Hormonal Issues 

,“Managing life stresses can help maintain hormonal balance”

 says Dr Fahimullah, an endocrinologist at Rehman Medical Institute Peshawar

 SN: What are glands and hormones?sni

Glands are small structures which secrete different chemicals. They are of two types; exocrine and endocrine. Exocrine glands have ducts (tubes) attached to them through which they deliver chemicals to the body’s surface. Whereas endocrine glands secrete substances directly into the blood and their secretions are called hormones. Examples of endocrine glands include pituitary gland in brain, thyroid and parathyroid in neck, adrenal gland and pancreas in abdomen, ovaries in pelvis and testes in scrotum. Liver, kidneys, stomach, intestines and uterus also secrete hormones but these body parts have other functions as well so they do not work exclusively as endocrine glands.sni

SN: Which hormones are crucial for life?sni

Insulin and cortisol are essential for life. Humans cannot survive in their absence. Insulin is secreted by pancreas. Cortisol is produced by adrenal gland.sni

SN: Many associate testosterone hormone to men and estrogen to women. Does it mean that hormones are gender specific?sni

Mostly, glands work similarly in both genders. But some are exclusively found in one. Testes in men produce testosterone and ovaries in women secrete estradiol and progesterone hormone for reproductive purpose. On the other hand, some hormones are present in both genders but work differently. For example, prolactin hormone controls milk production in nursing mothers but has no such function in men.sni

SN: What are other causes of hormonal imbalance?sni

Some hormonal dysfunctions are caused by certain diseases. Immune system dysregulation leads to autoimmune hormonal problems like Hashimoto’s thyroiditis, Grave’s diseases or Addison’s disease. These are the leading causes of hypo and hyperthyroidism and adrenal insufficiency respectively. Genetic problems can cause imbalance too like congenital hypothyroidism (decreased production of thyroid hormone in newborns).sni

SN: What causes weight gain?sni

Many hormonal disorders are linked with obesity like hypothyroidism or Cushing’s disease (overproduction of cortisol hormone). Several rare genetic diseases also play a role. Deficiency of leptin hormone or its receptors is one example.sni

Combined menopausal hormone therapy that is with estrogen and progestin (a synthetic version of the progesterone) can increase a woman’s risk of breast cancer

SN: How do symptoms of hormonal weight gain differ from obesity caused by unhealthy lifestyle?sni

Obesity caused by hormonal disorders has other symptoms which point towards that specific endocrine abnormality. In case of hypothyroidism, under-eye swelling, cold intolerance, dry skin, constipation, weakness and depression appears along with weight gain. Mostly these changes are subtle and individuals suffering from such disorders do not recognize them for months and years.sni

SN: What are the natural ways to prevent obesity caused by hormonal imbalance?sni

Adopting a healthy lifestyle, exercising or walking daily for 30 to 45 minutes, eating fresh and organic fruits and vegetables can help. Avoiding alcohol and smoking is beneficial too. Stress is another important factor. Our body secretes various hormones in this situation like cortisol, glucagon, growth hormone, adrenaline and dopamine etcetera. Managing life stresses appropriately can help maintain humoral (bodily fluids) balance and prevent hormonal issues.sni

SN: How can on shed hormonal weight gain?sni

Obesity caused by hormonal illness requires specific treatment along with lifestyle modification.  Certain drug specifically designed for obesity can help treat it too.sni

SN: Hormonal changes are held responsible for acne during puberty. If everybody is going through these changes then why does the intensity of problem vary in individuals?sni

Puberty leads to number of hormonal changes in both genders. Growth hormone from pituitary gland is secreted at peak leading to spurt in height. Testosterone causes appearance of facial hair and voice and genital changes in men. Estradiol causes breast development and other genital changes in women. Likewise, some teenagers develop acne due to these changes and their effect on skin. Testosterone (male hormone also present in females) is mainly responsible for acne. Severity of the problem depends on the level of this hormone, skin type, how the skin and sweat glands react to this hormone, the type of bacteria in skin and certain other genetic differences.sni

SN: Which hormones are responsible for intense emotional reactions in teenagers?sni

Other than physical changes hormones control our social responses. For example, a nine-year-old girl’s behavior in public is completely different from the behavior of a 13 or 14 years old as when pubertal or female hormones have taken over. Stress response and other reactions are hormone driven too. For instance, an individual gets happy when he passes by a stall, smells his favorite food and is also hungry. This is due to release of dopamine and serotonin hormone. All other emotions like happiness, love and hatred etcetera are controlled by hormones. Stress hormones like cortisol, adrenalin, noradrenaline are responsible for certain reactions. These are called flight and fight response hormones.sni

SN: Which hormones control appetite and fullness. Also what are the natural ways to control them to avoid weight gain?sni

Satiety and hunger centers in our brain are under the control of certain hormones. When food reaches intestines, hormones such as glucagon-like peptide 1 (GLP 1) and glucose-dependent insulinotropic polypeptide (GIP) are secreted from the intestines into the blood. On reaching the brain they stimulate the satiety center and suppress the hunger center by sending a signal to the pancreas to release insulin and slow down our stomach. Hence we feel full and stop eating. To help regulate these hormones one must control appetite and weight. Therefore, reducing the amount of food intake, eating slowly, chewing properly and eating in courses is recommended. These hormones are licensed to be used in obesity treatment and weight loss.sni

Managing life stresses appropriately can help maintain humoral (bodily fluids) balance and prevent hormonal issues

SN: With good control can sugar level of a diabetic go down to a prediabetes stage?sni

Prediabetes is a stage before diabetes. It is when blood glucose levels are mildly elevated but have not exceeded a certain level that is fasting blood glucose level of more than 100 mg/dl but less than 126mg/dl. Prediabetes can be reversed with proper diet, exercise and weight loss of few kilograms. Diabetes can be reversed in early stages too with around 12 to 15 kg of weight loss in obese individuals.sni

SN: Is there any scale for diabetics to measure on their own the amount of insulin they need?sni

There are two major types of diabetes. Type 1 is usually found in children and develops when immune system destroys the insulin secreting cells of pancreas. These children have no insulin in their system. Those affected with this type can calculate the amount of insulin they need before each meal, if they know the amount of carbohydrates they are taking. Individuals with type 2 diabetes can have insulin deficiency and resistance (insulin does not work properly). Estimating the exact amount of insulin is difficult for them. However, they can roughly estimate the amount they may need for certain foods based on previous experiences.sni

SN: What is the link between hormone and cancer?sni

Some hormones are associated with certain cancers. For example, combined menopausal hormone therapy that is with estrogen and progestin (a synthetic version of the progesterone) can increase a woman’s risk of breast cancer. Menopausal hormone therapy with estrogen alone increases the chance of endometrial cancer. It is only used in women who have had hysterectomy (surgical removal of uterus). Also growth hormone is linked with the recurrence of certain cancers.sni

SN: What is hormone replacement therapy? Also what is the future of hormonal treatments?sni

Hormone replacement therapy focuses on restoring and maintaining hormonal balance. Almost all significant hormones are being used for the treatment of disorders associated with their deficiencies and many are to be discovered. For example thyroid, testosterone, estrogen, progesterone and growth hormone are used in patients with their deficiencies. Similarly insulin for diabetes, steroid hormones for adrenal patients and parathyroid hormone for patients suffering from calcium deficiency due to parathyroid disorder are being used. Use of glucagon-like peptide 1 hormone has been approved in 2022 to treat obesity. Other hormonal treatments are in pipeline and will be used in future.sni

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