The endocrine system is made up of organs and tissues that produce hormones. Hormones are natural chemicals produced in one location, released into the bloodstream, then used by other target organs and systems.
The hormones control the target organs. Some organ systems have their own internal control systems along with, or instead of, hormones.
As we age, changes naturally occur in the way that body systems are controlled. Some target tissues become less sensitive to their controlling hormone. 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, in turn, 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. It has two parts:
The thyroid gland is located in the neck and produces hormones that help control metabolism. With aging, the thyroid often becomes lumpy (nodular). Metabolism gradually declines, beginning around age 20. Less thyroid hormone may be produced, but there is also less body mass (because of loss of muscle and bone tissue). This means that thyroid function tests usually show results within the normal range.
The parathyroids are four tiny glands located around the thyroid. Parathyroid hormone affects calcium and phosphate levels. This, in turn, affects the strength of the bones. Changes in the level of parathyroid hormones may contribute to osteoporosis.
Insulin is produced by the pancreas. A molecule of insulin fits into a place on the cell wall called an insulin receptor site. It acts like a lock and key to help sugar (glucose) go from the blood to the inside of cells, where it can be used for energy.
The average fasting glucose level rises 6 to 14 mg/dL (milligrams per deciliter) for each 10 years after age 50. This is because the cells become less sensitive to the effects of insulin, probably because of a loss in the number of insulin receptor sites in the cell wall.
Aldosterone secretion decreases with age, which can contribute to light-headedness and a drop in blood pressure with sudden position changes (orthostatic hypotension). Cortisol secretion decreases with aging, but the blood level stays about the same. Dehydroepiandrosterone levels also drop, although the effects of this drop on the body are not clear.
The ovaries and testes have two functions. They produce the reproductive cells (ova and sperm). They also produce the sex hormones that control secondary sex characteristics, such as breasts and facial hair.
EFFECT OF CHANGES
Overall, some hormones are decreased, some unchanged, and some increased with age. Hormones that are usually decreased include:
In women, estrogen and prolactin levels usually decrease significantly.
Hormones that remain unchanged or only slightly decreased include:
Testosterone levels usually decrease slightly as men age.
Hormones that may increase include:
Minaker KL. Common clinical sequelae of aging. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 23.