One of the rapidly growing areas of scientific research involving body processes is the specialty of endocrinology. This science deals with hormones and the related glands producing them. Interacting closely with all hormone mechanisms is the field of nutrition. Dealing primarily with the science of body chemicals, nutrition relates to foods and diseases produced by overabundance or lack of these specific nutrients.

It is now generally agreed that hormones do not initiate new events in the complicated chemistry of metabolic processes, but rather produce their effect by regulating enzyme systems of the body. From this one may conclude that a true understanding of any disease and the factors regulating their production.

Characteristically, abnormalities in the hormone or endocrine system arise from either an increased or decreased hormone secretion. This deviation from “normal” produces the characteristic syndromes of endocrine disease. The suspicion that a hormone problem may play a role in the patient’ s illness often comes initially from the physical appearance of a patient.

Hypothyroidism or myxedema often produces puffiness of the face and appearance of mental dullness, with drying of the skin, hair loss, and tendency to fluid retention. Overactivity of the thyroid gland, on the other hand produces just the opposite hyperthyroid state, with nervousness, tremor, weight loss, prominence of the eyes, and a continuous perspiration.

Dwarfs and giants are commonly produced from variation in pituitary glands secretions, particularly growth hormone. The adult form of giantism is called acromegaly and occurs after the normal body height has been reached. This hormone excess often enlarges the hands and feet.

Overactivity of the cortex of the adrenal gland, called Cushing’s syndrome produces a characteristic obesity with thin arms and legs, increased tendency to bruising, a hump on the back of the shoulders, and roundness of the face like a full moon. Reduced function of the adrenal cortex is called Addison’s disease.

It is characterized by increase pigmentation of the skin, weakness, salt craving, weight loss, and low blood pressure. A rapid step towards the accurate diagnosis of these hormone problems has come with new laboratory tests, such as the radioimmunoassay. Most of the body’s endocrine hormones can be analyzed now.

Although the tests are expensive they are available in most large cities. One single determination of the hormone level does not necessarily establish or exclude an endocrine abnormality.

Wide fluctuations in hormone secretions are seen during a twenty-four hour period, Some disorders of the adrenal glands, particularly, may result from a loss of the normal cyclic 24-hour pattern. This is particularly seen in conjunction with disturbed sleep pattern, work schedules, and other tendencies toward irregularity.

Hypoglycemia

Low blood sugar, usually called hypoglycemia, has many causes. The most common one relates to our fast-paced lifestyle. Excessive sugar intake, frequent snacking, and caffeine or cola beverages contribute to this frequent malady. When the blood glucose level falls rapidly, emergency “fight-orflight” stress responses take over.

The individual feels weak, very hungry, and frequently becomes irrational. Emotional reactions to hypoglycemic episodes vary from agitated to angry, depressed to suicidal. Personalities change rapidly, but return to normal function with some form of food.

Rather than frequent feedings such as the “six meal a day” diet, I recommend the following regimen: First, begin the day with a wholesome, hearty breakfast. Some whole grain cereal, bread, nut butter, or fruit makes a great way to start the day. Avoid coffee and frequent snacks. They both aggravate any tendency to low blood sugar.

Mealtimes should be at regular intervals, usually five or six hours apart. Stress factors can affect hypoglycemia. Exercise is a great way to reduce or relieve stress. Try for an hour or two of extra sleep at night. Or find a weekend for a refreshing minivacation.

Careful testing of your blood, including the five-hour Glucose Tolerance Test (GTT), may help your medical advisor to “fine-tune” your dietary and lifestyle regimen. Most individuals can overcome this metabolic imbalance, particularly the so-called reactive hypoglycemia. This type comes several hours after a meal or sugar-rich snack.

It responds very well to the remedies mentioned above. Rarely, tumors of the pancreas may produce abnormal secretions of insulin. In such case the symptoms of hypoglycemia occur during a fast, often early in the morning. Removal of the tumor is necessary to cure this uncommon condition.

Finally, diabetes mellitus may be associated with hypoglycemia. It occurs in the context of early diabetes, erroneously termed borderline. Overdoses of insulin will produce hypoglycemia. They occur during vigorous exercise or at night. Adjusting the insulin dosage along with dietary modification will level the blood glucose fluctuations in all but the most “brittle” diabetics.

Water Retention

Adults who suddenly increase their body weight may have an increase in fatty (adipose) tissue, accumulation of fluid (edema) or both disorders. Weight gain in excess of two pounds per day usually implies excess fluid retention. It is easy to confirm this by comparing the body weight in the morning and then again in the evening.

Weight gains of less than two pounds during one day usually will subside by the following morning. Fluid retention may disclose increased salt and water intake or decreased sodium and water secretion. Checking weight changes from morning to evening often provides early evidence of disease.

Dietary indiscretion, the use of diuretics, excessive intake of licorice root, or a cortisol-type drug preparation may also be responsible. A special type of fluid retention called cyclic edema occurs predominantly in women. This is characterized by periodic episodes of fluid retention, frequently accompanied by distention of the abdomen, Patients may weigh several pounds more in the evening than in the morning.

Although there is some relation to the menstrual cycle, evidence suggests also that psychological and hormonal factors may be related. The treatment of cyclic edema includes restriction in salt intake, rest in the feet elevated (supine) position for several hours during the day, and the use of elastic stockings. Careful medical work-up is sometimes indicated to evaluate underlying causes.