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Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
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Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
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Cushing's Syndrome Effects on the Thyroid.

Rosa Maria Paragliola1, Andrea Corsello1, Giampaolo Papi1

  • 1Department of Translational Medicine and Surgery, Unit of Endocrinology, Università Cattolica del Sacro Cuore-Fondazione Policlinico "Gemelli" IRCCS, Largo Gemelli 8, I-00168 Rome, Italy.

International Journal of Molecular Sciences
|April 3, 2021
PubMed
Summary

Cushing's syndrome disrupts the thyroid axis, causing central hypothyroidism and masking autoimmune thyroid disease. Treatment of Cushing's syndrome can restore thyroid function and reveal thyroid autoimmunity.

Keywords:
Cushing’s syndromehypothalamus–pituitary–thyroid axisthyroid function tests

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Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Thyroidology

Background:

  • Endogenous Cushing's syndrome (CS) is characterized by phenotypic and metabolic alterations due to excess cortisol.
  • Beyond metabolic effects, hypercortisolism significantly impacts other endocrine axes, including the hypothalamus-pituitary-thyroid (HPT) axis.

Purpose of the Study:

  • To elucidate the multifaceted effects of hypercortisolism on thyroid function.
  • To highlight the clinical implications for diagnosing and managing thyroid dysfunction in CS patients.

Main Methods:

  • Review of clinical studies examining HPT axis activity in patients with active and resolved CS.
  • Analysis of the impact of cortisol on thyroid autoimmunity and deiodinase activity.
  • Consideration of drug-induced thyroid function test alterations in CS management.

Main Results:

  • Inappropriate cortisol secretion impairs HPT axis activity, leading to central hypothyroidism.
  • Resolution of hypercortisolism often restores normal HPT axis function.
  • Hypercortisolism can mask autoimmune thyroid diseases, which may manifest or increase post-treatment.

Conclusions:

  • Thyroid function should be monitored in Cushing's syndrome patients during active disease and after remission.
  • Understanding these interactions is crucial for comprehensive patient care and management of endocrine comorbidities.