Calcium and Parathyroid Hormone Management
Disorders of calcium, vitamin D and parathyroid hormone are typically diagnosed and managed by endocrinologists in conjunction with your primary doctor.
Calcium is an important component of the body and is necessary for both the skeleton and a variety of functions. These include muscle contraction, nerve transmission, platelet function, hormone excretion, and many others. The calcium level in the body is regulated by parathyroid hormone and vitamin D.
Parathyroid Glands produce parathyroid hormone, which plays a role in the regulation of calcium levels in the blood. Precise calcium levels are important in the human body, since small deviations can cause muscle and nerve impairment. The parathyroid hormone releases calcium by bones into the bloodstream, absorbs calcium from food by the intestines, and conserves calcium by the kidneys.
Continuous Glucose Monitoring
Continuous glucose monitoring is diabetes care of the future. Instead of receiving blood sugar readings with a finger stick, you can receive a sequence of blood sugar checks and even trends for your blood sugar with a continuous glucose monitor.
There are several advantages to continuous glucose monitoring. One of the monitors (described below) comes with an associated app that you can access your readings through. You can then set up the app to alert you if your blood sugar drops too low. This includes an alarm that can wake you if you’re sleeping and your blood sugar levels drop to a critical level.
The continuous glucose monitor can predict high or low blood sugar before happens, which means you can proactively manage your blood sugar highs or lows before they happen. Finally, the continuous glucose monitor can give you useful information on the effect of different types of food on blood sugar, which can be used to make decisions about insulin at mealtimes.
Right now, Diabetes Wellness Center specialists recommend three options for CGM. The first is a freestanding monitor with a wearable sensor. The receiver or associated app will update every five minutes (up to 288 readings in a 24-hour period). This real-time data is used to predict trends for your blood sugar. Your family members can “follow” you with an app and also get updates on your blood sugar. You can access reports on your blood sugar that you can share with your doctor for insulin dose adjustments.
The second freestanding monitor also has a wearable sensor. To receive information, you must use the receiver to wand over the sensor. That reading will include the current blood sugar information as well as the information from the previous wand. No finger stick calibration is necessary, so this system can potentially replace blood glucose meters.
The third monitor works with an insulin pump that will automatically dispense basal insulin to adjust levels, but it is not considered freestanding because it interacts with the pump.
For more information about continuous glucose monitoring and how having one of the above sensors could help you manage your diabetes, contact the Diabetes Wellness Center at 217.528.7541.
In the dept of Endocrinology, we use a team consisting of physicians, diabetes educators, dietitians and nurses to provide a comprehensive and individualized approach to diabetes care.
Type 1 diabetes mellitus is a chronic condition in which the pancreas produces little or no insulin (the hormone that controls sugar or glucose levels in the blood and allows us to use sugar for energy). While this disorder is typically diagnosed in children and teenagers, it can occur at any age.
People who have type-1 diabetes are at increased risk for a variety of serious conditions. These include heart disease and stroke, blindness, kidney failure and nerve damage (resulting in loss of limbs). We know through medical research that good control of a person's blood glucose level can greatly reduced the risk of these complications.
Type 2 diabetes mellitus is a condition of abnormally high blood sugars caused by the body’s inability to make enough, or to properly use, insulin. Insulin is a hormone which moves blood sugar into the body’s cells and keeps blood sugar levels normal. Type 2 diabetes is the most common form of diabetes and used to be called non-insulin-dependent diabetes (NIDDM).
What is pre-diabetes?
Type 2 diabetes is commonly preceded by pre-diabetes. In pre-diabetes, blood sugar levels are higher than normal but not high enough to be defined as diabetes. Many people with pre-diabetes develop type 2 diabetes. Much like type 2 diabetes, pre-diabetes increases the risk of developing heart disease and stroke. With modest weight loss and moderate physical activity, people with pre-diabetes can delay or prevent type 2 diabetes.
What are some risk factors for type 2 diabetes?
- Age (people over age 45 are at higher risk for type 2 diabetes)
- Family history of diabetes
- Being overweight or obese
- Not exercising regularly
- Race and ethnicity (African-Americans, Hispanic Americans, and Native Americans are at increased risk for developing type 2 diabetes
- History of gestational diabetes or giving birth to a baby that weighed more than 9 pounds
- A low HDL cholesterol level (high-density lipoprotein – the “good” cholesterol)
- A high triglyceride level
How is type 2 diabetes managed?
- Proper diet
- Regular physical exercise
- Maintaining a normal body weight—every pound a person is above his or her ideal body weight increases the risk for type 2 diabetes
- Oral medications—help the body to make more insulin or improve how the body responds to its own insulin
- Insulin—Most people with type 2 diabetes eventually get to the point when they are not able to make enough insulin. The need for insulin therapy is not a sign of failure—this is simply the natural progression of the disease in many people.
- Regular monitoring of blood sugar
Appropriate growth is important for both normal physical and psychological development. A growth rate that is too rapid or too slow can sometimes indicate a significant underlying medical illness.
Growth evaluations usually begin with a careful medical history review. We are especially interested in the patient's growth history, as well as the heights, weights, and growth patterns of close relatives A complete physical exam can often offer clues as to the nature of the growth issue. A simple x-ray known as a "bone age" can give us information as to how a person's actual age matches their stage of development. These x-rays can also give us clues concerning a person's growth potential. We typically perform blood and urine testing to rule out various medical and endocrine illnesses.
Some patients need more complex studies of growth hormone production to see if they would benefit from growth hormone treatment.
Our pediatric endocrinologist specializes in the evaluation and treatment of patients under the age of 18 with a range of hormonal conditions, gland disorders, juvenile diabetes or other issues, including:
- Diabetes mellitus
- Diabetes insipidus
- Growth problems, such as short stature
- Early or delayed puberty
- Enlarged thyroid gland (goiter)
- Underactive or overactive thyroid gland
- Pituitary gland problems
- Adrenal gland excess or insufficiency
- Low blood sugar (hypoglycemia)
- Problems with vitamin D or calcium (rickets, high or low calcium)
Pituitary Function Tests
The pituitary gland is sometimes called the "master" gland of the endocrine system because it controls the functions of the other endocrine glands. The pituitary gland is no larger than a pea, and is located at the base of the brain. The gland is attached to the hypothalamus (a part of the brain that affects the pituitary gland) by nerve fibers.
The functions of the pituitary gland include:
- Growth hormone
- Prolactin (to stimulate milk production after giving birth)
- ACTH (adrenocorticotropic hormone stimulates the adrenal glands)
- TSH (thyroid-stimulating hormone stimulates the thyroid gland)
- FSH (follicle-stimulating hormone stimulates the ovaries and testes)
- LH (luteinizing hormone stimulates the ovaries or testes)
Testosterone is a hormone made by the testes which is very important in male biology. It helps to maintain sexual function and fertility, muscle mass, blood counts, and normal bone density.
Testosterone replacement therapy is generally safe and well tolerated. Potential adverse effects include enlargement of the prostate or problems with urination. Testosterone replacement may also cause elevation in certain blood counts or lowering of HDL (high-density lipoprotein – the “good” cholesterol) levels. Your health care provider will need to periodically perform blood work as well as physical examinations to monitor how well you are responding to therapy.
What methods of testosterone replacement are available?
- Testosterone patches
- Testosterone gels or creams
- Testosterone intramuscular injections
What are some conditions associated with abnormally low testosterone levels?
- Type 2 diabetes mellitus
- Sleep apnea
What are some signs and symptoms of low testosterone levels?
Low testosterone levels can result in many different symptoms. Fatigue and loss of muscle mass or strength can be noted. Sexual problems such as erectile dysfunction or inability to achieve orgasm can develop. Other physical symptoms can include breast tenderness or enlargement. Your health care provider will perform a thorough evaluation and laboratory profile to determine if you may be a candidate for testosterone replacement therapy.
Thyroid Lab Evaluation
The thyroid gland is located in the anterior part of the neck. It moves up or down with swallowing, but we don’t feel it. In fact it is located in front of our voice box and the soft tissue around it is our thyroid.
Endocrinologists utilize different radiological methods and lab evaluation and if needed biopsies to differentiate between the thyroid disorders. We work with your primary care provider and if needed would refer you to the proper surgery expert.
Thyroid disorders are divided into different categories:
- Hyperthyroidism or over secretion of thyroid hormone is mainly due to Graves’ disease in which all of the thyroid gland becomes overactive. It can be associated with other features; the main one affects the eyes and is called Graves’ ophthalmopathy (eye disease) in which the eyes can become dry and itchy, the eye lids can swell up, the white section of the eyes can become red due to the inflammation. In severe cases, the eyes can bulge out of the eye sockets and rarely it can lead to blindness. Hyperthyroidism can lead to serious health effects if not treated properly.
- Hypothyroidism or under secretion of thyroid hormone occurs usually due to Hashimoto thyroiditis. It is more common in women and on occasions can affect several members of the same family.
- Anatomical is when the thyroid gland shape can change due to a benign growth (adenoma or cyst) or a malignant growth.