- Aging changes in hormone production: MedlinePlus Medical Encyclopedia
- Aging changes in hormone production
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The amount of hormones produced may also change. Blood levels of some hormones increase, some decrease, and some are unchanged. Hormones are also broken down metabolized more slowly. Many of the organs that produce hormones are controlled by other hormones. Aging also changes this process. For example, an endocrine tissue may produce less of its hormone than it did at a younger age, or it may produce the same amount at a slower rate.
The hypothalamus is located in the brain. It produces hormones that control the other structures in the endocrine system. The amount of these regulating hormones stays about the same, but the response by the endocrine organs can change as we age. The pituitary gland is also located in the brain. This gland reaches its maximum size in middle age and then gradually becomes smaller.
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The thyroid gland is located in the neck. It produces hormones that help control metabolism.
With aging, the thyroid may become lumpy nodular. Metabolism slows over time, beginning at around age Because thyroid hormones are produced and broken down metabolized at the same rate, thyroid function tests are most often still normal. In some people, thyroid hormone levels may rise, leading to an increased risk of death from cardiovascular disease.
The parathyroid glands are four tiny glands located around the thyroid. Parathyroid hormone affects calcium and phosphate levels, which affect bone strength. Parathyroid hormone levels rise with age, which may contribute to osteoporosis. Insulin is produced by the pancreas. It helps sugar glucose go from the blood to the inside of cells, where it can be used for energy.
The diagnosis should be suspected in older people presenting with declining functional status and vague symptoms, even when hyperkalemia and orthostatic hypotension are absent. Pharmacotherapy to prevent fractures should begin as soon as corticosteroids are started. There is little evidence of long-term clinical benefit from supplementation with dehydroepiandrosterone DHEA , testosterone, and growth hormone GH in older adults. When adrenal incidentalomas are identified, consider restricting screening for corticosteroid excess and consideration of adrenalectomy to younger patients and those with a symptom complex suggesting Cushing syndrome.
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As in other organ systems, the normal aging of the endocrine system is characterized by a progressive loss of reserve capacity, resulting in a decreased ability to adapt to changing environmental demands. This loss of homeostatic regulation reflects important alterations in hormonal synthesis, metabolism, and action, but these changes may not be clinically apparent under baseline conditions. In fact, basal plasma concentrations of many hormones and metabolic fuels are essentially unchanged with normal aging.
This is illustrated by fasting plasma glucose levels that exhibit little change with normal aging, but after a glucose challenge, glucose levels increase much more in healthy older persons as compared to young adults. In some instances, the function of aging endocrine systems is maintained by compensatory changes in secretion of one hormone to offset the loss of function of another hormone in a feedback system, or to compensate for alterations in metabolic clearance.
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Aging changes in hormone production: MedlinePlus Medical Encyclopedia
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Case Files Collection. These age-related changes to insulin production, clearance and response contribute to the creation of a diabetogenic environment. This may partially explain why the risk of developing type 2 diabetes increases with age Brown, Many age-related changes to the endocrine system contribute to this accumulation of adipose tissue, including the somatopause, autoimmune hypothyroidism, insulin resistance, and reduced circulating sex hormones.
This abdominal fat accumulation is linked to heart disease, high blood pressure and type 2 diabetes. These conditions may occur in isolation or together in the form of metabolic syndrome Gong and Muzumdar, The two adrenal glands are located above the kidneys and each consists of two main regions: the adrenal medulla inner region and the adrenal cortex outermost layer. The adrenal medulla is the location of chomaffin cells, which secrete the catecholamines adrenaline epinephrine and noradrenaline norepinephrine.
The effects of adrenaline and nor-adrenaline include:. Ageing is associated with a decline in the secretion of adrenaline, but adrenaline plasma levels remain relatively constant as clearance by the kidneys is usually reduced. There is some evidence that older men secrete less adrenaline in response to acute stress than younger men Seals and Esler, Aldosterone Aldosterone is a mineralocorticoid that regulates plasma levels of sodium and potassium, and plays an important role in water balance and blood pressure control.
Decreased aldosterone secretion may contribute to postural hypotension and the light-headedness that is often experienced by older people when they stand up.
Aging changes in hormone production
This is supported by research demonstrating significant reductions in serum aldosterone levels in older people when they are upright, as opposed to recumbent Hegstad et al, Since sodium attracts water into the cardiovascular system via osmosis, lower plasma sodium levels hyponatraemia can lead to reduced blood volume and blood pressure. Several medications commonly prescribed to older people — such as opiates, non-steroidal anti-inflammatory drugs, diuretics and antidepressants — can exacerbate hyponatraemia Liamis et al, Blood volume and blood pressure may be further reduced by age-related increases in the secretion of atrial natriuretic hormone ANH , a powerful diuretic produced by the heart Miller, Cortisol Cortisol is a glucocorticoid and its release is triggered by biological stressors such as physical injury or starvation.
It is a natural anti-inflammatory and plays an important role in the breakdown of protein and fat. Research into how cortisol levels change with ageing is often contradictory. More recently, however, it has been shown that this is not necessarily true: in some people, cortisol secretion diminishes with age, in others levels remain relatively stable throughout life Wolf, There appears to be a link between increased cortisol levels, reduced bone density and increased risk of bone fracture.
There is also growing evidence that a higher cortisol concentration can contribute to the loss of cells from the hippocampus, resulting in hippocampal atrophy. This is often associated with a reduction in cognitive function in older people Chahal and Drake, Other studies have shown that age-related increases in cortisol may also be linked to memory loss and sleep disorders Chahal and Drake, ; Wolf et al, There is some evidence that exercising regularly and maintaining a low percentage of body fat may slow the onset of the somatopause, help maintain bone density and improve the control of blood glucose.
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Supplementation with synthetic growth hormone has recently been shown to increase lean muscle mass in older people. However, this kind of therapy is associated with many side-effects such as joint pain, oedema and impaired glucose tolerance Jonas et al, The most famous and most thoroughly researched hormone replacement therapies are those that are used to treat the complications of the menopause. These therapies will be explored in the next article in this series.
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Braverman ER et al Age-related increases in parathyroid hormone may be antecedent to both osteoporosis and dementia. BioMed Central Endocrine Disorders ; 9: 21, Brown JE The ageing pancreas. British Journal of Diabetes and Vascular Disease ; 3, Journal of Pathology ; 2, Gentili A Growth hormone replacement in older men. International Journal of Endocrinology ; Hegstad R et al Ageing and aldosterone.
American Journal of Medicine ; 3, Jonas M et al Aging and the endocrine system. Knight J, Nigam Y Diabetes management 1: disease types, symptoms and diagnosis. Nursing Times ; 4, Croatian Medical Journal ; 5, Liamis G et al A review of drug-induced hyponatremia. American Journal of Kidney Disease ; 1, Miller M Fluid balance disorders in the elderly.
American Society of Nephrology online curricula: geriatric nephrology. Portale AA et al Aging alters calcium regulation of serum concentration of parathyroid hormone in healthy men. American Journal of Physiology ; Journal of Physiology ; 3,