Dr. Richard A. Guthrie, M.D.

Hashimoto's disease is an auto-immune disease that is caused by your inheritance. The immune system can destroy the thyroid gland resulting in a hypothyroid state. Hypothyroid problems result in poor function of all organs, including the kidney. The kidney maintains water balance so if it is not working well there is fluid retension that can be manifested by weight gain. If you have Hashimoto's disease be sure to take your thyroid replacement daily and see the Dr. often to get the thyroid level checked & kept in control. Now though there are many other causes of wt. gain so see your Dr. to be sure the wt. gain does not have another cause and can be fixed.

The fastest way to bring up blood sugar (BS) is intravenous glucose (IVG). If you have diabetes, the 2nd best way is IV or sub-cutaneous glucagon (there is now a new form of glucagon that can be giver intranasal). Then eat some carbohydrate & protein ( we have had good success with mild hypog. in kids at camp with a mixture of peanuts & raisins. You can also use high sugar foods such as orange or grape juice or glucose tablets you can buy over the counter. If you have non-diabetic hypoglycemia, see your Dr. as you could have an insulin secreting tumor of the pancreas. This can be removed to solve the problem. For treatment of this problem, just eat something with high sugar. As above juices, candy, regular soda pop, glucose tablets, etc. DON'T overdo it. We tend to eat too much sugar foods when we are low & then go high. 20 grms. (2 glucose tablets) or equivalent is all you need. If you take too much you will go high and that stimulates more insulin secretion which will make you go low again. So up & down like a roller-coaster. So don't "pig out" on high sugar foods. Another good thing to take in moderation, regardless of the kind of hypog. you have, is honey, and it tastes good, too.

I am going to presume from your question that it is non-diabetic. You should 1sr see a Dr. since this type of hypog. can be due to an insulin secreting tumor of the pancreas. Removal of the tumor will cure the problem. If not a tumor, then treatment is food or drink. Rapid acting foods include juices such as orange or grape juice. Other high sugar foods are raisins, ice cream, honey, plain table sugar, grapes, dried fruit, etc. You can also buy glucose tablets over the counter & eat 2 or 3 of those. DON'T over do it. We are tempted to eat too much when we are low. This will push the blood sugar too high and cause the pancreas to put out a lot of insulin to bring it down & produce hypo again-like a roller-coaster. If you have diabetes the bet treatment for hypo is IV glucose or IV or IM glucagon followed by high sugar foods with some protein. At diabetic camp we have had good success with a mixture of peanuts & raisins.

You can't; at least I know of no home test for thyroid function. You may make a personal diagnosis by symptoms of slow function or a thyroid swelling but it would have to confirmed by a blood test for thyroid hormone & pituitary and perhaps thyroid antibodies before treatment is started. This is true because there are many different diseases of the thyroid and each is treated differently. For example Hypothyroid is treated with thyroid hormone replacement, hyperthyroid is treated by suppressing the thyroid, tumors are treated by removal, etc. so true test by the Dr. is needed to be able to prescribe the correct treatment.

There is no magic bullet to keep the thyroid healthy. Thyroid function is the result of many factors including other endocrine glands like the pituitary gland in the brain. Most thyroid diseases have a genetic connection and we cannot change our genetics. So just eat a good diet & exercise well. Don't smoke or use much alcohol (these are all things for good health of all organs) and then nature will determine the presence or absence of thyroid disease.

Probably can be cured in the future but not today. Hashimoto's is an autoimmune disease where the immune system that normally just protects you from foreign invasion like bacteria or virus diseases, goes wild & attacks a part of your body. In this case the thyroid gland. Other autoimmune diseases include Type 1 diabetes, rheumatoid arthritis, several intestinal diseases, and many others. We know what causes these diseases but not why the immune system malfunctions. Until we know why, we probably will not know how to reverse. Also be aware that most organs of the body cannot regenerate ( the liver is an exception) once they are destroyed. Here the thyroid cells are destroyed & cannot regenerate. So the "cure" it we would have to find a way to detect it before it destroys the gland or find a way to make that tissue regenerate. It can't be cured today but it can be treated and you can have a full life with one pill a day & once in a while a blood test to see if the medicine dose is still correct. Don't forget your pill!

Hypothyroidism simply means that the thyroid gland has quite functioning without saying why it has quit. There are many reasons why the thyroid quits. Hashimoto's thyroiditis is one of the causes of hypothyroid. In Hashimoto's disease, the immune system goes bonkers and attacks the thyroid cells & destroys them thus the thyroid can't produce thyroid hormone=hypothyroid. You can have Hashimoto's & early the gland may enlarge but you may not have low thyroid or hypothyroid yet. Further you can have hypothyroid from a variety of causes such as a germ or virus infection, a poorly functioning pituitary gland, old age, cancer or several other diseases. So you can have Hashimoto's without hypothyroid or hypothyroid without Hashimoto's. Hashimoto's the is a cause and hypothyroid is the result. Hope this clears it up.

DISASTER!!! IF UNTREATED IN A 12 YR. OLD BOY, HE WILL NOT GROW WELL & END UP VERY SHORT. HE WILL ALSO RETAIN A LOT OF FLUID SINCE THE HEART & KIDNEY WILL BE OPERATING AT A VERY LOW RATE. DAMAGE TO THE HEART & KIDNEY WITH UNTREATED HYPOTHYROID IS USUALLY PERMANENT & IRREVERSIBLE. HE WOULD THE LIKELY DIE FROM CONGESTIVE HEART FAILURE & KIDNEY FAILURE. BE SURE HE TAKES HIS ONE PILL A DAY (NO BIG DEAL-I HAVE DONE IT FOR 27 YRS.) AND GETS THE THYROID LEVEL CHECKED REGULARLY SINCE WITH GROWTH THE DOSE WILL CHANGE. BUT NEVER STOP THE MEDICINE, SUCH CAN BE FATAL & HE'S TOO YOUNG TO DIE!!!!

NONE! FOOD HAS LITTLE TO DO WITH THE THYROID EXCEPT IN AREAS WHERE THE SOIL IS LOW IN IODINE THAT IS NEEDED BY THE GLAND TO MAKE THYROID HORMONE. THEN IODINIZED SALT IS NEEDED. I HAVE HYPOTHYROIDISM & EAT ABOUT EVERY THING. TAKE YOUR MEDICINE THOUGH ON AN EMPTY STOMACH SINCE FOOD WILL SLOW OR PREVENT THE ABSORPTION OF THE MEDICINE. If YOUR HYPOTHYROID IS CONTROLED BY THE PROPER DOSE OF THYROID HORMONE & YOU HAVE NO OTHER DISEASE,YOU CAN EAT ABOUT ANYTHING. ENJOY!!

I'll try to answer it in general terms. 1) Get him under the care of a pediatric endocrinologist who is well trained in diabetes care of children. 2) See a dietician to learn the best diet for him & how to calculate his insulin based on how much he eats (especially carbohydrates). 3) Find a diabetes education class & you & his father attend the class to learn all you can about diabetes. Take him to class with you if he is old enough. 4) Join a diabetes support group of parents who have children with diabetes for mutual support.
I hope this helps & good luck, your son's life depends upon good diabetic control, so use all the resources you can find. Also, contact the American Diabetes Association. They have a lot of resources to help you, some of which I helped to write.
All the best.

There are no dietary restrictions in hypothyroidism nor will any special diet help or cure hypothyroidism. You can eat anything you want for breakfast. Though a good breakfast has other helps so eat a good well balanced. I have hypothyroidism and eat 1 egg, a piece of meat (2 strips of bacon, or a sausage patty or a little ham) & some hashbrown potatoes. Toast can be substituted for the potatoes. Orange juice, grapefruit juice or other fruit juice and coffee is ok. Be aware though that fruit juices are high in sugar & can cause wt. gain & raise the blood sugar in people with diabetes. The same can be said for things like pancakes, waffles, etc. that are covered with syrup. The treatment for hypothyroidism is thyroid hormone replacement, not diet. Please be aware though that you should take your thyroid medication on an empty stomach & not eat for about an hour to let the medication be absorbed before the stomach is filled since food will slow or prevent the absorption of the meds.

There are a lot of effects if you don't take your medicine & they can be fatal. Ifyou take your medicine & the dose is correct there should be no side effects since you are just replacing what has been lost. The dose must be correct though. If it is to high you can get symptoms of hyperthyroid (rapid heart rate & other metabolic parameters, such as wt. loss, shaky feelings, etc.). If you are taking too low a dose or missing doses then all the symptoms of low thyroid that you had before starting treatment will recur. A few people develop allergy to the preservatives or coloring, etc. in the pills & have allergic reactions such as hives & respiratory symptoms. This is very rare. Check with your Dr. at frequent intervals to be sure the dose is correct & you should have no side effects.

When your thyroid has been low for awhile, it will take a few weeks for all the organs to get back to full function. It shouldn't take more than 3 months however & if it does, see your Dr. and get checked to be sure the dose is right. If the dose is too low it will take longer for symptoms to subside or they may not subside at all, so be sure your dose is correct.

If your child has diabetes, it would be Type 2 that occurs mainly in adults, but we are seeing more of in children. Early forms of this are called "metabolic Syndrome" or "Pre-diabetes". These early forms may have no or very few symptoms. Check the back of her neck & see if it is rough & has pigmentation. This is called Acanthosis Nigrecans & is associated with high insulin levels due to the insulin resistance of obesity. Look also to what kind of obesity she has. That associated with these problems is central or truncal obesity and the excess fat is intra-abdominal not just under the skin. We often illustrate this by using as an example apples & pears. Pears are small on top & bigger on the bottom. This is fat under the skin & they do not usually develop diabetes. It is the apples with central, abdominal obesity that do develop it. Other symptoms are excess urination & thirst. If it has gone this far without medical care, it has gone too far. Please see you doctor & get it evaluated. Tests can be run to confirm the physical signs & perhaps set you heart at ease. In any event see a dietician and get help for the obesity. The YMCA has a good program with dieticians & exercise specialists to help and it is relatively cheap. Please see Dr., Dietician & if available the YMCA for help as continues obesity with or without diabetes is detrimental to your childes health.

Yes you can. Go to the pharmacy & buy, without a prescription, a urine test kit for sugar (glucose) & ketones. The kit will contain strips the you just "pee" on & they change color if glucose is present in the urine. There should be no sugar in the urine. If the test is positive or indeterminant, see a physician for blood testing. You can also buy a blood glucose meter & do a finger stick blood glucose test but this is more expensive & you would need some training on how to do the procedure. Good luck.

How long a person lives with Type 1 diabetes (T1D) is variable depending on many factors including how well the diabetes is controlled. We used to believe that it took 10 or more years off life expectancy & it does if not well controlled. If the diabetes is well controlled, we now believe the person will as long as their genetics & life style permits just as any one else would. That means keeping the blood sugar in good control, their Hb1c >7 or 6.5., keeping blood pressure normal, keep lipids normal, don't smoke or use drugs, etc. So follow the rules & life span can be the same as anyone else. There are thousands of people who have had T1D for over 50 yrs., hundreds over 60 yrs and some over 75 yrs. with a healthy, fulfilling life. I have had it for 27 yrs. & feel fine. I am 84 yrs. old. You can do it!!

There are many symptoms of low thyroid (hypothyroidism). Thyroid hormone (thyroxine) is the hormone that keeps things going (stokes the furnace) so the symptoms of low thyroid are that every organ slows down. I will list here only a few of the main symptoms: the heart slows down & loses the strength to pump blood (that causes congestive heart failure), puffy face & legs, dry scally skin, problems of the mind such as slow decision making & learning and even hallucinations, fatigue & slow movements, slow speech and a deep voice due to swelling of the vocal cords, etc. Get the point everything slows down. If this continues & is not treated, it can be fatal from damage to the heart. If things are slowing for you, see a Dr. right away. Hypothyroid can be diagnoses with a simple blood test and can be treated with all functions returning to normal.

Type 1 diabetes may get more severe & harder to control with longer duration. Soon after diagnosis & treatment, the beta cells that make insulin may get better & insulin needs decrease. This is called the "honeymoon period). It doesn't last forever. Later, depending on the level of control, more beta cells may be killed and less internal insulin is produced. After a time that varies with the individual & level of control, all the beta cells may die & the individual will have more difficulty in control since they are now totally dependent on external insulin that cannot completely duplicate the smooth action of internal insulin. There is some memory in the pancreas so the better the control at the beginning the better is the control later on. So get in control & continue that control & you may save some beta cell & make control better. This loss of beta cells is not age related but is related to duration of the diabetes.

That depends on what type of diabetes you have & how you feel. If you have Type 2 diabetes & are taking oral agents, the answer is No. You do need to see a diabetes Dr. though & get your medication adjusted to get the blood sugar down. If you have Type 1 diabetes, the answer is probably yes since ketoacidosis may be starting. If you are not sick & BS that high & you are taking insulin, you can treat this at home by taking some supplementary doses of short acting insulin. If this is a chronic problem (that way all the time) you need to see your doctor since BS this high & sustained will lead to complications such as loss of vision, kidney failure, heart attacks & stroke and foot ulcers & amputations. Occasional high BS from overeating or eating too much carbohydrate will occur in all of us & needs only take a little extra medication or MORE IMPORTANT follow the dietary rules.

What to eat before bed depends on what kind of diabetes you have. If you have Type 2 diabetes & are overweight, you should probably eat nothing. If you are not overwt. then a simple snack of some complex carbohydrate & protein in small amount is all you need. If you are Type 1 diabetes, then a good high protein snack maybe with some complex carbs is needed. If you exercise in the evening, then a bigger snack is needed to replenish your liver stores of sugar. I have type 1 diabetes & have had it for 27 yrs. I usually eat a peanut butter sandwich before I go to bed. It works well. I may eat cheese sometimes but be careful not to over do it. Try several foods with complex carbs & protein and check your blood sugar before eating, maybe once during the night and when you get up to see effects with different foods to find the one and amount you need. Using a Freestyle Libra meter will allow many blood sugars without finger sticks. Don't be afraid to experiment but to do so you must check your blood sugar many times to see the results with different foods & amounts.