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A child’s growth and development rely on hormone-producing glands belonging to the Endocrine System.
Factors such as mood, energy levels, and puberty all depend on the correct amount of hormones being released into the bloodstream to ensure proper body functions in adolescence.
Abnormalities of growth and development in adolescents often result from endocrine disorders.
Growth disorders, Puberty Disorders, Juvenile Diabetes, Hypoglycemia, Adrenal Disorders, Polycystic Ovary Syndrome, Thyroid Disease, Lipidemia, are just a few of the vast number of the adolescent endocrinology issues we can help identify and treat.
Adrenal Insufficiency (AI) - also known as Addison's Disease - occurs when the adrenal glands, two glands located just above the kidneys, don’t make enough cortisol (the hormone whose most important job is to help the body respond to stress). Cortisol controls blood pressure and affects how your immune system works. It helps break down fats, proteins, and carbohydrates in your body. Due to the importance of cortisol, the adrenal glands work with the hypothalamus and pituitary glands in the brain to maintain a very precise balance of cortisol levels. There are two types of Adrenal Insufficiency:
Primary Adrenal Insufficiency
The adrenal cortex, the outer layer of the adrenal glands, is destroyed by the body's own immune system for unknown reasons. The body produces antibodies that attack its own tissue and/or organs, slowly destroying them over time. Adrenal Insufficiency occurs when 90 percent (or more) of the adrenal cortex has been destroyed.
Secondary Adrenal Insufficiency
Too little Adrenocorticotropic Hormone (ACTH), a hormone made by the pituitary gland, reduces the production of cortisol. This version of Addison's Disease can occur as a result of certain medications, cysts in the pituitary gland, or some inflammatory diseases.
Symptoms of Adrenal Insufficiency tend to begin gradually. Chronic fatigue, muscle weakness, loss of appetite loss, weight loss, low blood pressure, and sometimes darkening of the skin (hyperpigmentation) in both exposed and unexposed parts of the body.
Adult Growth Hormone Deficiency
Growth Hormone is a protein made by the pituitary gland and is best known for its role in children's growth and height increase as they age. Growth Hormone Deficiency (GHD) occurs with low or absent secretion of growth hormone from the pituitary gland. Growth Hormone is not only vital for children, but also continues to play a very important role through adulthood.
Though it is more common in children, Growth Hormone Deficiency also occurs in adults. Adult Growth Hormone Deficiency (AGHD) is either congenital (present at birth) or acquired. If acquired, most Adult Growth Hormone Deficiency cases are caused by pituitary tumors or by their treatment with surgery, radiation therapy, or both.
- Anxiety or depression
- High levels of body fat, especially around the waist
- High triglycerides levels
- Decreased libido or sexual function
- Low stamina or low tolerance to exercise
- Baldness (in men)
- Decreased muscle mass and strength
- Insulin resistance
- Sensitivity to heat and cold
- Difficulty with concentration
- Lack of memory
Calcium disorders are known as Hypocalcemia (too little calcium) and Hypercalcemia (too much calcium). Calcium is absorbed in the gastrointestinal (GI) tract and required for the proper functioning of muscle contraction, hormone release, nerve conduction, & blood clotting. Proper calcium concentration is also crucial to various other metabolic processes. Low levels of Vitamin D make it harder for the body to absorb calcium.
Symptoms of Hypocalcemia (Low Calcium)
- Muscle cramps/spasms
- Muscle weakness
- Facial twitching
- Numbness or tingling in hands or feet
- Slow heartbeat
- Anxiety and depression
- Easy fracturing of the bones
- Weak or brittle nails
Symptoms of Hypercalcemia (High Calcium)
- Fatigue or weakness
- Muscle pain
- Appetite loss
- Increased thirst
- Frequent urination
- Stomach pain
- Constipation or digestive problems
- Anxiety and depression
- Confusion or disorientation
Cushing's Syndrome (or Hypercortisolism) is a rare hormone disorder resulting from too much cortisol in the body, over a long time period.
Cortisol is a hormone produced by the adrenal glands and is necessary for life. It helps the body respond to stressful situations such as illness and extreme emotion, and has effects on almost all body tissues. It's produced in bursts, most in the early morning, and very little at night.
Cushing’s Syndrome occurs when the adrenal glands make too much cortisol, either due to the presence of a tumor or the presence of too much Adrenocorticotropic Hormone (ACTH).
- Central obesity (weight concentrated in the chest and abdomen) with thin arms and legs
- Weight gain in the face, above the collar bone, or behind the neck (often characterized as a shoulder or upper back hump)
- Red, round face
- Skin changes (easy bruising and thinning)
- High blood pressure
- Weakness and fatigue
- Thin or brittle bones
- Excessive hair growth on the body
- Balding (in females)
- Menstrual disorders
- Decreased libido or fertility
- Mood swings and depression
Diabetes 1 & 2
Type 1 and Type 2 Diabetes both occur when the body cannot properly store and use sugar (glucose), which is essential for energy. Glucose collects in the blood instead of reaching the cells that need it, which can lead to serious complications.
What is type 1 diabetes?
Type 1 Diabetes (previously called Juvenile Diabetes or Insulin-Dependent Diabetes) is usually diagnosed in children and adolescents but can develop at any age. It's a chronic condition in which the pancreas produces little or no insulin - the hormone needed to allow glucose to enter cells to produce energy. Different factors, like genetics and some viruses, may contribute to Type 1 Diabetes. Despite active research, there is no cure for Type 1 Diabetes. Treatment focuses on managing blood sugar levels with a combination of insulin, diet & lifestyle to prevent complications.
Symptoms of Type 1 Diabetes
• Unquenchable thirst
• Frequent urination
• Low energy levels
• Heavy diapers (in babies and toddlers)
• Sudden onset bedwetting (in children)
• Weight loss (despite decreased appetite)
• Fruity-smelling breath
• Blurred vision
• Stomach pain, nausea, or vomiting (in more advanced cases)
What is Type 2 Diabetes?
Type 2 Diabetes (previously called Adult-Onset Diabetes) is a chronic condition in which the body either resists the effects of insulin, or produces too little insulin to maintain normal glucose levels. Currently, more children are being diagnosed with Type 2 Diabetes, possibly due to the rise in childhood obesity. Similar to Type 1 Diabetes, there's no cure for Type 2 Diabetes, but weight loss, a healthy diet, and exercise can help manage the disease. If diet and exercise are not effective in managing blood sugar levels, Diabetes medications or insulin therapy may be required.
Symptoms of Type 2 Diabetes
- Increased thirst and/or hunger
- Frequent urination
- Dry mouth or dehydration
- Unintentional weight loss
- Blurred vision
- Frequent infection or slow-healing sores
- Tingling hands and feet
- Red, swollen, or tender gums
Continuous Glucose Monitoring (CGM)
Continuous Glucose Monitoring (CGM) is an advanced method for people living with Diabetes to track glucose levels throughout the day and night. A CGM system takes automatic glucose readings at regular intervals (24-hours a day) and translates the readings into dynamic data, generating glucose direction and rate of change. This allows for less fingersticking. Continuous Glucose Monitors can be used with or without an insulin pump. Here at EDC, your endocrinologist will fit you with the solution catered to your personal preferences and lifestyle.
An insulin pump is a tool that provides continuous delivery of short acting insulin all day for patients with Diabetes.
It's about the size of a smartphone and attaches to the body using an infusion set (thin plastic tubing and either a needle or a small tapered tube called a cannula that you insert under the skin). The place of insertion - your abdomen, buttocks, or sometimes thigh - is called the infusion site.
Whether or not to use an insulin pump is a personal decision. Diabetes can be managed equally well with insulin pumps or injections.
Using one method over the other is not a lifelong commitment. An insulin pump might benefit someone who is active, wants flexibility, or is seeking fewer needle sticks. Your endocrinologist here at EDC will help you determine the perfect approach to managing your Diabetes.
Hair Growth in Women
Hair growth in women, also known as Hirsutism, is characterized by coarse or dark (excessive) hair growth on the face and body, as opposed to the normal, faintly visible hair that's normally present. Typically, the excessive hair growth occurs in places where hair growth normally occurs in men, such as above the lips, on the chin, chest, abdomen, or back. This usually results from the body producing too much of the male hormones, called androgens, which are secreted by the ovaries or adrenal glands and produced locally in the hair follicle.
(aside from those mentioned above)
- Deepening voice
- Irregular menstruation
- Increased muscle mass
- Decreased breast size
- Receding scalp line or thinning hair in the head's crown area
Metabolic Syndrome occurs when a group of five risk factors are present in a single individual. These five "metabolic factors" are:
- Insulin resistance
- Hypertension (high blood pressure)
- High blood glucose (blood sugar) levels
- Low levels of HDL (good cholesterol)
- Excess fat around the waist
These five metabolic factors increase a person's likelihood of developing Heart Disease, Diabetes, and Stroke. If you have only one of the five factors above, then it's not that you necessarily have metabolic syndrome, but it will still increase the likelihood of developing Cardiovascular Disease. Having three or more of these factors results in a diagnosis of Metabolic Syndrome.
Metabolic Syndrome is rather common. Around 32% of the U.S. population has Metabolic Syndrome. In addition, about 85% of Type 2 Diabetes patients also suffer Metabolic Syndrome.
Symptoms of Metabolic Syndrome are similar to Diabetes symptoms, but some people experience no symptoms at all.
- Large waist circumference (40 inches or more in men and 35 inches or more in women)
- High triglycerides (150 mg/dL or higher)
- High blood pressure (130/85 mm Hg or higher)
- High blood sugar (fasting level of 100 mg/dl or higher)
- Increased thirst and urination
Osteoporosis & Osteopenia
Osteoporosis and Osteopenia are both characterized by weakening, loss of bone mass, or low bone density resulting from calcium deficiency, vitamin D deficiency, or inactivity.
What is osteoporosis?
Osteoporosis is the condition in which bones become thinner (low bone mass) and loss of bone tissue leads to weak and fragile bones, prone to fractures (particularly in the hip, spine, and wrist).
What is Osteopenia?
Osteopenia is the midpoint between having healthy bones and having Osteoporosis. The bones are weaker than normal but haven't yet been reduced to Osteoporosis.
Symptoms for both Osteoporosis and Osteopenia are similar and may or may not be apparent depending the stage of bone degradation.
- Receding gums
- Reduced grip strength
- Back pain
- Bones fracture easily
- Loss of height
- Stooped posture
There are typically four rice grain sized glands, known as the parathyroid glands, that sit on the thyroid gland. The parathyroid glands make parathyroid hormone (PTH) which helps maintain the right level of calcium (and phosphorus) in the body in order to ensure proper function of the nervous and muscular systems. There are two types of parathyroid disorders: Hypoparathyroidism and Hyperparathyroidism.
What is Hypoparathyroidism?
Hypoparathyroidism occurs when the parathyroid glands don't produce enough parathyroid hormone, resulting in too little calcium (Hypocalcemia) and too much phosphorus (Hyperphosphatemia).
Symptoms of Hypoparathyroidism
- Weakness and fatigue
- Tingling (paresthesia) in fingertips, toes, and lips
- Muscle aches or cramps in abdomen, legs, feet, or face
- Hair loss (in patches)
- Dry hair and skin, brittle nails
- Memory loss
- Painful menstruation
- Depression or anxiety
What is hyperparathyroidism?
Hyperparathyroidism occurs when the parathyroid glands produce too much parathyroid hormone regardless of having a normal calcium level, resulting in the rise of blood calcium (Hypercalcemia).
Symptoms of Hyperparathyroidism
- Chronic fatigue
- Osteoporosis and Osteopenia
- Bone pain (can be anywhere, but common in hands, feet, arms, legs)
- Memory loss
- Trouble concentrating
- Reduced kidney function
- Abdominal pain
- Nausea, vomiting, or loss of appetite
- Kidney stones
Pituitary Tumors & Disorders
The pituitary gland is a pea-sized gland that sits at the base of the brain. It is nicknamed the "master gland" because it secretes many hormones that affect metabolism, response to stress, growth & development, and sexuality & reproductive function. It directs various functions throughout the body and stimulates other glands to produce other hormones.
Pituitary disorders result from having too much or too little of one of the hormones produced by the pituitary gland. Injuries can cause pituitary disorders, but a pituitary tumor is the more likely cause.
The hormones below are all produced by the pituitary gland:
- Adrenocorticotropic Hormone (ACTH)
This hormone stimulates the adrenal glands to release the hormone cortisol and is vital to the stress response.
- Growth Hormone (GH)
This is the principal hormone that causes growth in children. In adulthood, it regulates metabolism, body & brain development, bone maturation, and is essential for healthy muscles.
- Thyroid Stimulating Hormone (TSH)
This hormone stimulates the thyroid gland to release thyroid hormones Thyroxine (T4) and Triiodothyronine (T3). Thyroid hormones control basal metabolic rate and are crucial for growth and maturation. Thyroid hormones affect almost every organ in the body.
- Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH)
These hormones control the production of sex hormones in both men and women (estrogen and testosterone) and manage sperm and egg maturation and release.
- Prolactin (PRL)
This hormone stimulates production of breast milk.
Also called anti-diuretic hormone (ADH): This hormone maintains blood pressure, blood volume and tissue water content by controlling the amount of water (reabsorbed by) and the concentration of urine (excreted by) the kidneys. Thus, it plays an essential role in water and electrolyte balance.
This hormone contracts the uterus during childbirth, stimulates breast milk production, and is involved in many other processes.
Symptoms for pituitary disorders vary depending on the specific hormones (listed above) that are in overproduction/underproduction. General symptoms are:
- Vision problems (particularly peripheral vision)
- Moodiness or irritability
- Changes in the menstrual cycle
- Sexual dysfunction
Polycystic Ovary Syndrome
Polycystic Ovary Syndrome (PCOS) is the most common hormonal disorder in women of reproductive age. With PCOS, a woman’s body produces excessive amounts of androgens or testosterone (the hormones associated with male sex characteristics and reproduction).
The condition is named such due to the presence of enlarged ovaries containing multiple small cysts (polycystic ovaries). Most women with PCOS have polycystic ovaries, but some affected women do not. PCOS is also known as Stein-Leventhal Syndrome and Polycystic Ovarian Disease (PCOD).
- Irregular menstrual periods
- Heavy bleeding or no bleeding at all
- Excess facial and body hair (Hirsutism)
- Acne on face, chest, or upper back
- Hair loss or thinning (mimics male pattern baldness)
- Weight gain or difficulty with weight loss
- Mood changes, anxiety, or depression
- Sleep problems (poor sleep, insomnia, or sleep apnea)
- Pelvic pain
Testosterone Deficiency in Men
Testosterone Deficiency in men is also known as male Hypogonadism. Testosterone is the key male sex hormone that regulates: masculine growth & development during puberty, muscle mass, bone growth, libido, sperm production, fat distribution, and red blood cell production.
In adolescence, too little testosterone may prevent normal masculinization. For example, the genitals do not grow at a normal pace, there's little to no facial and body hair, and the voice may not deepen normally.
Testosterone Deficiency is completely treatable. Lifestyle changes such as adding resistance exercise and losing weight can help to naturally increase testosterone. In addition, your Endocrinologost here at EDC can administer testosterone replacement therapy in a variety of ways, including oral supplements, adhesive patches, gel that is applied to the skin, or liquid injected into the body.
- Reduced body and facial hair
- Loss of muscle mass
- Hot flashes
- Low sex drive, impotence
- Low sperm count
- Small testicles
- Brittle bones, prone to fracture
- Irritability or mood changes
- Anxiety and depression
The thyroid is a butterfly-shaped gland at the base of the neck, right below the Adam's apple. The thyroid produces hormones that regulate body temperature, heart rate, blood pressure, and weight. Thus, thyroid cancer occurs in the cells of the thyroid gland.
Although thyroid cancer is not as common in the United States, rates are increasing, likely due to new technology and improvements in detection. The cause of thyroid cancer is unknown, but certain risk factors have been identified, such as: genetic (family history and certain hereditary syndromes) and environmental (exposure to high levels of radiation). Diagnosing thyroid cancer requires ultrasounds and biopsies of the thyroid, performed by our certified physicians. Treatments tend to be successful, including surgery, hormone therapy, radioactive iodine, radiation, and in some cases chemotherapy.
Thyroid cancer usually presents with no symptoms whatsoever. However, below are some common symptoms in cases where they do become evident.
- Lump in the neck (If a symptom does present, it's usually this one)
- Pain in the neck and throat
- Swollen lymph nodes in the neck
- Hoarseness or change in voice (not as common)
- Difficulty swallowing
A thyroid disorder is a dysfunction of the thyroid gland, a butterfly-shaped gland at the base of the neck, just below the Adam's apple.
The thyroid gland produces hormones that impact every part of the human body. It regulates mood, metabolism, digestion, the heart, bone maintenance, muscle control, and brain development.
The most common types of thyroid disorders are Hypothyroidism, Hyperthyroidism, and Thyroiditis.
What is Hypothyroidism?
Hypothyroidism (an underactive thyroid) occurs when the thyroid gland doesn't produce enough thyroid hormone to maintain normal body functions. Your Endocrinologist can diagnose Hypothyroidism when tell-tale symptoms are present and too little thyroid hormone is observed in a blood test.
Symptoms of Hypothyroidism
- Weight gain
- Increased sensitivity to cold
- Muscle aches (stiff or tender muscles)
- Joint pain (swollen or stiff joints)
- Heavy or irregular menstrual periods
- Weak memory
- Dry skin
- Thinning hair
- Slowed heart rate
- Enlarged thyroid (goiter)
What is Hyperthyroidism?
Hyperthyroidism (an overactive thyroid) occurs when the thyroid gland produces too much of the thyroid hormone Thyroxine. Hyperthyroidism is detected with symptoms, and when too much thyroid hormone is present in the blood.
Symptoms of Hyperthyroidism
- Hyperactivity, nervousness, trembling or shaky hands, anxiety, irritability
- Unintentional weight loss
- Rapid heartbeat (tachycardia) or heart pounding (palpitations)
- Fatigue or muscle weakness
- Increased appetite
- Sweating, increased sensitivity to heat
- More frequent bowel movements
- Difficulty sleeping
- Enlarged thyroid (goiter)
- Changes in menstrual cycles
- Alopecia (particularly patchy hair loss)
- Infertility, loss of interest in sex
What is Thyroiditis?
Thyroiditis is the inflammation (but not an infection) of the thyroid gland. Thyroiditis includes a group of individual disorders causing thyroid inflammation, but Hashimoto's Thyroiditis is the variety most common for causing hypothyroidism.
Hashimoto's Thyroiditis occurs when the body's own immune system attacks the thyroid (hence the term autoimmune) and gradually weakens the thyroid gland until it can’t produce enough thyroid hormones.
Symptoms of Thyroiditis
Symptoms of Thyroiditis depend on what is causing it - If Thyroiditis is caused by Hypothyroidism, the symptoms of Hypothyroidism will be prevalent. The same rule applies to the scenario of the symptoms being caused by Hyperthyroidism, the symptoms of Hyperthyroidism will prevail. If you observe any of the symptoms listed above, please come see one of our expert Endocrinologists here at EDC.
Thyroid Nodules & Goiter
What are Thyroid Nodules?
Thyroid nodules are solid or fluid-filled lumps that form on the thyroid gland. Most thyroid nodules aren't serious and cause no symptoms. Thyroid cancer accounts for only a small percentage of thyroid nodules.
Symptoms of Thyroid Nodules
- Lump in the neck
- Feeling a mass while swallowing
- Enlarged thyroid
- No symptoms (most common)
What is a Goiter?
A goiter is the abnormal enlargement of the thyroid gland. Although goiters are typically painless, a large goiter can cause coughing and difficulty with swallowing or breathing.
Symptoms of goiter
- Lump or swelling in the neck
- Difficulty swallowing or breathing
- Hoarseness or coughing
- No symptoms (very common)
Ultrasound & Biopsy
Our certified physicians are experts in treating thyroid disorders with the use of ultrasounds and biopsy (fine-needle aspiration of the thyroid when necessary.
Vitamin D Deficiency
Vitamin D is known as the sunshine vitamin because it's produced by the body in response to skin being exposed to sunlight.
If you avoid sun exposure, avoid dairy, or adhere to a strict vegan diet, you may experience a vitamin D deficiency. Vitamin D occurs naturally in a few foods including fatty fish (salmon, tuna, mackerel), fish liver oils, beef liver, mushrooms, and egg yolks. Other foods are fortified with vitamin D, such as dairy (cheese, milk, yogurt), breakfast cereals, orange juice, infant formula, and grain products, have added vitamin D.
- Getting sick often (particularly frequent respiratory infections)
- Fatigue or lethargy
- Bone and back pain
- Sensitivity, low pain threshold
- Poor exercise recovery, long lasting soreness
- Slow healing wounds
- Muscle pain
- Hair loss
- Bone loss
Symptoms (specific to children)
- Frequent illness
- Dental deformities
- Impaired growth
- Easily fractured bones
- General weakness or fatigue
- Short stature
If you suspect a vitamin D deficiency, an expert Endocrinologst here at EDC will do bloodwork and help you determine the correct supplement and dose. Call us to schedule your appointment today!