Aging changes in hormone production
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 back (posterior) portion stores hormones produced in the hypothalamus.
- The front (anterior) portion produces hormones that affect the thyroid gland (TSH), adrenal cortex, ovaries, testes, and breasts.
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 20. Because thyroid hormones are produced and broken down (metabolized) at the same rate, thyroid function tests usually show results within the normal range.
The parathyroid glands are four tiny glands located around the thyroid. Parathyroid hormone affects calcium and phosphate levels, which affect the strength of the bones. 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 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.
The adrenal glands are located just above the kidneys. The adrenal cortex, the surface layer, produces the hormones aldosterone and cortisol.
- Aldosterone regulates fluid and electrolyte balance.
- Cortisol is the "stress response" hormone. It affects the breakdown of glucose, protein, and fat, and has anti-inflammatory and anti-allergy effects.
Aldosterone release decreases with age, which can contribute to light-headedness and a drop in blood pressure with sudden position changes (orthostatic hypotension). Cortisol release also decreases with aging, but the blood level of this hormone 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.
- With aging, men sometimes experience a slightly decreased level of testosterone.
- Women have decreased levels of estradiol and other estrogen hormones after menopause.
EFFECT OF CHANGES
Overall, some hormones are decreased, some unchanged, and some increased with age. Hormones that are usually decreased include:
- Growth hormone
In women, estrogen and prolactin levels usually decrease significantly.
Hormones that remain unchanged or only slightly decreased include:
- Thyroid hormones T3 and T4
Testosterone levels usually decrease slightly as men age.
Hormones that may increase include:
- Follicle-stimulating hormone (FSH)
- Luteinizing hormone (LH)
- Parathyroid hormone
Minaker KL. Common clinical sequelae of aging. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 24.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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