We now present a few common symptoms and the possible relationships to specific endocrine diseases. Clinical experience is certainly important in interpreting these relationships. Nevertheless, the suspicion that there is something wrong is often the first step toward an accurate diagnosis.

Weakness and increased fatigability are without doubt the most frequent symptom of adults seeking medical diagnosis. In the majority, these complaints derive primarily from emotional or psychological disturbances. When hormone abnormalities are suspected, one should inquire first whether the symptoms have been accompanied by weight loss.

If so, insufficiency of the adrenal gland, overactivity of the thyroid, and diabetes mellitus should be considered. Adrenal insufficiency is usually accompanied by increased pigmentation, low blood pressure, and perhaps salt craving. Hyperthyroidism is suggested by goiter (enlargement of the thyroid gland), bulging eye changes, tremor, and heat intolerance.

Sugar diabetes is usually accompanied by excessive urination and increased thirst. Without weight loss, but with symptoms of weakness and fatigability one could consider underactive thyroid, underactive pituitary gland, overactive parathyroid gland with high calcium levels, and hypersecretions of aldosterone, another hormone from the adrenal gland regulating the salt balance.

The first of these are associated with hypoactive reflexes, intolerance to cold, dry skin. Hypopituitarism is suggested by delayed or absent menstrual cycle, impotence, decreased tolerance to cold, hypoglycemia, and low blood pressure. Hyperparathyroidism is usually associated with bone pain, kidney stones, and increased urination.

Elevated aldosterone levels are accompanied by high blood pressure, muscle weakness, and signs of potassium depletion. Menstrual irregularities are associated with four major hormone disturbances. Primary failure of the ovaries prior to a natural menopause is characterized by hot flushes, weight gain, emotional instability.

Secondary ovarian failure, associated with reduced stimulating hormones from the pituitary gland is often related to diseases in the thyroid or adrenal. Underactive thyroid gland is often associated with excessive menstruation, as well as decreased flow. The final, but much more rare syndrome is seen in conjunction with adrenal gland dysfunction.

The menstrual irregularities in this case are usually associated with increased muscle development, increased body hair (hirsutism) and other signs of masculinization. The use of birth control pills should always be investigated as a cause of menstrual irregularity. Breast changes are also commonly associated with hormone disorders.

Enlargement of the breast in males (gynecomastia) occurs normally at puberty and may persist through adolescence. Rarely, hormone-secreting tumors of the adrenal gland or testes may also produce these problems. Several varieties of drugs may cause breast changes as well.

Abnormal lactation (galactorrhea) is sometimes observed in-patients with tumors of the pituitary gland. A number of drugs, including some antihypertensive and tranquilizing preparations may also produce this problem. Hypertension may also be associated with hormone disorders, although it is more commonly related to stress, salt intake, and obesity.

Cushing’s syndrome or adrenal gland excess can definitely cause high blood pressure and should be considered if unusual obesity, associated with a tendency to bruising, is present. An episodic hypertension is caused by secretion from the adrenal medullary tumor called pheochromocytoma.

The picture of rapid heart rate, nervousness, sweating, although classic, is infrequent. Increased secretion of the parathyroid hormone or the adrenal hormone aldosterone can also cause hypertension, and should be excluded in complete diagnosis of the problem.

Obesity suggests the possibility of a hormone disturbance, but it is usually caused by habitually increased food intake or deep-seated emotional problems. Diabetes should definitely be investigated and excluded in the presence of obesity, particularly in adults. Thyroid disorders are commonly related and can be evaluated with simple blood measurements.

One must also consider the possibility of problems induced by hormone administration, as we see the frequent prescribing of cortisone preparations, thyroid or sex hormone in nonspecific therapies for varying symptoms. These so-called iatrogenic (physician caused) problems can often be improved by the discontinuance of the offending drug.