia and aneurysms.

More about Magnetic Stereotaxis System

Malignant: Prone to spread, cancerous.

Menopause: The cessation of menstruation, occurring at the average age of 52. For more information, visit Power Surge.

MEN type 1: There are at least 3 tumors of the endocrine glands, one of the pituitary, one possibly of the thyroid, one possibly of the pancreas.

More about MEN1

Myasthenia Gravis: A neuromuscular disorder characterized by weakness and fatigability of skeletal muscles. The defect is due to a decrease in the number of acetylcholine receptors at neuromuscular junctions, due to an antibody-mediated autoimmune attack. Common symptoms include weakness of the eye muscles, diplopia, and a drooping eyelid (ptosis).

MRI (magnetic resonance imaging): Strong magnets and radio waves are used to produce a picture of the inside of the body. An MRI gives more detailed pictures than a CT scan.

~N ~

Nelson's Syndrome: A complication of removal of the adrenal gland (for the treatment of Cushing's syndrome) when there is a pituitary tumor secreting ACTH (Cushing's disease).

This clinical condition results when a patient with an ACTH-producing pituitary adenoma undergoes bilateral adrenal gland removal (adrenalectomy). Approximately 15-25% of patients with Cushing's disease treated with adrenalectomy will develop Nelson's syndrome within 1 to 4 years. Because these ACTH-secreting tumors are typically aggressive and invasive in their growth, patients may develop large tumors resulting in visual loss, pituitary failure (hypopituitarism) and headache. These adenomas also secrete melanocyte-stimulating hormone, resulting in characteristic hyperpigmentation of the skin. ACTH blood levels are generally markedly elevated but hypercortisolemia is absent.

Transsphenoidal surgery is generally the primary therapy, however cure is often difficult. Radiotherapy, preferably with stereotactic radiation, is effective in controlling tumor growth in the majority of patients who have residual tumor after surgery.

Neoplasm: Tumor or new growth.

Neurologist, Neurology: Doctor specially trained to diagnose and treat diseases of the nervous system.

~O ~

Octreotide Scan:A type of radionuclide scan used to find carcinoid and other types of tumors. Radioactive octreotide, a drug similar to somatostatin, is injected into a vein and travels through the bloodstream. The radioactive octreotide attaches to tumor cells that have receptors for somatostatin. A radiation-measuring device detects the radioactive octreotide, and makes pictures showing where the tumor cells are in the body. This procedure is also called somatostatin receptor scintigraphy (SRS).

Oestrogen (Estrogen): Female hormones produced by ovary and responsible for regulating certain reproductive functions. Estrogen is responsible for stabilizing moods and plays a role in lubrication. Estrogen is involved in breast development and may help some types of breast cancer to grow.

Oncologist, Oncology: Doctor specially trained to treat cancer.

Osteopenia: The precursor to osteoporosis, marked by bone thinning

Osteoporosis: A disease which causes bones to lose mass and become porous and brittle. Frequently leads to fractured spine, wrists or hips in elderly women. It is a weakening of bones, leading to bone loss; often as a result of extended exposure to low estrogen levels. One of the primary risks of premature ovarian failure and early menopause.

Once-Weekly Fosamax (Alendronate) Approved In US For Treatment, Prevention Of Postmenopausal Osteoporosis

Ovaries: The pair of female reproductive organs that produce eggs and hormones.

Ovarian Failure: A state that exists when the ovaries run out of eggs and the ovary fails to respond to FSH. Ovulation does not occur. This can be due to an autoimmune disorder, ovarian damage, or malformation of the ovary, among other things.

Oxytocin: Induces milk movement, and uterine contractions.

~P ~

Panhypopituitarism: Production of all pituitary hormones decreases or stops. This disorder can result when the entire pituitary gland is damaged. Sometimes only one pituitary hormone is missing. For example, if only luteinizing hormone is missing (isolated luteinizing hormone deficiency), the testes develop and produce sperm, because these functions are controlled by follicle-stimulating hormone, but the testes do not produce enough testosterone. Testosterone is the hormone that stimulates the development of male secondary sexual characteristics, such as deepening of the voice, growth of facial hair, and maturation of the penis. Consequently, boys who have isolated luteinizing hormone deficiency do not develop these characteristics. Abnormally long arms and legs may be another symptom of this deficiency.

Parlodel® (Bromocriptine) Prescription medication that reduces prolactin levels and/or shrinks pituitary tumors. Used to treat hyperprolactinemia and pituitary tumors.

Parathyroid Hormone (parathormone, PTH): A hormone, synthesized and released by the parathyroid glands, that controls the distribution of calcium and phosphate on the bones

PCOS: See Polycystic Ovary Syndrome

Petechiae: Pinpoint-sized hemorrhages of small capillaries in the skin or mucous membranes. Petechiae result from tiny areas of superficial bleeding into the skin. They appear as round, pinpoint-sized dots that are not raised. The color varies from red to blue or purple as they age and gradually disappear. Petechiae commonly appear on the lower legs, but may be distributed all over the body.

Petrosal Sinus Sampling: See under Tests

Pheochromocytoma: A pheochromocytoma is a tumor that originates from the adrenal gland's chromaffin cells, causing overproduction of catecholamines, powerful hormones that induce high blood pressure and other symptoms.

More about pheochromocytoma
Limited Adrenal Gland Surgery Saves Lives

Phlebotomist : A phlebotomist draws blood for tests, transfusions, donations and research. S/he draws blood samples by venipuncture, skin puncture or arterial collection. For apparent reasons, safety precautions must be taken to prevent the transmission of infectious diseases. Phlebotomists must adhere to strict policies and procedures while treating patients with care. These healthcare professionals may work in hospitals, commercial laboratories, private physician offices, public health departments, clinics or blood banks.

PICC Line: A PICC line (Peripherally Inserted Central Catheter) is a semi-permanent IV line), which is inserted into a large vein, usually in your arm although other places may be used. This will allow fluids and injections to be given, and blood samples to be taken. It will save you the discomfort of repeated sticks.

Pituitary Adenoma: Pituitary adenomas cause most cases of Cushing's syndrome. They are benign, or non-cancerous, tumors of the pituitary gland which secrete increased amounts of ACTH. Most patients have a single adenoma. This form of the syndrome, known as "Cushing's disease", affects women five times more frequently than men.

Pituitary diabetes insipidus: Metabolic disorder due to injury of the pituitary gland causing a deficient production of anti-diuretic hormone.

Pituitary dwarfism: The pituitary gland produces inadequate amounts of growth hormone, causing abnormally slow growth and short stature. Most short children, however, have normally functioning pituitary glands and are short because their growth spurt is late or their parents are relatively short.

Pituitary gland: Because the pituitary controls the function of most other endocrine oval gland at the base of the brain, in the fossa (depression) of the sphenoid bone,which produces a number of different hormones . It oversees hormone production by the sex glands (the ovaries, in women), adrenal glands, and thyroid gland. Pituitary disorders (such as tumors) can cause amenorrhea -- and, thus, be mistaken for early menopause.