An endocrine disorder is any disease state associated with an abnormality of an endocrine gland or an abnormality of hormone secretion.  There are several types of endocrine disorders, all of which can have a profound effect on the sufferer.  All endocrine disorders are essentially caused by the over production or under production of hormones, resulting in structural or functional changes in the body.  Endocrine disorders can have a serious impact on other organ systems and should be evaluated as to their effects on the total body system. 
 

General Evaluation  

Because of the nature of endocrine disorders, the evaluation of a person with endocrine disease can be complex.  Not only do you need to understand the endocrine disorder itself, you also need to be aware of the many ways these diseases can interact with other medical conditions.  Below is a short list of some of the most common endocrine disorders:

Diabetes mellitus
Pituitary disorders
Parathyroid disorders 
Thyroid disorders
Hypoglycemia
Adrenal disorders
 

Diabetes Mellitus  

Diabetes is a common endocrine disease caused by a disorder of glucose metabolism from insufficient insulin produced in the pancrease.  With high levels of obesity, diabetes is one of the most common diseases suffered in the United States.  Diabetes produces an array of medically destructive side effects that can greatly complicate a claimant's overall condition.  Physiologically, diabetes is a secretion disorder of cells located in the pancreas.  These pancreatic cells, referred to as the Islet’s of Langerhans, are responsible for the secretion of insulin.  Insulin is a hormone that acts to reduce the concentration of sugar in the blood.

This abnormal secretion of insulin causes a variety of vascular manifestations such as changes in vessel walls, atherosclerosis and nerve destruction.  These manifestations then cause further destruction to the organs being fed by the diseased vessels or nerves.

Diabetes can and often does affect the eyes, kidneys, heart, blood vessels, nerve fibers and more.  The common signs and symptoms of diabetes mellitus are high blood sugar, frequent urination, thirst, hunger, weight loss, keto-acidosis (abnormal amount of ketones in blood) leading to poor appetite, nausea, air hunger, coma and death. There is no cure for diabetes as yet, but it can be treated.  Treatment seems to slow the destructive effects of the disease, but does not necessarily prevent later complications.

One of the more common manifestations of diabetes mellitus is a condition or symptom known as peripheral neuropathy.  Peripheral neuropathy is a symptom of nerve injury.  This condition is manifested by decreased sensory or motor capabilities in the affected limb.  Peripheral neuropathy most often affects the lower extremities.  The patient suffering from peripheral neuropathy may complain of poor sensory perception (numbness), tingling sensation, slow wound healing and pain in the involved limb. 

Peripheral vascular disease may also be present in a person suffering from diabetes.  This condition may manifest itself with discoloration of the involved limb, coolness, pain, poor or delayed healing, ulcers and other signs common to poor circulation.

Diabetic retinopathy is another symptom of the underlying diabetic disorder.  This condition affects the blood vessels of the eye causing damage to the retinal area.  If the diabetic condition is not properly controlled, it can lead to a serious visual decline.  Retinopathy can adversely affect both the blood vessels and the nerves of the eye.  In either case, the claimant may experience bleeding in the eye or damage to the optic nerve causing a decrease in vision that can lead to blindness.

When evaluating a person with a history of diabetes, always check for additional symptoms of visual disturbance, poor circulation, delayed healing, and sensory and motor interference due to nerve damage.  Think of diabetes as a complicating factor to any other impairment the claimant may have.

Incidentally, there are two types of diabetes.  Diabetes Mellitus (adult onset) diabetes is described above and Diabetes Insipidus which is a condition associated with the excessive loss of body water through the kidneys as a result of a decreased secretion of the antidiuretic hormone ACH.  Both diabetes mellitus and insipidus can have a serious effect on a claimant's ability to perform work.

Pituitary Gland Disease

The pituitary gland located in the sub reaches of the brain secretes a number of extremely important hormones.  If a malfunction of the pituitary gland occurs, it will cause either an abnormal increase or decrease in the amount of hormones secreted from the gland.  The pituitary gland has two parts referred to as the anterior and posterior segments or lobes.

Malfunction of the anterior lobe of the pituitary gland may cause a decrease in the secretion of its primary hormone.  This circumstance would adversely affect the sexual organs in both males and females.  If hormone secretion is reduced in the anterior lobe of a child, it can cause dwarfism due to a decrease in the secretion of the growth Hormone GH.  An increase in the secretion of hormones from the anterior lobe of the pituitary gland can cause gigantism and other growth abnormalities. 

Abnormal secretion from the posterior lobe of the pituitary gland can cause a disorder known as diabetes insipitus mentioned earlier in this report.  If you encounter a pituitary disorder, the medical evidence will usually list the effects the disorder is having on the sufferer.  As a disability advocate, don't waste your valuable time trying to understand which hormone is or is not being secreted.  Concentrate your efforts on identifying the symptoms of the disease and their negative effects on the claimant's ability to perform work. 

Thyroid Gland disease

Thyroid gland disease, like other endocrine gland disorders, will either manifest abnormally high or low secretions of the hormones it produces.  Hyperthyroidism is a condition of increased secretion of the thyroid hormone.  This condition can cause symptoms of goiter, fast heart rate, tremor, enlarged eyeballs, weakness and insomnia.

A hypo-secretion, or decreased secretion of thyroid hormone, can cause symptoms such as obesity, memory problems, decreased intellectual functioning, gradual changes in personality and even psychosis.  In evaluating this condition you must keep in mind the overt effects it is having on the claimant.  If the claimant shows symptoms of memory loss, for example, use this symptom (memory loss), to reduce the claimant's mental RFC.

Adrenal Gland disease

The adrenal gland is located at the superior ridge of the kidney.  The outer layer (cortex) of the adrenal gland secretes a hormone called cortisol.  The interior portion of the adrenal gland secretes aldosterone, epinephrine and nor-epinephrine.  Disorders of the adrenal gland will result in either an increased or decreased secretion of its primary hormones. 

An increased secretion of adrenal hormones can cause symptoms such as weakness, fatigue, low blood pressure, weight loss, dehydration, small heart and an abnormal heartbeat.  Increased secretion from the adrenal gland can cause disease complexes such as Cushing's syndrome and adrenal virilism or masculization.  The claimant and the medical evidence will supply most of the restrictive symptoms for you.  Describe these restrictive symptoms in your argument and show how they interfere with the claimant's ability to work.

If you address the issues as set forth in this report concerning claimants with severe endocrine disorders, you'll be able to extract enough supportive evidence to produce at least a fair argument for disability.  There are several other important considerations when evaluating endocrine disorders that are not discussed here.  For additional information about endocrine disorders and how they are evaluated by Social Security, see full discussion link.