ABOUT ENDOCRINE DISEASES

Diabetes is a chronic disease which causes high blood sugar levels. During childhood the commonest type of diabetes is known as Type 1 Diabetes (insulin dependent), where your body does not make insulin and the blood sugar level increases.

Type 2 Diabetes (non-insulin dependent) is less common and is seen more often in older overweight children. If you have type 2 diabetes, it means that your body is not using insulin well.

A rare form of diabetes called “Neonatal Diabetes” is seen in children less than 6 months- 1 year of age. This could be temporary or permanent and may respond to oral medicines. Patients with high blood sugar will typically experience polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (hunger). While there is no cure for diabetes, it can be controlled through proper diet, exercise and medications.

Growth depends on a complex range of factors, including genetic makeup, nutrition, and hormonal influences. Short height can be present for a wide range of reasons, including having parents with short stature, malnutrition, and certain genetic conditions.

If short stature results from growth hormone (GH) deficiency or other conditions, GH treatment can be used to boost growth. The younger the age of the child at which treatment starts, the better effect it will have on the child’s height.

Puberty is the process a child’s body goes through as it develops into an adult’s body. A pubertal disorder is when these processes and changes don’t occur as they normally should. If puberty occurs too early or is delayed , you need to get your child checked out as early as possible.

Types of Pubertal Disorders Include: ALL THIS IS INCLUDED IN THE FAQ’S

• Delayed puberty – puberty hasn’t started by the age of 13 years in girls and 14 years in boys
• Precocious puberty – puberty begins too early ie. before 8 years in girls and 9 years in boys or menses before 9 years in girls.
• Contrasexual pubertal development – development of male characteristics in females
• Premature thelarche – breast development without any other signs of puberty
• Premature adrenarche – appearance of hair in the pubic or underarm area without any other signs of puberty

Obesity is a condition where a person has accumulated so much body fat that it puts them at a higher risk for serious diseases, such as Type 2 diabetes, High Blood Pressure, Liver disease and Metabolic Syndrome, leading to an increase in the risk of heart disease later in life. It also leads to serious psychological problems in some children and increases the risk of PCOD in girls.

Obesity in children is classified as having a Body Mass Index (BMI) greater than the 95th percentile ie. greater than the upper limit of normal for that age and sex. There are BMI charts available for boys and girls of different ages. BMI is a tool used to measure obesity. Measure your BMI here.

If you experience one or more of these symptoms before or during your periods, you may have a menstrual cycle disorder. These include:

• Abnormal Uterine Bleeding (AUB): which includes heavy menstrual bleeding, no menstrual bleeding (amenorrhea) or bleeding between periods (irregular menstrual bleeding)
• Dysmenorrhea (painful menstrual periods)
• Premenstrual Syndrome (PMS)

Irregular or absent menses could be due to a disease and needs to be evaluated.

Hirsutism is the presence of hair in unwanted areas in females eg. face, neck, breast, tummy. It is caused by an excess of male hormones called androgens in the body, or if your body is more sensitive to these hormones. In girls and younger women, the most common cause is polycystic ovary syndrome (PCOS), a condition that can cause irregular periods, acne and small cysts in the ovaries. It can also occur due to androgens secreted by the adrenal glands. Tests would be needed to check the hormones responsible for hair in unwanted areas. There are a number of different treatments that can be used to treat this condition, depending on the cause.

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder, affecting adolescent girls. Girls suffering from Polycystic Ovarian Disease (PCOD) have multiple small cysts in their ovaries that secrete excessive amounts of androgens (‘male’ hormones such as testosterone) which can cause acne, menstrual irregularity, and hirsutism (excessive hair growth). Patients with PCOD may have some or all of these symptoms. There is no cure yet, but there are many ways by which you can decrease or eliminate the symptoms of PCOS.

What To Look For

• Missed/ irregular/ short duration of period
• Acne
• Thick hair on the face, neck, breasts and tummy

Gynecomastia is swelling of the breast tissue in boys or men, caused by an imbalance of the hormones: estrogen and testosterone. Gynecomastia can affect one or both breasts and it could be painful on touching. Newborns, boys going through puberty and older men may develop gynecomastia as a result of normal changes in hormone levels, though other causes also exist. Signs and symptoms of gynecomastia include: swollen breast gland tissue and breast tenderness.

Hypothyroidism occurs when the thyroid doesn't produce enough thyroid hormone, and the body functions slow done leading to symptoms such as:

• Tiredness
• Excessive sleepiness
• Constipation
• Weight gain
• Dry, coarse skin and hair
• Intolerance to cold
• Forgetfulness
• Poor growth

It could be present from birth ( congenital hypothyroidism) or could occur later in childhood.

Hyperthyroidism is a thyroid disorder that occurs when the thyroid produces an excess of thyroid hormones, and the body uses energy faster than it should.

The following are symptoms for hyperthyroidism:

• Irritability/nervousness
• Weight loss
• Rapid heart beat
• Shakiness of hands/ change in handwriting
• Sleep disturbances
• Enlarged thyroid gland
• Prominent/bulging eyes
• Heat sensitivity
• Poor attention span and behavior problems in children

All thyroid diseases can be treated, resulting in normal thyroid function. However, this frequently requires being on medication to maintain the normal thyroid state.

The adrenal glands, located on the top of each kidney, are responsible for releasing different hormones. It has 2 parts; the cortex and the medulla.

Adrenal gland disorders occur when the adrenal glands produce too much or too little of these hormones. The adrenal cortex produces hormones such as cortisol that helps you respond to stress , maintain blood sugar and blood pressure. Excess of cortisol can cause a serious condition called Cushing’s disease with weight gain, high blood pressure and muscle weakness and deficiency can lead to symptoms such as low blood sugar and darkening of complexion. The adrenal cortex also secretes sex hormones responsible for development of pubic hair. Excess of these sex hormones can result in early puberty in boys and masculinization in girls The adrenal medulla secretes hormones, excess of which can cause increased heart rate and tremors.

These conditions caused by overproduction or underproduction of adrenal hormones are treatable.

DSDs are medical conditions involving the way the reproductive system develops from infancy (and before birth) through young adulthood. There are several types of DSDs and their effect on the external and internal reproductive organs varies greatly. In most cases, children with DSDs have genitalia that are atypical in appearance. This may include ambiguous genitalia ( males with small penis or underdeveloped scrotum or females with a penile structure or dysgenetic (malformed) gonads.

These disorders also include small sized penis (micropenis), abnormal shape and urinary opening in the penis ( hypospadias, chordee), scrotal area appearing like female genitalia.

It may not be possible to cure some of these disorders but most of them can be treated in a way that the child can grow up with normal appearing genitalia, develop sexual changes appropriate for age and be able to have normal sexual function as an adult.

The ideal time for investigating these problems is soon after birth so that an appropriate decision regarding sex of rearing of the child can be made. The male and female sexual hormones are higher in the first few months of life, hence it is the ideal time for testing.

Calcium and bone disorders involve abnormalities of bone metabolism, which is associated with several hormones, including parathyroid hormone (PTH), estrogen, testosterone as well as other factors like Vitamin D, phosphate, and magnesium. Very low calcium levels can lead to tetany (abnormal movement of hands). Calcium and bone disorders contribute to weakening of the bones, loss of bone mass, abnormal appearance of bones or even destruction of bone tissue.