Diagnostic Tests - Identifying Common Endocrine Disorders (2023)

The Endocrine System

Have you ever wondered how your body is able to regulate its metabolism, mood, growth, temperature, heart rate, and even fertility? The endocrine system gets the credit and is able to regulate all of these functions via a system of glands, which are small excretory organs in charge of the release of hormones.[1][2][3][4][5] Disorders of the endocrine system result when there is an imbalance and/or lack of one or several hormones.[1][2]

Diagnostic Tests - Identifying Common Endocrine Disorders (1)

Hormonal imbalances can manifest in a variety of signs and symptoms via various disease processes, such as diabetes mellitus, hypothyroidism, hyperthyroidism, polycystic ovary syndrome (PCOS), adrenal insufficiency, and low testosterone.[1][2][3][4][5][6] There are many types of endocrine disorders, but these are some of the more commonly diagnosed ones, with diabetes at the top of the list. Patients who develop thyroid and cardiovascular disorders are also predisposed to develop diabetes.[3] Thus, proper diagnosis and management is necessary to prevent the progression of several endocrine (and other system) disorders.How do hormonal imbalances occur? Common causes are linked to injured glands, tumours, one gland failing to stimulate another gland (e.g. hypothalamus to stimulate pituitary to release hormones), infections, diseases, and genetics.[1][2][3][4][5] Identifying the cause is often part of the cure, whether a simple fix like adding a supplement is needed or a more complex fix such as referring a patient for possible surgery is indicated.

(Video) Endocrine Diagnostics

Diagnosing Endocrine Disorders

Patients cannot be diagnosed with an endocrine disorder based upon signs and symptoms alone. The signs and symptoms present will be based upon the specific glands being impacted. Further screening will be indicated in order to determine a course of treatment based upon initially obtaining a proper diagnosis. Serum blood tests are the mainstay of endocrine diagnostic tests, in addition to the use of urine and/ or imaging tests when indicated.[4]With cost containment and time as major variables to consider, your practitioner will order tests based upon presenting signs and symptoms in addition to predisposing risk factors. Common risk factors for endocrine disorders include genetics; lifestyle; diet; gender; body mass index (BMI); and exposure to endocrine-disrupting chemicals from food, environment, medications, personal-care products, and home products. Let’s further discuss the common endocrine disorders and commonly ordered diagnostic tests.[4][6]

Diabetes

Diagnostic Tests - Identifying Common Endocrine Disorders (2)

(Video) Endocrine Disorders

Serum blood tests are the mainstay of diagnosing diabetes mellitus, along with clinical signs and symptoms such as excessive urination (polyuria), thirst (polydipsia), and hunger (polyphagia). Diabetes results when the pancreas makes no or little insulin (type1), or when the body is unable to use insulin properly to absorb glucose into the cells, resulting in insulin resistance (type 2). Both scenarios result in elevated blood sugar levels, called hyperglycemia. The three typical serum blood tests for diabetes include random blood sugar, fasting blood sugar, and hemoglobin A1c (HbA1c) test.[3][4]A random blood glucose test is done at any time regardless of when you last ate. A level of 200mg/dl or more is positive for diabetes.[4]A fasting blood glucose test is done after fasting through the night. Results indicate as follows: Normal is less than 100mg/dl, prediabetes is 100–125mg/dl, and diabetes is 126mg/dl or greater. A diagnosis of diabetes is confirmed via two separate fasting blood glucose tests.[4]Finally, the HbA1c test measures the percentage of blood glucose molecules bound to hemoglobin over a two- to three-month window. Results indicate as follows: Normal is less than 5.7%, prediabetes is 5.7–6.4%, and diabetes is 6.5% or greater.[4]

Hypothyroidism and Hyperthyroidism

Disorders of the thyroid are initially and primarily diagnosed via serum blood tests. There are several common thyroid tests, commonly called the “thyroid panel,” your provider will order with suspected thyroid disorders, including free triiodothyronine (T3) or total T3, free thyroxine (T4), and thyroid-stimulating hormone (TSH). In order to help diagnose if the cause of thyroid dysfunction is autoimmune in nature, your provider should also order a thyroid antibodies or autoantibodies test to help with the diagnosis of Graves’ disease (autoimmune hyperthyroidism) or Hashimoto’s disease (autoimmune hypothyroidism).[3][4]

Diagnostic Tests - Identifying Common Endocrine Disorders (3)

(Video) Diagnosing diabetes | Endocrine system diseases | NCLEX-RN | Khan Academy

All three lab tests in the thyroid panel interact with one another. The pituitary gland makes TSH, which tells the thyroid gland to make free T3 and free T4. The amounts of circulating free T3 and free T4 determine how much TSH is made. Thus, TSH works on a negative feedback loop, with increased levels indicating hypothyroidism and decreased levels indicating hyperthyroidism.[1][3][4]In order to confirm hyperthyroidism, both free T3 and free T4 must be tested, because free T4 levels may still be normal while free T3 levels will be increased. Free T4 is not bound to protein molecules in the bloodstream and freely enter body tissues, which makes free T4 preferred over bound T4 molecules. Free T4 results indicate as follows: Hypothyroidism is less than 0.8ng/dL and hyperthyroidism is greater than 1.8ng/dL. Further testing may be needed beyond serum blood testing, including thyroid ultrasound imaging and radioactive iodine uptake test.[4]

Polycystic Ovary Syndrome (PCOS)

The ovaries are responsible for the secretion of estrogen and progesterone, and for the maturation and release of eggs. For a woman to be diagnosed with PCOS, at least two of the following signs and symptoms must be present:

  • Menstrual dysfunction
  • Elevated androgen (testosterone) levels
  • Ultrasound confirmation of polycystic ovaries [1,2,4]

Menstrual dysfunction includes an irregular or absent menstrual cycle with an absence of ovulation. A serum testosterone test showing a level greater than 20ng/dL will be seen in women with PCOS. A uterine ultrasound will also be ordered to see if at least twelve ovarian follicles are visible, or one or both ovaries have increased in size.[4]

(Video) Diabetes Mellitus Diagnostic Tests

Adrenal Insufficiency

Diagnostic Tests - Identifying Common Endocrine Disorders (4)

Imbalances of cortisol and/or aldosterone can cause adrenal insufficiency. The adrenal glands control reactions to illness or injury, regulate blood pressure, regulate blood glucose levels, and help with fat and protein metabolism.[1][4]Addison’s disease can be diagnosed with the adrenocorticotropic hormone (ACTH) stimulation test. The anterior pituitary releases ACTH and tells the adrenal glands to make cortisol. A positive diagnosis of Addison’s disease is made when only a low rise in cortisol is seen after ACTH is intravenously injected.[4]Cushing syndrome is caused by an excessive release of cortisol and can be diagnosed via three different tests, including corticotropin-releasing hormone (CRH) stimulation test, dexamethasone suppression test, and 24-hour urine-collection test. The hypothalamus releases CRH, which tells the pituitary gland to release ACTH by the anterior portion, and this tells the adrenal glands to make cortisol.[4]The CRH suppression test helps to identify excessive secretion of ACTH and subsequent hypersecretion of cortisol, which is also seen with Cushing disease and pituitary tumours. The dexamethasone suppression test is done with a blood or urine sample when testing for Cushing syndrome, because dexamethasone normally decreases cortisol levels. A positive diagnosis is made when there are no changes in cortisol levels. Finally, the 24-hour urine collection test measures the amount of cortisol in the urine over a full day, with too much cortisol suggesting Cushing syndrome.[1][4]

Low Testosterone

(Video) Endocrine Disorders

The testicles produce testosterone in men and the ovaries, in much smaller amounts, produce testosterone in women. Low testosterone, or hypogonadism, is classified as either primary or secondary. Primary hypogonadism is due to injury, infection, or genetic malfunctioning of the testicles. Secondary hypogonadism has a deeper root in the hypothalamus and, by default, pituitary. This results in a communication breakdown with the brain, causing low testosterone levels by inhibiting follicle-stimulating hormone (FSH) and luteinizing hormone (LH).[1][4]Normal testosterone levels are between 300 and 1000ng/dL, thus a level less than 300ng/dL is indicative of hypogonadism. If secondary hypogonadism is suspected, a cranial CT or MRI scan may be ordered to visualize a pituitary tumour as a source of low testosterone.[4]

In conclusion, endocrine diagnostic tests are used in conjunction with clinical signs and symptoms in order to diagnoses common conditions of the endocrine system. Most endocrine diagnostic tests are based upon serum blood tests, but some are based upon urine or imaging tests. Your provider will order and interpret the appropriate diagnostic tests, coupled with a physical assessment, before recommending an appropriate course of treatment.

FAQs

What are the basic diagnostic tests used to diagnose endocrine disorders? ›

These tests and tools are used to diagnose and evaluate endocrine disorders:
  • CT scan.
  • Dual-energy X-ray absorptiometry (DXA)
  • Nuclear medicine studies.
  • Parathyroid ultrasound.
  • Post-thyroidectomy ultrasound.
  • Thyroglobulin stimulation studies.
  • Thyroid ultrasound.
  • Ultrasound-guided fine needle aspiration.

What are the common disorders of the endocrine system? ›

Some of the most common types of endocrine disorders include:
  • Menopause.
  • Diabetes.
  • Addison's disease.
  • Cushing's disease.
  • Graves' disease.
  • Hashimoto thyroiditis.
  • Hyperthyroidism/hypothyroidism.
  • Prolactinoma.

What is the best test for endocrine system? ›

Various laboratory methods are used to assess endocrine problems including immunoassays and more recently, mass spectrometry. Immunoassays remain the most commonly used method to evaluate hormonal disorders [4].

What are the 7 commonly performed diagnostic tests? ›

The 7 most common diagnostic tests are the following:
  • X-rays. ...
  • CT scan. ...
  • MRI. ...
  • Mammogram. ...
  • Ultrasound. ...
  • PET scans. ...
  • Pathology test:
23 Jun 2022

What blood tests are most important for an endocrine diagnosis? ›

Blood tests for luteinizing hormone (LH) and follicle stimulating hormone (FSH) can help to detect female hormonal issues. Tests for total testosterone can pinpoint male hormonal issues.

What is the most common endocrine disorder? ›

In the United States, the most common endocrine disease is diabetes. There are many others. They are usually treated by controlling how much hormone your body makes.

What is the most common endocrine disorder in the world? ›

Thyroid Goitre is the most common endocrine disorder. It is characterised by an enlargement of the thyroid during normal production of hormones.

How do you identify endocrine disorders? ›

Blood and urine tests to check your hormone levels can help your doctors determine if you have an endocrine disorder. Imaging tests may be done to help locate or pinpoint a nodule or tumor. Treatment of endocrine disorders can be complicated, as a change in one hormone level can throw off another.

What are the four types of endocrine disorders? ›

Types of Endocrine Disorders
  • Adrenal Insufficiency. Adrenal glands, located on top of the kidneys, produce various hormones. ...
  • Congenital Adrenal Hyperplasia (CAH) ...
  • Hyperaldosteronism. ...
  • Osteoporosis. ...
  • Pituitary Disorders. ...
  • Thyroid Disorders.

What are the most common hormones tested? ›

A blood test is one of the most common ways to test hormone levels. This test can detect testosterone, estrogen, cortisol, and thyroid levels. You should order a test that's specific to your gender, as a women's hormone test will look for different levels of sex hormones than a men's test.

What are 4 types of diagnostic testing? ›

Diagnostic tests
  • Biopsy. A biopsy helps a doctor diagnose a medical condition. ...
  • Colonoscopy. ...
  • CT scan. ...
  • CT scans and radiation exposure in children and young people. ...
  • Electrocardiogram (ECG) ...
  • Electroencephalogram (EEG) ...
  • Gastroscopy. ...
  • Eye tests.

What is the most common diagnostic test? ›

Chest X-ray

Chest x-rays are one of the most commonly performed diagnostic medical tests. This test provides a black-and-white image of your lungs, heart, and chest wall.

What is the most common endocrine disorder in elderly? ›

Primary hyperparathyroidism (pHPT) is one of the most common endocrine diseases in the elderly and the chance of developing pHPT increases with age. Elderly patients with pHPT are often not referred for surgery because of their associated comorbidities that may increase surgical risk.

What is the causes of endocrine disorder? ›

Endocrine disorders have several potential causes, such as tumors, genetic factors, or hormonal imbalances. Because these conditions affect hormones, they can cause a wide range of symptoms and influence growth and development, metabolism, sexual function, and mood.

What are the 3 main functions of the endocrine system? ›

Below are the 3 vital functions of your endocrine system.
  • Makes Hormones for Mood, Development, and Growth. Many different vital hormones are created and controlled within the endocrine system. ...
  • Sends Hormones into Your Bloodstream. ...
  • Regulates the Release of Hormones.

What are the 5 types of endocrine glands? ›

Many glands make up the endocrine system. The hypothalamus, pituitary gland, and pineal gland are in your brain. The thyroid and parathyroid glands are in your neck.

What are the 6 types of endocrine glands? ›

The major glands of the endocrine system include the pineal gland, pituitary gland, pancreas, ovaries, testes, thyroid gland, parathyroid gland, hypothalamus and adrenal glands.

How many types of endocrine are there? ›

The endocrine system is made up of the endocrine glands that secrete hormones. Although there are eight major endocrine glands scattered throughout the body, they are still considered to be one system because they have similar functions, similar mechanisms of influence, and many important interrelationships.

What is the most common female endocrine disorder? ›

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among women of reproductive age, impacting 5-10% of premenopausal American women. During the reproductive years, women with PCOS seek medical attention related to infertility, hirsutism, and acne.

Why is it difficult to diagnose endocrine disorders? ›

Endocrine diseases can be challenging to diagnose, because symptoms often mimic those of other conditions. Our trusted team of experts has the experience and skills to offer an accurate diagnosis. We get you the answers you need and customize a treatment plan to help you feel better.

What are the 8 major endocrine glands? ›

While many parts of the body make hormones, the major glands that make up the endocrine system are the:
  • hypothalamus.
  • pituitary.
  • thyroid.
  • parathyroids.
  • adrenals.
  • pineal body.
  • the ovaries.
  • the testes.

What is the most common disease treated by an endocrinologist? ›

Diabetes is one of the most common metabolic conditions. An endocrinologist can specialize in the treatment of different kinds of diabetes and other metabolic conditions such as obesity. Thyroid disease: Many conditions can affect your thyroid, the butterfly-shaped gland in the front of your neck.

How many hormone tests are there? ›

A Fertility Hormone Blood Test Panel is made up of the four most commonly ordered tests to evaluate the reproductive abilities in women. Panel includes Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), Anti-Mullerian hormone (AMH), and Estradiol (E2).

What are 5 hormonal imbalances? ›

The five most important hormonal imbalances are diabetes, hypo- and hyperthyroidism, adrenal insufficiency, polycystic ovary syndrome, and hypogonadism. Hormonal imbalances are typically caused by problems with your endocrine system. This system is composed of eight major glands in various locations around your body.

What type of blood tests are usually used to determine hormone levels? ›

The blood serum test for hormone levels is a typical blood draw taken in your practitioner's office or lab and used to determine the concentration of specific hormones in your bloodstream.

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