About growth disorders
Growth disorders are a number of different that can cause your child to have an unexpected height and/or size for his or her age and sex. Some reasons for abnormal height that may be traced to endocrine disorders, including too little of the growth or thyroid hormones and Cushing’s disease.
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Growth disorder care at Children’s
Because not all growth problems are related to the endocrine system, we will first track your child’s growth over time. We will also conduct blood tests to measure hormone levels and to rule out other problems. Often, we take X-rays of your child’s wrists, as we use these to determine expected growth. We may also order scans of your child’s pituitary gland. If we detect a growth problem and the source of the problem is endocrine, we often recommend hormone replacement therapy. This includes daily or weekly injections of growth hormone to help restore balance. Our specialists are sensitive to you and your child’s needs and will work to ensure everyone is comfortable with your child’s treatment and informed of progress.
About thyroid problems
The thyroid gland is in front of the neck and is shaped like a butterfly or bowtie. The main job of the thyroid is to make thyroid hormones (T4 and T3). Thyroid hormones help maintain normal metabolism, growth, and development.
A thyroid disorder may be present at birth (congenital) or might develop later in life. The thyroid may make too little hormone (hypothyroidism) or too much (hyperthyroidism). Hypothyroidism is treated with thyroid hormone replacement pills; hyperthyroidism is treated with other medications, a radioactive medication, or surgery.
Thyroid care at Children’s
In pediatrics, treatment of thyroid issues is important to avoid problems with growth and development. Typically, a simple physical exam, basic blood tests, and a growth chart are all that is needed to diagnose a thyroid problem. When we begin treatment, we will follow you closely with blood tests and clinic exams. As the thyroid problem becomes controlled, you will need fewer tests or clinic visits. Hypothyroidism is usually permanent; hyperthyroidism can sometimes resolve.
About early or late puberty
Puberty can already be a trying time for your child, but sometimes a disorder makes this period extra challenging. Precocious and delayed puberty mean that the changes of sexual maturity come early or late in your child.
Precocious (early) puberty has two forms depending on whether the changes are related to the early release of sex hormones or not. Early puberty is defined as less than 8 years in girls or 9 years in boys. This can cause distress to parents and children, and we will do our best to determine if there is a condition that requires treatment.
Delayed (late) puberty is defined as late onset of sexual development, not occurring by age 13 in girls and age 14 in boys. Your child might already be self-conscious at this age and compare himself or herself to peers. If there is a genuine endocrine disorder causing a lack of sexual traits, we want to do everything we can to reassure and treat your teen.
Early or late puberty care at Children's
We begin by reviewing your child’s medical history and conducting a physical examination. Your child’s sexual maturity will be tracked and compared to other children of the same age and sex. If we detect early or late changes, we will, with your close involvement, develop a customized treatment path. If early puberty is detected, we may perform X-rays, ultrasounds, or an MRI of the adrenal glands and sex organs. We will also measure hormone levels in the blood and sometimes perform a gonadotropin-stimulating hormone (GnRH) stimulation test to determine the early puberty type. The evaluation for delayed (late) puberty follows much the same path, which includes blood tests, X-rays to determine maturity of the bones, and/or MRI. Hormone replacements and/or surgery may be recommended, depending on the cause. We will do everything in our power to assist you in ease and assist your child’s transition into adulthood.
About adrenal gland problems
The adrenal glands are two paired, pyramid-shaped glands that each sit on top of the two kidneys. Each adrenal gland has an outer portion (cortex) and inner portion (medulla). The adrenal cortex has three zones or layers, each layer producing a different hormone with a different purpose. One layer makes aldosterone, which regulates the salt and potassium in your body; one makes a stress-related hormone called cortisol; and one makes androstenedione that is converted to androgen ( male sex hormone). Problems occur when there is too much or too little of these hormones produced.
Adrenal gland care at Children’s
We often obtain blood and urine tests to confirm suspected adrenal gland problems. From there, we determine if there is a problem that needs treatment.. Treatments may include medications or surgery (if removal of a tumor is needed) and/or radiation or chemotherapy to shrink a tumor. We are committed to fully understanding and treating your child if he or she has an adrenal imbalance.
About pituitary gland problems
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, located at the base of the brain. The pituitary gland itself is regulated by an adjacent area called the hypothalamus. The normal function of the pituitary gland is critical for maintaining the health, growth, and development of your child or teenager.
Pituitary gland care at Children’s
Because the pituitary gland regulates other glands in the body, it is very important that any problems be treated immediately. The first thing our specialists do is perform blood tests to confirm suspected pituitary gland problems. Blood tests measure the amount of hormones in your child’s blood. We may also request urine tests. From there, we determine the best medications to treat the specific cause of imbalance. Both hyper and hypopituitarism may be treated with hormone therapy or surgery (if removal of a tumor is needed) and/or radiation or chemotherapy to shrink a tumor, if present and growing. Fluid restriction is often used in SIADH treatment.
About calcium and bone problems
Because your child is growing, any problems concerning your child’s bones are potentially serious. Bone health is affected by many different factors including diseases of the parathyroid glands (hypo or hyperparathyroidism) and abnormalities of vitamin D and its metabolism (e.g. various forms of rickets). There are also inherited forms of rickets due to loss of phosphate in the urine, and resistance to vitamin D. In the endocrine program, we specialize in treating all these bone problems, including weak or excessively porous bones from any cause (e.g. juvenile osteoporosis or osteogenesis imperfecta).
Parathyroid hormone (the hormone made by the parathyroid glands) tells your body to absorb more calcium. It also stimulates the release of calcium from your bones into your bloodstream. Hyperparathyroidism causes too much calcium to be pulled out of the bones. It is rare in children, but when it does occur in kids, they may experience worse pain, tiredness, and other symptoms than in adults. In hypoparatyroidism, too little parathyroid hormone is produced so the level of calcium in the blood can become too low for proper functioning, which leads to painful nerve spasms and other symptoms. Hypoparathyroidism may appear by itself or as part of DiGeorge syndrome, which also includes heart defects, an underdeveloped or missing thymus, and cleft lip and/or palate.
Vitamin D plays an important role in bone health and lack of vitamin D (because of dietary deficiency or lack of sun exposure) is a common problem that may lead in extreme cases to a condition called rickets, where the bones become too soft and are easily bent. These and other vitamin D problems are also treated in the endocrine clinic.
Calcium and bone problem care at Children’s
As with every condition, we review your child and family’s medical history and perform a physical exam first. Our specialists may assess your child’s bone density using a DXA scan (dual-energy x-ray absorptiometry). We also use blood tests to measure your child’s calcium and hormone levels. In most cases we treat hyperparathyroidism by removing the problem tissue. Juvenile osteoporosis and Hypoparathyroidism may be treated with calcium supplements and/or injections as well as with Vitamin D. If your child has DiGeorge syndrome, coordination with other programs may be necessary to treat the entire condition and give your child the best outcome.
Hypoglycemia is a condition in which the amount of blood glucose (sugar) in the blood is lower than normal.
Approximately two out of 1,000 newborn babies have hypoglycemia. Read more >>