Complex interactions exist amongst the various components of the neuroendocrine system in order to maintain homeostasis, energy balance and reproductive function. These components include the hypothalamus-pituitary- adrenal and -gonadal axes, the renin-angiotensin-aldosterone system, the sympathetic nervous system and the pancreatic islets. These
hormones,
peptides and
neurotransmitters act in concert to regulate the functions of many organs, notably the liver, muscles, kidneys, thyroid, bone, adrenal glands, adipocytes, vasculature, intestinal tract and gonads, through many intermediary pathways. Endocrine and metabolic disorders can arise from imbalance amongst numerous hormonal factors. These disturbances may be due to endogenous processes, such as increased secretion of
hormones from a tumour, as well as exogenous
drug administration. Drugs can cause endocrine abnormalities via different mechanisms, including direct alteration of
hormone production, changes in the regulation of the hormonal axis, effects on hormonal transport, binding, and signalling, as well as similar changes to counter-regulatory
hormone systems. Furthermore, drugs can affect the evaluation of endocrine parameters by causing interference with diagnostic tests. Common
drug-induced endocrine and metabolic disorders include disorders of carbohydrate metabolism,
electrolyte and
calcium abnormalities, as well as
drug-induced thyroid and
gonadal disorders. An understanding of the proposed mechanisms of these
drug effects and their evaluation and differential diagnosis may allow for more critical interpretation of the clinical observations associated with such disorders, better prediction of
drug-induced adverse effects and better choices of and rationales for treatment.