Glandular Products

Jennifer Baker and Allison Solomon

Concept: "Like heals like"

Endocrine System: Includes glandular secretory cells/tissues whose chemicals released affect only adjacent cells. Glands of the endocrine system include the pineal, pituitary, thyroid, parathyroid, thymus, adrenal, pancreas, and gonads (testes or ovaries). Other organs that are not true glands but often referred to as products of glandular therapy include the heart, lung, kidney, spleen, prostate, uterus and brain.

Glandular Products: Common products most effective orally are thyroid, adrenal cortex, and pancreatin therapies. Other pharmaceutical glandular preparations include liver, aorta, lung, kidney, thymus, pituitary, spleen, orchic (testes), mammary, uterus and ovarian extracts.

Adrenal Extracts

Medulla

Epinephrine: Primarily prepares the body for 'fright, flight or fight' and has widespread effects on circulation, the muscles and sugar metabolism.

Norepinephrine: Actions include constriction of small blood vessels leading to an increase in blood pressure, increased blood flow through the coronary arteries and a slowing of the heart rate, increase in the rate and depth of breathing and relaxation of the smooth muscle in intestinal walls.

Cortex

Glucocorticosteroids (GC): Essential for the utilization of carbohydrate, fat and protein by the body and for a normal response to stress. Naturally occurring and synthetic GC have very powerful anti-inflammatory effects and are used to treat conditions involving inflammation.

• Cortisol
• Corticosterone
• Cortisone

Mineralocorticoids (MC): Essential for the regulation of salt and water balance. Aldosterone increases the retention of sodium and the excretion of potassium by the body.

Sex Hormones: Estrogen and primarily androgen, the male hormone dehydroepiandrosterone (DHEA).

Clinical Applications

• Severe allergies
• Inflammation (asthma, eczema, psoriasis, RA)
• Low adrenal function: fatigue, inability to cope with stress
• "General adaptation syndrome"---some causes include emotional crisis, performing strenuous tasks, fighting infection

• Alarm---"flight-or-fight"
• Resistance---GC convert proteins to energy; MC retain sodium and maintain BP
• Exhaustion---Total collapse of body function or a specific organ function. Two major causes include K+ and GC depletion. Hypoglycemia is manifested and tremendous loads are placed on the heart, blood vessels, adrenals and immune system.
• Conditions strongly linked to stress include:

1. Angina
2. Asthma
3. Cancer
4. Cardiovascular disease
5. Common cold
6. Diabetes (II)
7. Depression
8. HA
9. Irritable bowel syndrome
10. Hypertension
11. Ulcers
12. RA

Dosage:

• Extracts may come from whole adrenal or just adrenal cortex
• Dosage depends on quality & potency of product
• Effectiveness measured by level of stimulation
• Overdose = irritability, restlessness, & insomnia
• 1/3 recommended dose on label increasing every 2 days until maintaining desirable stimulatory effect.

Pancreatic Extracts

Pancreas: Produces & secretes enzymes (lipases, proteases, amylases) necessary for digestion & absorption of food.

Clinical Applications

• Pancreatic insufficiency (S/S: Abdominal bloating, gas, indigestion & passing  of undigested food) common with: Cystic fibrosis
• Autoimmune diseases (RA, scleroderma, lupus, various cancers, MS)
• Sports injury & trauma
• Viral infections (Herpes zoster [shingles], AIDS)

Dosage:

• Strict definition for level activity set by US Pharmacopoeia (USP)
• 1X pancreatic enzyme product = pancreatin: not < 25 USP units of amylase activity, not < 2 USP units of lipase activity & < 25 USP units of protease activity
• Higher potency products are given whole number multiple to indicate its strength
• Full-strength extract is 10 X USP------this is preferred strength b/c is undiluted
• Enteric-coated & nonenteric-coated PO preparations
• Recommended dose = One 10X USP product (=500-1,000 mg pancreatic enzyme)
• Taken 10-20 minutes prior to eating meal/snack

Thyroid Extracts

Thyroid-stimulating hormone (TSH): Secreted by pituitary gland & stimulates thyroid to secrete thyroid hormone.

Thyroid hormone: Two hormones include triiodothyronine & thyroxine. Affects almost all body functions: Body metabolism (best reflected by basal body temperature), endocrine regulation (libido/menstruation/fertility), mental status (depression), muscle strength, cardiovascular function.

Clinical Application

• Hypothyroidism

Dosage

• FDA requires preparations to be thyroxine-free
• Potency best for mild form of hypothyroidism
• Products often contain thyroid supportive nutrients like iodine, zinc & tyrosine
• Dosage depends on potency & level of supportive nutrients (factors vary with manufacturer)-----best to follow manufacturer's recommendations
• Use basal body temperature to determine effectiveness of product
• Keep physician involved

Other Considerations/Counseling points

• Diet: Iodine (necessary to make thyroid hormones, but too much inhibits) intake  should not exceed 600 mg/day
• Goitrogens prevent iodine utilization (found in turnips, cabbage, mustard cassava root, soybean, peanuts, pine nuts & millet). Cooking usually  inactivates goitrogens.
• Vitamins & Minerals: Zinc, vitamin E & vitamin A deficiencies result in lower production of thyroid hormone.
• Exercise: Stimulates & improves thyroid gland sensitivity