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CNM Nutrition 2 S1 > Endocrine System > Flashcards

Endocrine System Flashcards

1
Q

What is the endocrine system and what 9 things in the body makes it up?

A

A collection of glands that secrete hormones directly into the bloodstream. Made up of hypothalamus, pituitary, pineal gland, thyroid, four
parathyroid glands, two adrenal glands, endocrine portion of the pancreas, thymus and gonads.

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2
Q

Define hormones.

A

Chemical messengers which travel through the body via the bloodstream to arrive at target tissues with a specific receptor.

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3
Q

Which gland oversees the other glands of the endocrine system, modulating hormone production and release and what is it controlled by?

A

Pituitary gland under the influence of the hypothalamus.

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4
Q

What happens to hormones once they have done their job at the target tissues? Why is this important?

A

They are metabolised and excreted via the kidneys. It stops the accumulation.

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5
Q

State 6 ways the endocrine system can fail?

A
  1. Glands can under/over-secrete hormones.
  2. Glands can secrete faulty hormones - poor nutrients.
  3. Hormones fail to reach target tissues - poor circulation.
  4. Feedback mechanism faulty.
  5. Breakdown of hormones not working correctly.
  6. Inability of target receptor to pick up hormone = functional hormone resistance.
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6
Q

What is functional hormone resistance?

A

Inability of target receptor to pick up hormone = reduced ability of the target cell to utilise the hormone properly despite adequate levels. It can cause a decrease in the effect of the hormone and/or, overproduction of the hormone as the body attempts to maintain homeostasis.

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7
Q

State a form of functional hormone resistance that is well accepted?

A

Insulin resistance.

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8
Q

What are POPs and what have they been linked to?

A

Persistent organic pollutants - linked to impaired thyroid function and insulin resistance.

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9
Q

State the 4 most common endocrine disorders that present in clinical practice.

A
  1. Hypothyroidism.
  2. Hyperthyroidism.
  3. Diabetes mellitus type 1.
  4. Diabetes mellitus type 2.
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10
Q

What is the thyroid?

A

A large ductless gland in the neck which secretes hormones regulating growth and development through the rate of metabolism. The hormones of the thyroid gland are required for mitochondrial metabolism in every cell of the body.

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11
Q

Thyroid cells are the only cells in the body which can absorb what?

A

Iodine.

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12
Q

What are the 2 thyroid hormones?

A
  1. Tetraiodothyronine (T4).

2. Triiodothyronine (T3) - most active.

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13
Q

What amino acid does the thyroid combine with iodine to make T3 and T4?

A

Tyrosine.

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14
Q

What percentage T4 and T3 does a healthy thyroid produce?

A

80% T4, 20% T3 - but T3 is 4x the strength.

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15
Q

Hypothalamus releases what in response to a decrease in circulating thyroid hormone?

A

Thyrotropin-releasing hormone (TRH).

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16
Q

Thyrotropin-releasing hormone (TRH) signals the pituitary gland to release what?

A

Thyroid stimulating hormone (TSH).

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17
Q

Thyroid stimulating hormone (TSH) stimulates the thyroid to what?

A

Increase thyroid hormone production. Then Blood levels rise signalling hypothalamus to switch off TRH.

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18
Q

Define Hypothyroidism.

A

A lack of thyroid hormones, slows metabolism with widespread effects such as depression, sluggishness, weight gain.

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19
Q

Define Hyperthyroidism.

A

An excess of thyroid hormones, over stimulates the body resulting in symptoms such as increased heart rate, anxiety, and weight loss.

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20
Q

What is Subclinical Hypothyroidism?

A

Mild hypothyroidism - normal serum free T4 levels with slightly high serum TSH. Often go undetected based on current pathology guidelines.

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21
Q

State 4 causes of Hypothyroidism.

A
  1. Thyroid produces too little thyroid hormone - 95% of cases.
  2. Inadequate TSH secretion from the pituitary gland.
  3. Inadequate thyrotropin-releasing hormone (TRH) from the hypothalamus.
  4. Decreased conversion from T4 to T3.
  5. Overproduction of reverse T3.
  6. Body is not efficiently using thyroid hormone.
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22
Q

Deficiency or excess in what mineral can cause Hypothyroidism?

A

Iodine.

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23
Q

What are goitrogens and how might they cause hypothyroidism?

A

Foods that block iodine utilisation, such as: Brassica family, soybeans, peanuts, pine nuts. Cooking inactivates them.

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24
Q

What is Hashimoto’s Thyroiditis?

A

An autoimmune condition where body recognises thyroid antigens as foreign and causes a chronic immune reaction. Individuals have circulating antibodies to thyroid tissue.

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25
Q

What is Postpartum thyroiditis?

A

Thyroiditis developed 2-4 months following childbirth. 10% of women experience, 25% of those with T1D. Usually lasts 2-4 months and is treated with levothyroxine (LT4) - but increases risk of permanent hypothyroidism.

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26
Q

What is a goitre?

A

Low thyroid function can lead to the development of goitre (enlarged neck). Can be caused by insufficient iodine or hashimoto’s. Feedback to the hypothalamus and pituitary increases TSH which stimulates thyroid growth as well as hormone production.

27
Q

Which is the most sensitive blood test for detecting hypothyroid and hyperthyroid states, TSH or T4?

A

TSH.

28
Q

What is Reverse T3 (rT3)?

A

A relatively inactive form of T3 and if in higher than normal amounts, it can block T3 activity by competing for receptor sites - individual can be in a hypothyroid state but with normal circulating T3.

29
Q

What is the orthodox medical treatment for hypothyroidism?

A

Synthetic T4 drugs, including Synthroid and Levoyxl (levothyroxine). Combination therapy using levothyroxine administered at the same time as T3 ca be helpful.

30
Q

Nutritional support for hypothyroidism should begin with optimisation of the nutrients needed for thyroid hormone production and cellular conversion of T4 to T3. State 5 nutrients needed.

A
  1. Iodine - thyroid hormone formation.
  2. Tyrosine - thyroid hormone formation.
  3. Selenium - thyroid hormone synthesis, activation, and metabolism.
  4. Zinc - conversion of T4 to T3.
  5. Iron - thyroid hormone synthesis.
  6. Copper - conversion of T4 to T3.
  7. B vitamins - thyroid hormone synthesis.
  8. Vitamin A - production of TSH and thyroid hormone.
  9. Vitamins C and E - reduce the oxidative stress associated with hypothyroidism.
31
Q

Why should we refrain from iron supplementation with someone on thyroid medication?

A

It may decrease the absorption of the thyroid medication.

32
Q

State 2 reasons why exercise helps in people with hypothyroidism.

A
  1. Exercise stimulates thyroid gland secretion.

2. Increases tissue sensitivity to thyroid hormone.

33
Q

What can be used as an alternative to synthetic hormones?

A

Desiccated natural thyroid - the benefit is that it provides both T4 and T3, as well as relevant amino acids and micro nutrients.

34
Q

State 5 things to consider doing/aiming for with a client with hasimoto’s or hypothyroidism.

A
  1. Address gut dysbiosis.
  2. Consider food elimination - allergies/sensitivities.
  3. Support liver detoxification.
  4. Stress management.
  5. Reduce exposure to toxins and manage existing heavy metal toxicity.
35
Q

List 3 additional supplements you would consider for a client with hasimoto’s.

A
  1. Omega-3 fatty acids - anti-inflammatory.
  2. Quercetin - anti-inflammatory, shown to inhibit thyroid growth.
  3. Selenium.
  4. Vitamin D - immune modulator.
  5. Turmeric - anti-inflammatory and antioxidant
    effects.
36
Q

What are the 3 forms of hyperthyroidism?

A
  1. Graves’ Disease (around 85% of cases) - goitre, autoimmune, antibodies stimulate the thyroid to produce excessive amounts of thyroid hormones, overwhelms normal feedback regulation of TSH.
  2. Toxic Nodular Goitre - one or more nodules (benign tumours) in the thyroid produce an excess of thyroid
    hormone.
  3. Secondary Hyperthyroidism - pituitary gland stimulates the thyroid to overproduce thyroid
    hormones.
37
Q

State 3 risk factors for hyperthyroidism.

A
  1. Female.
  2. Stress.
  3. Genetics.
  4. Digestive function.
  5. Infection.
  6. Smoking.
38
Q

State the 3 orthodox treatments for hyperthyroidism.

A
  1. Radioactive iodine - radioactive iodine becomes concentrated in the thyroid, destroying the hyper
    functioning tissue.
  2. Thyroid depressants - decrease production of thyroid hormone.
  3. Beta-blocking drugs - help to control some of the symptoms.
39
Q

Nutritional interventions for a client with hyperthyroidism aim to reduce symptoms while aiming to re-establish normal thyroid status, state 3 interventions.

A
  1. Reduce risk factors (smoking, stress).
  2. Consume raw food containing goitrogens (raw cabbage).
  3. Vitamin C supplementation - antioxidant and improves immune status.
  4. Selenium supplementation - helps to regulate
    thyroid antibodies and thyroid function.
  5. Magnesium supplementation - required for energy production, may reduce tremors, muscular aches
    and palpitations associated with hyperthyroidism.
40
Q

Define type 1 diabetes.

A

Failure of insulin production in the pancreas resulting from autoimmune destruction of the beta cells of the pancreas.

41
Q

Define type 2 diabetes.

A

Insulin resistance and decreased sensitivity of the insulin receptor. Individuals become resistant to utilising the insulin they produce.

42
Q

What is insulin?

A

It transports glucose from the bloodstream into the cells and is required for carbohydrate, fat, and protein metabolism.

43
Q

Insulin stimulates what 2 processes?

A
  1. Glycogenesis - converts glucose to its storage form glycogen.
  2. Lipogenesis - fat storage.
44
Q

Insulin inhibits what 2 processes?

A
  1. Glycogenolysis - release of stored glucose from liver glycogen.
  2. Gluconeogenesis - breakdown of protein and fat for glucose production in both liver and kidneys.
45
Q

What is normal a blood glucose level in the morning and before meals? 2 hours after a meal and before bed?

A

Morning/before meals: 80 to 120 mg/dl.
2 hours after meals: 140 to 160 mg/dl.
Before bed: 100 to 140 mg/dl.

46
Q

State 3 classic symptoms of diabetes.

A
  1. Polyuria.
  2. Polydipsia - excess thirst.
  3. Polyphagia - excessive appetite.
  4. Obesity.
  5. Hypertension.
47
Q

What is the best way to test for diabetes?

A

Fasting blood glucose level combined with HBA1C.

48
Q

State 3 complications associated with diabetes.

A
  1. Retinopathy - diabetes leading cause of blindness.
  2. Neuropathy - nervous system damage (amputations).
  3. Periodontal disease - gum disease.
  4. Cardiovascular disease.
  5. Depression.
49
Q

The cause of T1D is unknown, state 3 risk factors.

A
  1. Poor gastrointestinal integrity - gut dysbiosis, poor protein digestion (cows milk and gluten linked to T1D).
  2. Viral infection, particularly GI tract - enteroviruses and rotavirus.
  3. Nutrient deficiencies - omega-3 fatty acids and vitamin D during pregnancy and in childhood, vit D supplementation is protective.
  4. Nitrates - fertilisers and cured or smoked meats, in GIT react to form toxic compounds to particularly to pancreas, exposure during pregnancy increases risk.
50
Q

What is the conventional treatment for T1D?

A

Insulin usually in a shot form.

51
Q

Supplementation with what 2 things has been shown

to prevent further damage and destruction to beta cells in T1D?

A

Niacinamide and epicatechin.

52
Q

Epicatechins have a long history of use in India in T1D, what is a good source and what are the benefits?

A

Green tea extract.

Antiviral activity against rotavirus and enterovirus (2 viruses suspected to cause), also is a powerful antioxidant.

53
Q

State 3 common symptoms of T2D.

A
  1. Polyuria.
  2. Blurred or poor vision.
  3. Candida infections.
  4. Pruritus - itchy skin.
  5. Numbness or burning sensation of distal extremities.
54
Q

What type of drug is Metformin and how does it work?

A

Biguanide - improves insulin action at target cells and reduces insulin resistance. But they can increase homocysteine production.

55
Q

Suggest 2 treatments aims for a client with T2D.

A
  1. Reduce weight.
  2. Stabilise blood glucose/improve insulin sensitivity.
  3. Improve metabolism of blood glucose.
56
Q

Why is it beneficial for a client with T2D to increase their intake of soluble fibre to 50g per day?

A

Slows digestion and absorption of carbohydrates, thereby prevents rapid rises in blood sugar, increasing the sensitivity of tissues to insulin.

57
Q

What role does exercise play in relation to T2D?

A

Regular exercise improves insulin sensitivity and blood glucose control due to increased lean muscle and enhanced muscle cell metabolism.

58
Q

How can chromium (in particular Chromium picolinate) help clients with T2D?

A

It is an essential mineral that plays a role in the regulation of insulin and its effects carb, protein an lipid metabolism. It enhances insulin activity by improving uptake into the cell. It binds with insulin receptors and promotes enzymes involved in insulin signalling. Individuals with T2D are regularly deficient. Supplement 200-1000mcg.

59
Q

How is alpha lipoic acid helpful for clients with T2D?

A

It is a water and fat soluble antioxidant which protects against complication such as kidney, blood vessel and eye issues. It directly terminates free radicals - high levels associated with T2D.

60
Q

How is vitamin E helpful for clients with T2D?

A

Preventing oxidative damage to cellular membranes caused by increased free radical oxidative stress associated with T2D. T2D individuals have low levels.

61
Q

How is magnesium helpful for clients with T2D?

A

It is an essential co-factor involved in glucose oxidation and modulates glucose transport across cell membranes. 50%+ of individuals with T2D show deficiency.

62
Q

How is zinc helpful for clients with T2D?

A

T1D and T2D often show low levels usually due to increased irinary zinc loss. Zinc plays a significant role in normal insulin metabolism.

63
Q

How might milk thistle be helpful for someone with T2D?

A

It improves liver function - liver involved in blood sugar regulation and non-alcoholic fatty liver is associated with T2D so extra liver support is helpful.

CNM Nutrition 2 S1 (10 decks)

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