As an endocrinologist, I am very familiar withthe importance of the endocrine glands tohuman functioning. These glands work continuouslyto maintain the health of all individuals as wemove through each and every day of our lives. Infact, when one or more of the endocrine glandsmalfunction, the person’s entire system is oftenthrown into disarray. For example, if a persondevelops Hashimoto’s thyroiditis, an autoimmunedisorder that causes hypothyroidism, the person’sonce-normal thyroid levels will drop. He or shemay become lethargic and show a variety of symptoms.These range from annoying to severe andaffect many activities of daily living. Due to lethargy,the patient’s physical activity level will usuallydecrease. Thus the patient may gain weight, eventhough he or she eats about the same amount offood as they had before becoming hypothyroid.The individual with hypothyroidism may alsoappear apathetic and depressed, sometimes leadingthe patient to seek treatment for these symptomsrather than for the underlying cause.

 

    There are many other examples of endocrinediseases that manifest profound effects on thosewho live with these illnesses, especially if theirendocrine disorder is not identified and treated. Forexample, diabetes mellitus has a major healthimpact on millions of people. Sadly, many peoplewho have diabetes, and particularly Type 2 diabeteswhich usually can be treated with oral medications,are undiagnosed and untreated. These peoplerisk suffering severe complications from theirlong-term untreated illness.

 

    Other, less common endocrine diseases and disordersalso have an impact. Some patients face cancerof their endocrine glands, such as cancer of thepancreas, thyroid, ovaries, testes, and the otherorgans that comprise the endocrine system. Thesecancers are not as commonly diagnosed as are cancersof the lung, breast, prostate, or colon.However, they are equally as devastating to thosewho experience them.

 

    Some people develop very rare diseases of theendocrine system. One such disease, gigantism,causes extremely tall height due to a malfunctionof the pituitary gland. Other individuals haveunusually short stature, or dwarfism, often due togenetic mutations they have inherited from theirparents and sometimes from deficiencies of growthhormone.

 

    In this volume, we have attempted to cover thegamut of endocrine diseases and disorders, rangingfrom the more common diseases, such as thyroiddisease and diabetes, to the rarer medical problems.Our goal is to provide readers with a broadoverview of the endocrine system, illustrating howthe endocrine glands function when they worknormally as well as describing what happens whenthe endocrine glands malfunction and discussingwhat can be done in the case of the latter.

 

    We must also point out that although doctorscannot cure all diseases and disorders, many illnessesthat were not treated years ago—becausethe medical tools were not available at that time—can now be treated by endocrinologists. For example,if infertility is caused by an endocrine disorder,the problem can often be identified and treated,enabling an anxious couple to become transformedinto happy parents.

 

    If the illness is potentially fatal, such as cancer,many treatments are available that can helppatients resolve their cancer or extend their life formany years. We doctors still do not have all theanswers, of course, but we are learning more allthe time. Continuing research will enable us to discovermuch more about endocrine diseases anddisorders and how to treat them more effectively.

 

    In the meantime, we also know that patientscan take many actions to increase the probability oftheir good health. For example, eating a healthydiet and exercising regularly will not only helpmany patients avert the scourge of obesity but willalso significantly reduce their risk of developingdiseases such as diabetes or hypertension.

 

    Such healthy habits are very important. Recentstudies have shown that the prevalence of bothobesity and severe obesity has greatly increased.For example, a study reported in a 2003 issue ofArchives of Internal Medicine reported that the prevalenceof people with a body mass index (BMI) of 40or greater and who were about 100 pounds ormore overweight (and thus considered severelyobese) increased from one in 200 Americans in1986 to one in 50 by the year 2000.

 

    In addition, over the same time period, thenumber of people who were obese (with a BMI of30 or greater) increased from one in 10 to one infive Americans—another dramatic change. Clearly,obesity is a major problem in the United States. Itis also one that needs to be addressed by bothpatients and their doctors.

 

    Patients also bear other responsibilities in managingtheir health. For example, they should haveannual checkups and should see their doctors morefrequently if they are ill. Doctors are not mindreaders. They need to see their patients regularly.

 

    Doctors also need to be given complete andaccurate information by their patients. Whenpatients withhold information from their doctors,such as facts about smoking habits, intake of alcohol,and use of alternative remedies, they may becompromising their health.

 

    In summary, when doctors and patients worktogether in a healthy partnership, many endocrinediseases and disorders, as well as many other medicalproblems, can often be successfully resolved ormanaged.

 

    —William Petit Jr., M.D.