29
insulin- like growth factor 1 (IGF-1) [52], so, in acromegaly, there is an increased
level of both hormones, i.e., GH and IGF-1 leading to tissue enlargement and metabolic alterations which ultimately causes visible malformations and increased mortality [53]. This disease usually occurs between the ages of thirty and fifty. The
onset is concealed and progresses slowly, often delaying the diagnosis to the late
stage of the disease [51]. GH counteracted the effects of insulin on glucose metabolism. It also regulates tissue response to insulin; consequently, increased GH may be
the cause of insulin resistance. Acromegaly is associated with abnormal lipid
metabolism. The study found that patients with acromegaly had higher serum triglyceride levels [54].
Hyperprolactinemia or Galactorrhea
The galactorrhea is lactation in non-breastfeeding women or in men. The galactorrhea is usually caused by a pituitary adenoma (prolactinoma) that secretes prolactin.
Most of the tumors in women are microadenomas (<10 mm in diameter), but only a
small fraction of them are large adenomas (>10 mm) after diagnosis. The frequency
of microadenomas in men is quite lesser, which may be due to later recognition.
Pituitary non-functional lesions can also increase prolactin levels by compressing
the pituitary stalk, thereby reducing the action of the prolactin inhibitor dopamine.
Hyperprolactinemia and galactorrhea may also be caused by certain medications, including phenothiazine and some other antipsychotics, opioids, and certain
antihypertensives (especially alpha-methyldopa). Primary hypothyroidism can
cause galactorrhea and hyperprolactinemia, as elevated levels of thyroid releasing
hormones increase the secretion of prolactin and TSH. Hyperprolactinemia may be
associated with gonadotropin deficiency and hypogonadism, possibly by inhibiting
the release of gonadotropin releasing hormone (GnRH) or acting on pituitary
gonadotropins [52].
Signs and Symptoms
There is no quantitative definition of lactation abnormalities. Milk release is inappropriate for the patient, persistent or worrying. Impulsive lactation is rare than milk
released in response to artificial expression. The milk is white and the fat globules
can be seen when the sample is examined with a microscope. Women with galactorrhea usually have amenorrhea or oligomenorrhea. Because high prolactin levels
inhibit the release of gonadotropin and follicle stimulating hormone, women with
galactorrhea and amenorrhea may also have signs and symptom of estrogen deficiency, including difficulty in sexual intercourse and decreased libido. However,
estrogen secretion may be normal, and signs of excessive androgen, including hirsutism, are observed in some women with hyperprolactinemia. Hyperprolactinemia
may cause other menstrual cycle disorders other than amenorrhea, including fewer
ovulations and luteal dysfunction. Men with prolactin secreting pituitary tumors
1 Physiology of Endocrine System and Related Metabolic Disorders
insulin- like growth factor 1 (IGF-1) [52], so, in acromegaly, there is an increased
level of both hormones, i.e., GH and IGF-1 leading to tissue enlargement and metabolic alterations which ultimately causes visible malformations and increased mortality [53]. This disease usually occurs between the ages of thirty and fifty. The
onset is concealed and progresses slowly, often delaying the diagnosis to the late
stage of the disease [51]. GH counteracted the effects of insulin on glucose metabolism. It also regulates tissue response to insulin; consequently, increased GH may be
the cause of insulin resistance. Acromegaly is associated with abnormal lipid
metabolism. The study found that patients with acromegaly had higher serum triglyceride levels [54].
Hyperprolactinemia or Galactorrhea
The galactorrhea is lactation in non-breastfeeding women or in men. The galactorrhea is usually caused by a pituitary adenoma (prolactinoma) that secretes prolactin.
Most of the tumors in women are microadenomas (<10 mm in diameter), but only a
small fraction of them are large adenomas (>10 mm) after diagnosis. The frequency
of microadenomas in men is quite lesser, which may be due to later recognition.
Pituitary non-functional lesions can also increase prolactin levels by compressing
the pituitary stalk, thereby reducing the action of the prolactin inhibitor dopamine.
Hyperprolactinemia and galactorrhea may also be caused by certain medications, including phenothiazine and some other antipsychotics, opioids, and certain
antihypertensives (especially alpha-methyldopa). Primary hypothyroidism can
cause galactorrhea and hyperprolactinemia, as elevated levels of thyroid releasing
hormones increase the secretion of prolactin and TSH. Hyperprolactinemia may be
associated with gonadotropin deficiency and hypogonadism, possibly by inhibiting
the release of gonadotropin releasing hormone (GnRH) or acting on pituitary
gonadotropins [52].
Signs and Symptoms
There is no quantitative definition of lactation abnormalities. Milk release is inappropriate for the patient, persistent or worrying. Impulsive lactation is rare than milk
released in response to artificial expression. The milk is white and the fat globules
can be seen when the sample is examined with a microscope. Women with galactorrhea usually have amenorrhea or oligomenorrhea. Because high prolactin levels
inhibit the release of gonadotropin and follicle stimulating hormone, women with
galactorrhea and amenorrhea may also have signs and symptom of estrogen deficiency, including difficulty in sexual intercourse and decreased libido. However,
estrogen secretion may be normal, and signs of excessive androgen, including hirsutism, are observed in some women with hyperprolactinemia. Hyperprolactinemia
may cause other menstrual cycle disorders other than amenorrhea, including fewer
ovulations and luteal dysfunction. Men with prolactin secreting pituitary tumors
1 Physiology of Endocrine System and Related Metabolic Disorders