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Case Study: A Male injected himself with anabolic steroids and is seeking…

- - - - Due to the reason
        
        That anabolic steroids are variants of testosterone
        
        When levels of testosterone rises, a negative feedback system occurs to inhibit LH, FSH, & GnRH
        
        By way of
        
        The hypothalamic-pituitary-gonadal-axis & Feedback loop
        
        1) When testosterone levels increase, the hypothalamus sends signals to pituitary to inhibit release of GnRH #
        
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        2) Due to the down-regulation of testosterone receptors
        
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        3) Spermatogenesis slows down
        
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      - Disorders associated w/ low testosterone https://www.endocrineweb.com/endocrinology/overview-testes
        
        Lessened sperm production
        
        Leading to infertility
        
        Muscle & bone density atrophy
        
        Compromised libido
        
        Body hair loss
        
        Bloated face
    - - Patient was soon to be married & possibly desired more of a muscular physique & increased strength
        
        Anabolic-androgenic steroids work in this area by
        
        Blocking the muscle wasting effects of glucocorticoids (a class of corticosteroids)
        
        Resulting in bigger & stronger muscles
        
        Replenishes lost testosterone after muscle building
        
        This accelerates muscle repair
- - - - Hormonal disruptions
        
        His testosterone receptors will need much more steroid to respond
        
        Due to the down-regulation of receptors #
        
        This is because their are so many receptors that prolonged exposure decreases the amount of receptors
        
        Due to this, the body may stop making it's own testosterone
        
        Because the body relies so greatly on the continual testosterone
        
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        Gynecomastia
        
        His breasts may enlarge
        
        Due to steroids breaking down to estradiol
        
        Def: Imbalance of estrogen and testosterone
      - Effects on Integumentary system #
        
        Male pattern baldness
        
        Severe acne
      - Effects on digestive system
        
        Liver damage, tumors, & liver cancer
        
        Peliosis hepatis
        
        Blood filled cysts form in liver
        
        Cysts can rupture
        
        Causing internal bleeding or death
      - Effects on the cardiovascular system
        
        Changes in blood cholesterol levels
        
        Possible raise in LDL (bad) cholesterol & decreased levels of HDL (good)
        
        Along with high BP
        
        Can lead to heart disease
        
        Could lead to atherosclerosis
        
        Increase risk of blood clots
        
        Could damage the heart muscle to where it does not pump well
      - Psychiatric Effects
        
        Depression
        
        Could lead to suicide
        
        Illusions
        
        Manic behavior
        
        Leading to violent outbreaks
        
        Such as "roid rage"
        
        Anxiety
        
        Due to the steroid reacting w/ GABA receptors
    - - If stopped abruptly
        
        Withdraw symptoms
        
        Such as
        
        Appetite loss
        
        Mood swings
        
        Exhaustion
        
        Anxiety
        
        Muscle aches
        
        Steroid cravings
        
        Nausea
      - If stopped slowly
        
        Libido should appear
        
        Muscle size & strength may go back to the extent it was before steroid abuse
        
        GnRH -> FSH & LH levels should go back to normal over time
        
        He should be able to gain close to full recovery of testicular size
- - - - Functions of system
        
        Glands secrete hormones that regulate processes such as
        
        Metabolism
        
        Growth
        
        Reproduction
        
        Mobilization of body defenses
        
        Maintenance of electrolyte, H2O, & nutrient balance of blood
        
        Influences metabolic activity by way of hormones
        
        Target most cells of the body
      - Glands/organs included
        
        Pineal gland
        
        Hormones produced
        
        Melatonin
        
        Derived from serotonin
        
        Has to do w/ sleep cycles
        
        Controls production of protective antioxidant & detoxification molecs in cells
        
        May inhibit precocious (early sex development)
        
        Hypothalamus # # #
        
        Summary
        
        Hormones produced
        
        TRH - Thyrotropin-releasing hormone
        
        Triggers release of TSH in pituitary
        
        CRH - Corticotropin-releasing hormone
        
        Stimulates ACTH production in pituitary
        
        GnRH - Gonadotropin-releasing hormone
        
        Stimulates gonadotropin (FSH & LH) in pituitary
        
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        GHIH - Growth hormone-inhibiting hormone
        
        (AKA somatostatin) "Off switch for pituitary to stop creating GH & TSH secretion"
        
        PRH - Prolactin-releasing hormone
        
        Stimulates prolactin production in pituitary
        
        GHRH - Growth hormone-releasing hormone
        
        "On switch for pituitary to create GH"
        
        PIH - Prolactin-inhibiting hormone (Dopamine)
        
        Inhibits prolactin production
        
        Pituitary gland
        
        Summary
        
        Anterior (Master gland)
        
        Hormones produced
        
        GH- Growth hormone
        
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        PRL - Prolactin
        
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        Tropic hormones
        
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        Characteristics
        
        AKA: Adrenohypophysis
        
        Composed of grandular tissue
        
        Manufactures & releases hormones
        
        Hypothalamus & anterior pituitary (AP) interactions
        
        2) Hypothalamic hormones travel through veins -> anterior pit.
        
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        1) When stimulated, hypothalamic neurons secrete releasing or inhibiting hormones into primary pituitary capillary plexus
        
        3) In response to releasing hormones, AP secretes hormones into secondary capillary plexus
        
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        Posterior
        
        Hormones produced
        
        Oxytocin
        
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        ADH - Atidiuretic hormone AKA: Vasopressin
        
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        Characteristics
        
        Composed of neural tissue & nerve fibers
        
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        Releases
        
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        This lob is a hormone-storage area! So NOT A TRUE ENDOCRINE GLAND that manufactures hormones
        
        This lob + infundibulum = neurohypophysis
        
        Hypothalamus & posterior pituitary interactions
        
        1) Hypothalamic neurons synthesize Oxy. or ADH
        
        2) Then they are transported down axons of hypothalamic-hypophyseal tract (bundle axons) -> posterior pituitary
        
        3) Oxy. & ADH are stored in axon terminals (AT) in posterior pituitary
        
        4) When neurons fire, APs arriving at AT cause oxy. or ADH -> released in blood
        
        Thyroid gland
        
        Characteristics
        
        Isthmus (A median tissue) connects the lateral lobes
        
        Its the LARGEST PURE ENDOCRINE GLAND in the body
        
        Structure of gland
        
        Composed of hollow spherical follicles #
        
        Walls of each follicle are formed by cuboidal or squamous cells (follicular cells)
        
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        Central cavirty of follicle stores colloid
        
        Amber-colored consisting of thyroglobulin molecs w/ iodine atoms attached
        
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        Parafollicular cells in thyroid produce calcitonin
        
        Hormones produced
        
        TH - Thyroid hormone
        
        Major metabolic hormone
        
        It is 2 iodine-containing amine hormones
        
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        Function
        
        Metabolism development
        
        Calorigenic effect - Body heat production
        
        Regulation of tissue growth & development of the skeletal & NS
        
        Maintaining BP by increasing # of adrenergic receptors
        
        Calcitonin
        
        Ca2+ deposition
        
        A polypeptide hormone released by parafollicular or C cells
        
        In response to rise in blood Ca2+ levels
        
        In high [calcitonin], targets skeleton
        
        1) Inhibits osteoclast activity inhibiting release of Ca2+ from bone
        
        2) Stimulates Ca2+ uptake -> bone
        
        Characteristics
        
        TH affects nearly EVERY cell in body
        
        Parathyroid gland
        
        Characteristics
        
        There are generally 4-6, sometimes 8 of them
        
        Contain oxyphil cells & contain many parathyroid cells
        
        Hormones produced
        
        PTH - Parathyroid hormone
        
        Controls Ca2+ balance in blood
        
        Falling blood Ca2+ levels trigger PTH release & rising levels inhibit release
        
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        Thymus
        
        Hormones produced
        
        Thymosins
        
        Thymulin
        
        Involved in T lumphocytes & immune response & act as paracrines
        
        Thymopoietins
        
        Adrenal glands (AKA suprarenal glands)
        
        Hormones produced
        
        Cortex
        
        Synthesizes over 2 dozen steroids
        
        Known as corticosteroids
        
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        Medulla
        
        Medullary chromaffin cells are modified postganglionic sympathetic neurons
        
        The cells synthesize catecholamines
        
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        Pancreas
        
        Characteristics
        
        Composed of
        
        Endocrine glands
        
        Exocrine glands
        
        IT develops an outpocketing of epithelial lining gastrointestinal tract
        
        Acinar cells (Forming bulk of gland) #
        
        Produce an enzyme juice
        
        Carried by ducts -> small intestine
        
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        Gonads
        
        Testes
        
        Hormones produced
        
        Testosterone
        
        Appearance of male secondary sex characteristics
        
        Sex drive
        
        Maturation of male reproductive organs
        
        Is important for
        
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        Testosterone production
        
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        Overies
        
        Hormones produced
        
        Progesterone
        
        Works w/ estrogesn to promote cyclic changes in menstrual cycle
        
        Estrogen
        
        Maturation of reproductive organs
        
        Appearance of female secondary sex characteristics
        
        Characteristics
        
        They produce steroid sex hormones identical to cortical cells
        
        Endocrine gland stimuli
        
        3 Types of stimuli trigger glands to produce & release their hormones
        
        Neural stimuli
        
        Hormone release caused by neural input such as stress
        
        Stimulus: Stress
        
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        Hormonal stimuli (Axis)
        
        Hormone release caused by another hormone
        
        Stimulus: Hormones from hypothalamus
        
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        A chain rxn of glands sending signals down to other glands
        
        Humoral stimuli (In body fluid)
        
        Simplest endocrine controls
        
        Hormone release caused by altered levels of ions or nutrients
        
        Stimulus: Low [Ca2+] in blood
        
        Therefore, stimulates PTH
        
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      - Local chemical messengers
        
        Hormones
        
        LONG DISTANCE chemical signals that carry hormones through blood or lymph
        
        Hormone classification
        
        Steroids
        
        Examples
        
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        They are
        
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        Direct gene activation of lipid-soluble & thyroid hormone
        
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        Amino acids
        
        Examples
        
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        Typically are
        
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        Eicosanoids
        
        Characteristics
        
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        Includes
        
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        Characteristics
        
        Typically produces 1 or more changes
        
        Alter membrane potential
        
        Ex: opening or closing ion channels
        
        Stimulates synthesis of enzymes & other proteins within cell
        
        Activates or deactivates enzymes
        
        Induces secretory activity
        
        Stimulates mitosis
        
        Hormone receptors
        
        3 Factors that depend on degree of target cell activation
        
        2: Relative #s of receptors for the hormone or in target cell
        
        3: Affinity (Strength) of binding between hormone & receptor
        
        1: Blood levels of hormones
        
        General rules for receptors
        
        Smaller # low-affinity receptors
        
        Reduces target cell response or causes endocrine dysfunction
        
        Large # high-affinity receptors
        
        Produce a pronounced hormonal effect
        
        Up-regulation
        
        Persistently low levels of hormone -> Target cells to add more receptors for that hormone
        
        Down-regulation
        
        Prolonged exposure to high [hormone] -> Decrease the # receptors for that hormone
        
        Regulation of hormone release
        
        Synthesis & release of most hormones are regulated by
        
        Negative feedback loops
        
        Work by
        
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        Blood - "A soup of hormones"
        
        3 Types of hormone interaction
        
        Synergism
        
        A greater effect is achieved w/ other hormones
        
        Ex: Glucagon & epinephhrine release C6H12O6 to blood, yet when working together, amount of C6H12O6 is 150% greater
        
        Antagonism
        
        "Hormones cancel each other out"
        
        Ex: Insulin (lowers blood C6H12O6 levels) is antagonized by glucagon (Raises blood C6H12O6 levels)
        
        Occurs by
        
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        Permissiveness
        
        For a hormone to exert its full effects, another hormone must be present
        
        Hormones have no choice but to work together
        
        Ex: Lack of thyroid hormone delays reproductive development
        
        Paracrines
        
        Also short distance signals
        
        These signals talk to the cells next door
        
        They can affect cells that don't release paracrine chemicals
        
        Only received in a small region of the body
        
        Example
        
        Testostrone tells testis how much sperm to produce
        
        Autocrines
        
        Short distance signals
        
        That act within a cell or from one cell to the adjacent cell
        
        They act on the SAME cells that secrete them