Dr. Stuart J. Brink

Sorry, no.

Details depend on exact diagnosis gestational diabetes related to pregnancy, medication induced diabetes, type 1 diabetes, type 2 diabetes, metabolic syndrome, prediabetes etc.

Not likely related to weight lifting.

Long list of possibilities from family growth patterns of short stature, delayed puberty to growth hormone and other hormone deficiencies like underactive thyroid and a long list of genetic conditions like Noonans Syndrome, Celiac Disease and other inflammatory conditions. Key is looking at his eight and height, plot them on the standard charts and see if there is some clue by the pattern. Then get a hand xray called a bone age and compare this to height and weight ages.

Physical exam would also be done and likely consultation with a pediatric endocrinologist experienced with growth and short stature conditions with likely screening blood tests such as IGF1, T4, TSH, chemistry profile, celiac testing and whatever else is suggested by detailed systems review, history and physical. If none of this provides a specific diagnosis, more detailed genetic testing and xrays as well as closer followup and plotting the height on the growth charts would then be done as part of the endocrine evaluation.

Long list of possibilities from family growth patterns of short stature, delayed puberty to growth hormone and other hormone deficiencies like underactive thyroid and a long list of genetic conditions like Noonans Syndrome, Celiac Disease and other inflammatory conditions. Key is looking at his eight and height, plot them on the standard charts and see if there is some clue by the pattern. Then get a hand xray called a bone age and compare this to height and weight ages. Physical exam would also be done and likely consultation with a pediatric endocrinologist experienced with growth and short stature conditions with likely screening blood tests such as IGF1, T4, TSH, chemistry profile, celiac testing and whatever else is suggested by detailed systems review, history and physical. If none of this provides a specific diagnosis, more detailed genetic testing and xrays as well as closer followup and plotting the height on the growth charts would then be done as part of the endocrine evaluation.

Minimally but depends on how high the blood sugar level is, whether its from medication side effects, some type of diabetes.

Important to find out the cause of the high glucose and whether there is any positive family history or any specific symptoms associated with the high sugar. If this wasnt already explained to you, then ask for a diabetes consultation evaluation. If you are symptomatic or cannot get in touch with your own medical exam, then go to the emergency room or urgent care center and ask those medical teams whats going on.

Long list of possibilities from family growth patterns of short stature, delayed puberty to growth hormone and other hormone deficiencies like underactive thyroid and a long list of genetic conditions like Noonans Syndrome, Celiac Disease and other inflammatory conditions. Key is looking at weight and height, PLOT them on the standard charts and see if there is some clue by the pattern. Then get a hand xray called a bone age and compare this to height and weight ages. Physical exam would also be done and likely consultation with a pediatricadolescent endocrinologist experienced with growth and short stature conditions with likely screening blood tests such as IGF1, T4, TSH, chemistry profile, celiac testing and whatever else is suggested by detailed systems review, history and physical. If none of this provides a specific diagnosis, more detailed genetic testing and xrays as well as closer followup and plotting the height on the growth charts would then be done as part of the endocrine evaluation.

Excellent question and likely represents some genetic tendency. There are good early scientific studies that show immune treatments have been helpful but none of them are of long duration to really know safety issues.I would strongly recommend that you ask these questions to your childrens diabetes exam an either they can make a referral if someone in their systems is doing such treatments andor have an ongoing research study for them or other members of the family.

Important to know how much iron he is getting in his food and also, with thyroid problems, does he have autoimmune Hashimotos thyroiditis, are the thyroid levels abnormal enough to warrant thyroid replacement pill daily and especially if there is thyroiditis with positive thyroid antibodies, does he also have celiac disease or some other autoimmune bowel problems IBS, Crohns, ulcerative colitis etc. You are correct that you should ask for an explanation of the low thyroid levels and low ironan d hemoglobin or get consultation from pediatric endocrinologist andor pediatric hematologist. i

Yes hyperthyroidism is serious because it can have effects on general health, energy, weight, growth, puberty timing, gonadal function, skin, hair, sleep, learning, body temperature, bowel function, muscle and nerve function. Also is considered an autoimmune thyroid condition called Graves disease and sometimes also associated with inflammatory thyroid eye disease. Usually first treatment is with thyroid blocking pills and then titrated according to history and followup exams as well as thyroid blood levels. If that doesnt work or if there are allergic problems with the antithyroid drugs, then surgery on the thyroid gland or radioactive iodine treatment are the next lines of treatment and all three have longterm safety data known. Id recommend asking this question directly to your thyroid doctor since its important to get an answer more specifically for your situation, labs, response etc. Also would be important to get celiac screening since celiac is also commonly associated with any kind of thyroid problem.

Thyroid gland enlargement is called a goiter and most often is associated with an autoimmune condition called Hashimotos thyroiditis. Thyroid problems also commonly, but not always, occur in multiple family so there is some genetic contribution. Important to get it checked out with her physician who will likely not only do a detailed history and full physical examination as well as check blood Total T4, free T4, TSH levels as well as two thyroid antibodies. If these show positive antibodies, then the explanation is Hashimotos thyroiditis for what sounds like it could be enlarged thyroid gland that you are describing causing the goiter. If T4 levels are low and TSH high, then simple treatment is one pill daily with replacement thyroxine. Depending on your daughters medical exam experience with thyroid issues, consultation with a pediatricadolescent thyroid specialist would also be considered.

Long list of possibilities from family growth patterns of short stature, delayed puberty to growth hormone and other hormone deficiencies like underactive thyroid and a long list of genetic conditions like Noonans Syndrome, Celiac Disease and other inflammatory conditions. Key is looking at his eight and height, plot them on the standard charts and see if there is some clue by the pattern. Then get a hand xray called a bone age and compare this to height and weight ages. Physical exam would also be done and likely consultation with a pediatric endocrinologist experienced with growth and short stature conditions with likely screening blood tests such as IGF1, T4, TSH, chemistry profile, celiac testing and whatever else is suggested by detailed systems review, history and physical. If none of this provides a specific diagnosis, more detailed genetic testing and xrays as well as closer followup and plotting the height on the growth charts would then be done as part of the endocrine evaluation.

Multiple causes for short stature with most common being a familygenetic history of similar short stature and growth pattern in others. But also lack of growth hormone or other pituitary hormones that could affect growth hormone, thyroid hormone problems, excess adrenal or decreased adrenal hormone problems, chronic inflammation like celiac disease, inflammatory bowel condition, multiple medications that interfere with these effects and also multiple delays in pubertal hormones like testosterone or estrogen and the pituitary, hypothalamic and brain control sites. Detailed height and weight data should be reviewed and specifically assessed plotted on a growth chart with consultation with a pediatric endocrinologist if your sons medical team cannot explain whats going on. Detailed history including family growth information and physical exam including gonadal exam and Tanner staging should be done and, if no obvious explanation, some screening blood tests like IGF1, blood count, sedimentation rate or CRP levels, full general chemistry profile as well as total T4, free T4 and TSh would also likely help with this evaluation but if you have noticed this and nobody on the medical team has confirmed this, then go get it checked out. .

Any pediatric endocrinologist who treats diabetes should either be involved with dietary advice andor have a diabetes nurse educator or diabetes dietician who does such teaching for your son and both parents, grandparents etc. This should include not just avoiding simple high sugar foods and drinks but details about protein, fat, timing, changes with exercise and insulin dosing as well as actual sugar levels. If you need more information that what has been provided, let your sons diabetes team know that and ask them what options they have available andor ask for a specific dietary consultation.

First you need to consult with her physician and see where she is on the growth chart height and weight charts. These often provide some clues as to what needs to be checked out in addition to a detailed history and physical exam. If nothing is obvious, then screening lab testing will be done including inflammatory conditions, underactive thyroid, insufficient growth hormone, excessive cortisol levels among others. Keeping some detailed information about exactly what and how much she is eating at meals and snacks for 34 days would also be important to gather and bring with you to the appointment. Important that you have made this observation but don delay in getting it evaluated in more detail.

Yes frequent and high dose steroids cortisol, prednisone can effect height, usually also with associated weight gain as well as slower height gain. You should set up a followup consultation with his physicians and especially check that they have actually PLOTTED height and weight on the growth charts of his medical records. Could be unrelated to thesthma or steroid treatments and might be a family pattern as well as along list of other possibilities for delayed puberty and slow growth. Full detailed history and complete physical exam including size and shape of penis, how much and what Tanner stage are his genitalia pubic hair, testicular examination and size all will help in this assessment. If still unclear explanation, then some lab screening tests like urinalysis, blood count, sedimentation rate, Creactive protein level, full chemistry panel, thyroid tests T4 and TSH as well as IGF1 screen and hand bone age xray determination may also be needed based on his actual plotted growth chart and exam. If still persisting, then consultation with a pediatric endocrinologist would be recommended.

Long list of possibilities from family growth patterns of short stature, delayed puberty to growth hormone and other hormone deficiencies like underactive thyroid and a long list of genetic conditions like Noonans Syndrome, Celiac Disease and other inflammatory conditions. Key is looking at his eight and height, plot them on the standard charts and see if there is some clue by the pattern. Then get a hand xray called a bone age and compare this to height and weight ages. Physical exam would also be done and likely consultation with a pediatric endocrinologist experienced with growth and short stature conditions with likely screening blood tests such as IGF1, T4, TSH, chemistry profile, celiac testing and whatever else is suggested by detailed systems review, history and physical. If none of this provides a specific diagnosis, more detailed genetic testing and xrays as well as closer followup and plotting the height on the growth charts would then be done as part of the endocrine evaluation.

Good for you to think about ketoacidosis and any stress such as food poisoning might set it off if you were otherwise susceptible. No relation to the plane ride, by the way.

Simplest overthecounter test is a urine glucose strip that tests for sugar glucose and urine ketones. Both are negative if you are healthy.

So you should immediately contact your doctor who will order these tests or do them in the office as well as review what symptoms you have, your physical exam and probably also check blood sugar levels and salt levels to see if this is diabetesDKA or some other condition. Most gastrointestinal illnesses like diarrhea that cause weight loss, dehydration etc are associated with less urination because normal kidneys try to save fluids if you are dehydrated so the excess urination is an important symptoms to explain and diabetes is on the top of the list to check out. Best of luck.

Hashimotos thyroiditis is the technical name for autoimmune thyroiditis named after the Japanese doctor who first described it more than 100 years ago. Very commonly can cause the thyroid gland to not be able to make normal amounts of its main thyroid hormones. Can also cause the thyroid gland to enlarge called a goiter and sometimes be associated with thyroid nodules or cysts. But based on blood thyroid hormone levels total and free T4, TSH and sometimes also T3 levels measured, if they are low with positive antibodies, then usually the treatment is a veery simple, straightforward onceaday levothroxine thyroid replacement pill. This needs to be changed over time depending on followup symptoms, size of thyroid and, most importantly bringing the levels of T4 and free T4 to normal while decreasing the TSH levels caused by the low T4s from the inflammation. Inexpensive, very safe and easy to take onceaday probably for life thyroid hormone pill.

Right now we do not have any significant research studies using the new immune blocking drugs and they may not work andor may cause significant side effects in addition to be incredibly expensive. Theres ongoing research about how these new drugs can be used but mostly as anticancer drugs especially with how lethal cancer can be compared to Hashimotos with or without hypothyroidism. So not yet ready for what you are suggesting although lots more animal and lab research may change this over the coming years. Id encourage you to also ask this question to your thyroid doctor because its a good question

Puzzling how you got a prescription drug like testosterone without a prescription. Sounds like what you described was secondary to the boost in testosterone levels. Now you need to see a pediatric/adolescent endocrinologist to get hormone levels and full genital exam/pubertal Tanner staging done with appropriate blood hormone levels too. Also need all your prior height and weight specific information and plotted on a growth chart to see what your pattern was before as well as since the testosterone. Maybe also a bone age xray which would determine how much advanced your bone age response was to the testosterone and also allow prediction for final height expectations.

If there are no available appointments, ask to be put on a cancelation list since that usually gets you seen within a week or so. Also you can calmly call the office once or twice a week to ask if anybody cancelled that same day and just take that slot so you don't have to wait excessively. Good luck.

Need more information to really answer your questions, Kallman's and Klinefelter's are possible and easily tested with a blood genetics sample yor docs can order. Any estrogen exposure or similar chemicals may also cause what you are describing. Some folks are sensitive to soy, almonds and heated plastics (PSPs) If FSH low, may also need specific hypothalamic and pituitary testing including MRI scans of the region but need all the exact details of leels of estrogen, testosterone free and totals, DHEAS, FSH, LH, prolactin and thyroid testing T4 and free T4 as well as TSH, Something call Peyronie's can also make a penis somewhat small and crooked. Endocrinology and maybe also urology assessment afterwards would be best consultation. The abdominal fat may indicate prediabetes, metabolic syndrome or insulin resistance so blood glucose, liver enzymes, insulin and lipid levels should also be evaluated.