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Pathology Tests Explained
Pathology Tests Explained
To learn more about specific endocrine glands, the hormones they produce, and the disorders associated with their improper function,
see the table of endocrine glands on the Tests page.
All of the endocrine glands are normally carefully controlled with the use of feedback systems. For example, the amount of thyroid
hormone in the bloodstream acts as a regulating factor on the hypothalamus and pituitary, telling them to release more TRH and TSH
respectively when thyroid hormone concentrations in the blood decrease. In some cases, such as thyroid hormone, the body strives to
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keep a relatively constant amount in the blood.
Some hormones have a daily or monthly pattern of release. For example, cortisol (produced by the adrenal glands) concentrations are
high in the morning and lower late in the evening, while both follicle-stimulating hormone (FSH) and luteinising hormone (LH) (produced
by the pituitary gland) increase and decrease with and regulate a woman’s monthly menstrual cycle. Other hormones are generally
present in very small quantities in the blood and are released in specific situations, such as the release of adrenaline (epinephrine) from
the adrenal glands in response to stress.
Endocrine gland dysfunction may be due to either a problem with the gland itself, a problem “upstream” in the feedback system, and/or
due to a lack of response by the target tissues. There may be decreased hormone production related to trauma, disease, infection,
crowding of the hormone-producing cells by a tumour, or due to an inherited gene mutation that affects the quantity, quality, or use of a
hormone. Decreased production may also be due to failure of the “upstream” gland to produce its hormone(s). Increased production may
also be related to a problem upstream (such as the pituitary producing too much ACTH, leading to the production of too much cortisol),
hyperplasia or tumour of the hormone-producing cells, lack of tissue response, medication use or an inherited condition.
Tumours are generally small and usually benign. Most of them are located inside the affected gland and produce a single type of
hormone. Rarely they may be cancerous and also rarely they may be located elsewhere in the body. A tumour may cause symptoms
because of the excess hormone it is producing, because its growth crowds out and decreases the production of other hormones in the
gland, or because its physical size presses against surrounding nerves and structures.
Most inherited conditions are rare and are usually related to deficient or dysfunctional production of a single hormone or to the hormone
production of a particular gland (for example, congenital hypothyroidism). However, there are genetically-caused conditions that affect
the glands themselves. Two that have been identified as affecting several endocrine glands are MEN-1 and MEN-2 (multiple endocrine
neoplasia, types 1 and 2). These conditions are related to alterations in specific genes, and they increase the lifetime risk that those
affected will develop tumours in one or more of their endocrine glands.
TESTS
Growth hormone-releasing
hormone (GHRH
Communicates with
Thyrotropin-releasing hormone both nervous and
Precocious puberty (early GnRH
(TRH)
endocrine systems;
production);
Uterine contraction
Oxytocin
during labour
Hypopituitarism
syndrome
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growth, cell production, GH)
TSH
hormone Hypothyroidism
Butterfly- T4 (thyroxine)
Helps regulate the rate Thyroid diseases (including hypo
shaped; lies flat T3 (triiodothyronine) of metabolism & hyperthyroidism)
Thyroid against
windpipe in the Helps regulate bone
Calcitonin
throat status, blood calcium
4 tiny glands
located behind, Hyperparathyroidism
Regulates blood
Parathyroid next to, or Parathyroid hormone (PTH) Hypoparathyroidism
calcium
below the
thyroid
Blood pressure
Adrenaline
DHEA-S
at puberty Adrenal hyperplasia
EXAMPLES OF DISORDERS
ENDOCRINE LOCATION/ HORMONES GLAND GLAND/ HORMONE
ASSOCIATED WITH
GLAND DESCRIPTION PRODUCES FUNCTION
IMPROPER FUNCTION
Ovaries
2 located in the Oestrogen
Female sexual Polycystic ovary syndrome
(females only) pelvis Progesterone characteristics (PCOS)
Testes
2 located in the Male sexual
Testosterone Hypogonadism
(males only) groin characteristics
Large, gourd-
Insulin
Pancreas Glucagon
Glucose regulation
located behind Zollinger-Ellison syndrome
Somatostatin
the stomach
This table includes a listing of endocrine glands, the hormones they produce, and the diseases and conditions associated with their
improper function.
The goal with endocrine gland testing is to identify the hormone(s) that are being over- or under-produced, to determine which gland(s)
are involved, and to determine the cause. This may involve measuring hormone levels and their metabolites in the blood and/or urine. It
may also involve stimulation or suppression testing to evaluate hormone production and/or its “upstream” hormone stimulation (to find
out if it is the gland itself that is dysfunctional or if it is due to dysfunction by the gland preceding it). If a tumour is suspected, then
imaging scans may be used to help locate the tumour. If symptoms are suspected to be due to an inherited condition, then genetic
testing may be recommended. Patients often see an endocrinologist (an endocrine gland specialist) to help them determine the
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appropriate testing and treatment. Related testing on this site includes:
Laboratory tests
Aldosterone
Calcitonin
Calcium
Cortisol
Electrolytes
GH (Growth hormone)
LH (Lutenising hormone)
Metanephrines, urine
Oestrogen
Progesterone
Prolactin
Free T3 (triiodothyronine)
Free T4 (thyroxine)
Testosterone
Non-laboratory tests
Magnetic resonance imaging (MRI)
Ultrasound
Radioisotope scans
TREATMENT
Treatment of endocrine gland-related conditions depends on the cause. If the problem is due to a drug therapy, then the patient may be
able to be weaned off the medication (never abruptly stop taking a medication without consulting with your doctor). If it is due to
hyperplasia, then the action of the hormone may be able to be blocked. If is due to a tumour, then the tumour may be able to be surgically
removed. Often this will resolve the problem or decrease it to the point that it can be successfully controlled.
In some cases, after a gland has been removed to resolve the problem, the patient may need to take replacement medications, such as
thyroid hormone. Replacement is also often used when a patient’s gland has been damaged or is otherwise not capable of producing a
sufficient quantity of one or more hormones. When patients have a gene mutation associated with MEN-1 or MEN-2, careful lifetime
monitoring will be necessary. Treatment of all endocrine-related conditions should be tailored to the individual. Patients should work with
their doctor to determine the right course of action for them.
RELATED PAGES
On this site
Tests: ACTH, aldosterone, cortisol, calcitonin, calcium, catecholamines, plasma and urine, DHEAS, electrolytes, FSH, GH, hCG, IGF-1, LH,
metanephrines, plasma free and urine, oestrogen, progesterone, prolactin, PTH, free T3, free T4, testosterone, TSH
Conditions: Adrenal insufficiency & Addison’s disease, Cushing’s syndrome, Conn’s syndrome
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