Dr. Tseghai Berhe MD
Endocronologist (Pediatric) | Pediatric Endocrinology
1555 BARRINGTON RD HOFFMAN ESTATES IL, 60169Rating
4/5
About
Dr. Tseghai Berhe is a pediatric endocrinologist practicing in HOFFMAN ESTATES, IL. Dr. Berhe specializes in growth, puberty, diabetes or other disorders related to hormones that produce certain conditions in children and growing young adults. Pediatric endocrinologists possess copious knowledge on hormone chemicals and how they can affect other parts of the body and their functions.
Education and Training
Spartan Health Sciences University, School of Medicine,Vieux Fort, Saint Lucia Medicine
Board Certification
DermatologyAmerican Board of DermatologyABD
Provider Details
Dr. Tseghai Berhe MD's Expert Contributions
How can I improve my thyroid function?
The thyroid gland is a small but a vital gland at the base of the neck, below the Adams apple. It is responsible for energy production, metabolism, mood changes, growth and development by affecting protein synthesis, and bone growth. It also supports brain development and cardiovascular health. The thyroid hormones act on almost every cell of the body. They increase the basal metabolic rate of the body, increase heat generation and increase the body's sensitivity to adrenaline. They regulate protein, fat, and carbohydrate metabolism, so the cells can use them for energy production and heat generation. They are also useful in mineral and vitamin metabolism. In children the thyroid gland is at various sizes because children are going through a process of growth and development. In adults the thyroid gland measures about 4-6 cm . It weighs about 20 grams. If it gets larger, the thyroid gland, becomes a goiter. It may also develop a nodule or multiple nodules. The thyroid gland may be normal, under-active or over active. The thyroid gland produces three major hormones namely thyroxine (T4), triiodothyronine (T3), and calcitonin. If your thyroid gland does not make these hormones especially T3 and T4 you may develop a condition called hypothyroidism (low thyroid hormone) and when the thyroid makes excess of these hormones (over active thyroid) a condition called thyrotoxicosis or hyperthyroidism sets in. Calcitonin supports bone health. In hypothyroidism (under active thyroid) the person may experience the symptoms of sadness, weight gain, poor energy level, dry skin, constipation, hair loss and fatigue. The thyroid level can be low due to autoimmune condition, iodine deficiency or other various causes. The thyroid function test is a necessary blood test in the evaluation of the status of the thyroid gland, in the production of the thyroid hormones. This test will determine whether the thyroid gland is working well or not. Based on the thyroid function test, further work up may be performed to pin point the cause of thyroid disorder (low or high thyroid hormone). Further work up may include blood work for iodine and various antibodies or imaging studies such as Ultrasound or uptake and scan of the thyroid gland. When thyroid gland is functioning abnormally, the cause should be evaluated and treated properly by and expert. When some one is on thyroid treatment especially hypothyroid ( under-active thyroid) one need to be aware that certain food can affect the function and absorption of thyroid hormone. Soy products (isoflavones) such as miso and tofu can interfere with thyroid hormone absorption. Calcium products and Multivitamins can also affect thyroid hormone if they are taken within 2 hours of thyroid medication. Cruciferous vegetables ( goitrogens) such as cabbage, broccoli and cauliflower can affect thyroid function especially with people who have iodine deficiency. Gluten found in Rye, barely and wheat can also interfere with thyroid function. Excessive ingestion of high fiber food, high sugar intake, fatty foods and processed foods will negatively affect thyroid function especially in hypothyroid persons. Everything should be consumed in moderation. Eating healthy diet with daily (regular) physical activity and maintaining ideal weight should improve thyroid health. A healthy person who consumes balanced foods with regular physical activity and who maintains ideal body weight, should not worry about all the above mentioned food, which may negatively affect the thyroid function. A healthy life style should be beneficial for the thyroid to function optimally. These include: 1) Eating healthy balanced diet consisting of 50% vegetables, 30% whole grains, 10% fruits and 10% proteins with each meal. 2) At least an hour of moderate to vigorous daily physical activity. 3) Maintaining an ideal body weight (BMI between 18-24 kg/m2). 4) Supplementing enough multivitamins and iodine. 5) Good sleep and rest. 6) Avoidance of stress. Eating healthy food with enough vitamins and minerals may help the thyroid gland to function better, especially for those with iodine deficiency. Good Luck. READ MORE
Is blood sugar low in the morning?
In a none diabetic person blood sugar are considered normal if they are between 70-99mg/dl about 6 to 8 hours fasting or less than 140 mg/dl after 2hrs of eating a good size meal. In a none diabetic person, in the first hour after a meal blood sugars can go as high as 170mg/dl, by 2 hours blood sugars should be <140mg/dl. But by thee hours the blood sugars should come down to less than 100mg/dl. Most none diabetic people, have their lowest blood sugars before each meals, as long as the interval between the meals is at least 3 hours.. They are mostly around 70 to 90 mg/dl. Blood sugar of 60mg/dl may be normal for some people. Most none diabetic persons should have normal blood sugars in the morning between 70-80 mg/dl. Most none diabetic persons produce more insulin to counter act the effect of the Dawn phenomenon caused by the release of counter regulatory hormones in the early hours of the morning. In many diabetic patients the early morning blood sugars are higher due to the Dawn phenomenon, because they can not release sufficient insulin to counter this effect. In non diabetic persons blood sugars before breakfast, in the morning, hover around 70 to 90mg/dl. In a normal none diabetic person the morning blood sugars should be similar to those blood sugars before meals as long as there was no food consumed for at least 3 hours in between meals. In a diabetic patient the blood sugars are generally higher than non diabetic persons. Depending on the glycemic control, diabetes patients can experience from very low to very high blood sugars at different times of the day or days of the week. If you are a none diabetic person and is experiencing high or low blood sugars at any given time of the day consistently, you need to seek medical attention. Good Luck. READ MORE
What are the early signs of diabetes in children?
Diabetes and the earliest signs: Diabetes is a common metabolic disorder. It is caused by either insulin deficiency or insulin resistance. Most children will have type 1 diabetes which is a state of absolute insulin deficiency. It is mainly an autoimmune process where by insulin producing cells called beta cells are destroyed in the process. It is more common in the Caucasian children. Type 2 diabetes is also becoming more common in children due to the epidemics of obesity which results in insulin resistance. The incidence of type 2 diabetes is more common in the minority population than the caucasian population. Diabetes (type 1 and type 2) can be diagnosed clinically and biochemically. 1) Any person with symptoms of excessive urination, excessive thirsty, bed wetting, nocturia, weight loss and abnormal blood sugars above 200mg/dl have diabetes unless proven otherwise. 2) Any random blood sugar greater than 200 mg/dl at more than one occasion. 3) Any fasting blood sugar (at least after 8 hrs. fasting) >126 mg/dl at more than one occasion. 4) Any blood sugar >200 mg/dl on more than one occasion using the 2 hour standard glucola test of 75 gm. ( 1.75 mg/kg up to 75 grams) performed after 8 hours of fasting on more than one occasion. 5) Hemoglobin A1c greater or equal to 6.5% Another entity call a prediabetes state can also be established using blood sugar reference ranges if the individual is at risk for diabetes. Biochemically, a prediabetes state can be established as follows: 1) Fasting blood sugars between 99-126mg/dl at least in more than one occasion. 2) Blood sugars between 140-200 mg/dl in the standard 2 hour glucola test on more than one occasion. 3) Hemoglobin A1c between 5.7-6.4% The earlies signs of diabetes for both type 1 and type 2, are therefore; (biochemical markers) such as, abnormal blood sugars and abnormal hemoglobin A1c, followed by clinical signs, such as, excessive drinking, excessive urination, bed wetting, nocturia, weight loss etc. Again the first one to be abnormal are the biochemical markers before the emergence of the clinical signs and symptoms.` If you suspect your daughter/son has symptoms of diabetes or if she is at high risk for diabetes, you should check her/his blood sugars fasting and random (if you have access to glucometer). If you get >200mg/dl persistently with or with out frank symptoms of diabetes, you may take her/him to her/his doctor promptly. If you do not get high blood sugars you may be dealing with other conditions that share similar symptoms. If you do not have an access to glucometer and you suspect diabetes you should take her/him to her/his doctor or to the emergency room. Good luck. READ MORE
What is the main function of thyroid hormone?
The thyroid gland is a small but a vital gland at the base of the neck, below the adams apple. It is responsible for energy production, metabolism, mood changes, growth and development by affecting protein synthesis, and bone growth. It also supports brain development and cardiovascular health. The thyroid hormones act on almost every cell of the body. They increase the basal metabolic rate of the body, increase heat generation and increase the body's sensitivity to adrenaline. They regulate protein, fat, and carbohydrate metabolism, so the cells can use them for energy production and heat generation. They are also useful in mineral and vitamin metabolism. In children the the thyroid gland is at various sizes becuase children are going through a process of growth and development. In adults the thyroid gland measures about 4-6 cm . It weighs about 20 grams. If it gets larger, the thyroid gland, becomes a goiter. It may also develop a nodule or multiple nodules. The thyroid gland may be normal, under-active or over active. The thyroid gland produces three major hormones namely thyroxine (T4), triiodothyronine (T3), and calcitonine. If your thyroid gland does not make these hormones especially T3 and T4 you may develop a codition called hypothyroidism (low thyroid hormone) and when the thyroid makes excess of these hormones (over active thyroid) a codition called thyrotoxicosis or hyperthyroidism sets in. Calcitonin suppots bone health. In hypothyroidism (under active thyroid) the person may experience the symptoms of sadness, weight gain, poor energy level, dry skin, constipation, hair loss and fatigue. When the thyroid gland is over active, the person may experience, weight loss, fatigue, palpitations, heat intolerance, excessive sweating, irritability, frequent bowel movement and insomnia. The thyroid function test is a necessary blood test in the evaluation of the status of the the thyroid gland, in the production of the thyroid hormones. This test will determine whether the thyroid gland is working well or not. Based on the thyroid function test, further work up may be performed to pin point the cause of thyroid disorder (low or high thyroid hormone). Further work up may include blood work for iodine and various antibodies or imaging studies such as Ultrasound or uptake and scan of the thyroid gland. When thyroid gland is functioning abnormally, the cause should be evaluated and treated properly by and expert. When some one is on thyroid treatment especially hypothyroid ( under-active thyroid) one need to be aware that certain food can affect the function and absorption of thyroid hormone. Good luck READ MORE
Does Hashimoto's disease cause hair loss?
Hashimotos thyroiditis is an autoimmune disease that damages the thyroid gland. It usually startes after the age of 5 years. It is more common in the older population. In children, the incidence rate of Hashimotos thyroiditis is about 1.5% per year while in adults it is about 3.5%. Hasimatos thyroiditis is an autoimmune destruction of the thyroid gland. This may lead to inadequate production of thyroid hormone, leading to hypothyroidism. This is not always true. You can have hashimatos thyroiditis but not develop hypothyroidism, though, hashimatos thyroiditis is the commmonest cause of hypothyriodism in the USA. Hashimotos thyroditis affects about 2% of the USA population. Hashimotos thyroiditis can affect many organs of the body with or without hypothyroidism. It can cause hives, encephalitis, encephalopathy, malaise, fatigue, brain fog, body aches, joint pain, muscle pain, low grade fevers, cold intolerance, hair loss etc. Hashimatos thyroiditis with or without causing hypothyroidism can lead to the above mentioned symptoms including hair loss. Hashimatos thyroiditis may or may not cause hypothyroidis and hypothyroidism can occur independent of hashimatos thyroiditis (without autoimmune process). Good Luck READ MORE
How do you keep your thyroid healthy?
Thyroid health and Thyroid disorders: The thyroid gland is a small but a vital gland at the base of the neck, below the adams apple. It is responsible for energy production, metabolism, mood, growth and development. It also supports brain development and cardiovascular health. In children the the thyroid gland is at various sizes becuase children are going through a process of growth and development. In adults the thyroid gland measures about 4-6 cm . It weighs about 20 grams. If it gets larger, the thyroid gland, becomes a goiter. It may also develop a nodule or multiple nodules. The thyroid gland may be normal, under-active or over active. The thyroid gland produces three major hormones namely thyroxine (T4), triiodothyronine (T3), and calcitonine. If your thyroid gland does not make these hormones especially T3 and T4 you may develop a codition called hypothyroidism (low thyroid hormone) and when the thyroid makes excess of these hormones (over active thyroid) a codition called thyrotoxicosis or hyperthyroidism sets in. Calcitonin suppots bone health. In hypothyroidism (under active thyroid) the person may experience the symptoms of sadness, weight gain, poor energy level, dry skin, constipation, hair loss and fatigue. When the thyroid gland is over active, the person may experience, weight loss, fatigue, palpitations, heat intolerance, excessive sweating, irritability, frequent bowel movement and insomnia. The thyroid function test is a necessary blood test in the evaluation of the status of the the thyroid gland, in the production of the thyroid hormones. This test will determine whether the thyroid gland is working well or not. Based on the thyroid function test, further work up may be performed to pin point the cause of thyroid disorder (low or high thyroid hormone). The further work up may include blood work for iodine and various antibodies or imaging studies such as Ultrasound or uptake and scan of the thyroid gland. When thyroid gland is functioning abnormally, the cause should be evaluated and treated properly by and expert. When some one is on thyroid treatment especially hypothyroid ( under-active thyroid) one need to be aware that certain food can affect the function and absorption of thyroid hormone. Soy products (isoflavones) such as miso and tofu can interfere with thyroid hormone absorption. Calcium products and Multivitamins can also affect thyroid hormone if they are taken within 2 hours of thyroid medication. Cruciferous vegetables ( goitrogens) such as cabbage, broccoli and cauliflower can affect thyroid function especially with people who have iodine deficiency. Gluten found in Rye, barely and wheat can also interfere with thyroid function. Excessive ingestion of high fiber food, high sugar intake, fatty foods and processed foods will negatively affect thyroid function especially in hypothyroid persons. Everything should be consumed in moderation. Eating healthy diet with daily (regular) physical activity and maintaining ideal weight should improve thyroid health. A healthy person who consumes balanced foods with regular physical activity and who maintains ideal body weight, should not worry about all the above mentioned food, which may negatively affect the thyroid function. Good Luck. READ MORE
What is the best food to eat when your blood sugar is low?
Hypoglycemia (low blood sugars) and foods to eat. Hypoglycemia is a metabolic state where blood sugars are below normal range. It is usually defined as blood sugar less than 70 mg/dl. The average fasting blood sugars are 70-100mg/dl. Fasting blood sugars above 100mg/dl is abnormal with people without the history of diabetes. Low blood sugars is defined as hypoglyceia, while high blood sugar is a sign of some form of diabetes. Both forms of blood sugars extremes have short term and long term consequences. The symptoms of low blood sugars are primarily due to the hormones invoved in correcting the low blood sugar. Adrenalin cuases most of the symptoms of the early signs and symptoms of hypoglycemia. Other hormones involved in the correction of the low blood sugars are glucagon, cortisol and growth hormone. Glucagon is involved in the immediate release of sugars from the glucose storages (mainly the liver). The symptoms of low blood sugars are mainly adrenergic (neurogenic) symptom. Nueroglycopenic symptoms may also occur in sever or prolonged hypoglycemia when the brain lack glucose. 1. Adrenergic (neurogenic or sympathoadrenal activation) symptoms result from activation of the adrenergic (sympathetic) nervous system, primarily mediated by adrenalin. Adrenergic symptoms include: -Shakiness -Nervous or anxious -Sweating -Clamminess -Irritability -Impatience -Palpitation -Confusion -Lightheaded -Dizzyiness -Hunger -Nausea -Fatigue -Skin pallor 2. Nueroglycopenic symptomes are secondary to shotage of sugar in the brain due to hypoglycemia. -Abnormal mentation -poor judgement -Irritability/rage -Crying -Emotional lability -Slurred speech -Stuper/loss of consciousness -Siezures -Coma -Death Hypoglycemia or low blood sugars have various causes. Theses causes include: A. In diabetic patients; Both type 1 and type 2 diabetic patients may experience symptoms of low blood sugars. Type 2 diabetetic patients can experience syptoms os low blood sugars is they are on medications primarily oral hypoglycemic agens such as glipizide and glyburide. This may happen when the dose of insulin is too much or they are not eating enough carbohydrates to mactch the amount of insulin taken. In type 1 diabetes low blood sugars are either due to excess insulin, eating less than usual amount of food or skipped meals or exercising more than usual. B. In none diabetic patients 1. Medications. Taking blood sugar lowering medications that are intended for a diabetic patient (sulfonylurease). There are also medications intended for a different condition but who have side effects of hypoglycemia. These medications may include medications for blood pressure, malaria etc. 3. Illnesses. These include; -Adrenal insufficiency -Celiac disease -Liver disease -Kidney disease 4. Ketotic hypoglycemia; This condition ocurs; -In some skinny people who have less glycogen reserve -During prolonged starvation -Eating disorder (anorexia nervosa) -Valley dancers -Gymnasts -People exercising excessively 5. Hormone deficiencies. -Adrenal insuficiency -Pituitary hormone deficiency (growth hormone or cortisol deficiency) 6.Hypoglycemia due to Reactive Hypoglycemia (post prandial hypoglycemia); -This hypoglycemia occurs several hours after eating a meal due more insulin production than the body needed. -In dumping syndrome 7. Hypoglycemia due to metabolic diorders; many metabolic disorderes such as; -Glycogen storage diseases -Fatty acid oxidation disorder -Aminoacid disorders (amino acidopathies) 8. Hypoglycemia due to Insulin overproduction. This could be due to; -Insulin producing tumors known as insulinomas (mostly in adults) -Genetic defects in the pancreatic Beta cell potassium channels, calcium chanels, and others (mostly start in infancy) -Enlarged beta cells of the pancreas known as nesidioblastosis (mostly in babies). Low blood sugars secondary to insulin should follow a syndrome called whipple triad which consists of symptoms of low blood sugars, low blood sugars at the time of the symptom and improvement of the symptoms with the correction of low blood sugars. Consequencies of hypoglycemia; Hypoglycemia of any cause should never be taken lightly. Blood sugars should be kept >70mg/dl at all times.Our brain depends primarily on normal glucose level. In the absence of normal glucose the brain will suffer more than any tissue in the human body. Early recognition of the signs and symptoms of low blood sugar and prompt treament is vital to preventing life threatening injuries.If hypoglycemia is not recognized and treated early and proptly, it can lead to seizures, falls, injuries, accidents and even death. Causes of hypoglycemia should be investigated properly and be treated promptly. Proper measures should be taken to prevent the ocurrence of hypoglycemia if the cause can not be fixed. Going back to to you: You are experiencing low blood sugars. You are probably experiencing the full range of the signs and symptoms of hypoglycemia. There are many causes of low blood sugars. If you have diabetes and you are on either oral anti-diabetes medications or on some form of insulin regimen, the medications should be adjusted or the amount of food consumed should match the amount of insulin taken at each meal. If you are excerscing excessively, insulin should be lowere appropraitely or apropraite amount of food should be consumed to prevent the occurence of hypoglycemia. If you have no diabetes, the causes of hypoglycemia should be investigated thoroughly. Once the cause/causes are identified treatment plan should be hammered out. The best option in preventing hypoglycemia should be eliminating the cause of the hypoglycemia completely. If eliminating the cause is not possible, reasonable treatment plan should be worked out to keep the blood sugars >70mg/dl at all times to prevent acute and chronic complications of hypoglycemia. If you are experiencing the signs and syptoms of low blood sugar, the first step is to check your blood sugars (using home self monitoring blood glucose machine) to make sure you really have low blood sugars and not other medical or hormonal conditions. If the syptoms are due to low blood sugars you should take sugar drinks to keep the blood sugars >70mg/dl at all time using fast acting sugars such as juice or milk. You should seek help from your primary care doctor first. He/She will perform proper evaluation and will determine if you need to see an endocrinologist for further evaluation and treatment of the hypoglycemia. If you keep on experiencing the signs and syptoms of hypoglycemia, whether you truly have low blood sugars or other medical problems, you need proper and prompt evaluation by your primary care doctor who will determine the next appropraite steps. Ignoring signs and symptoms of low blood sugars with or without the actual low blood sugar will be a mistake. The foods that are helpful in managing low blood sugars depend on what the level of the blood sugars are. If your blood sugar is 70-80 mg/d you may take crackers and peanut butter or any form of starch which will gradually raise your blood sugar. if your blood sugar If your blood sugar is 55-70 mg/d, you can take raisins, medjool dates, applesauce, bananas, grapes, pineapple etc. These have some fibers but will allow the blood sugar to rise quickly. If your blood sugar is less than 55 mg/dL you should use 100% grape juice, honey, maple syrup etc that will raise your blood sugars much faster. Good Luck further reading references; 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991551/ 2. https://emedicine.medscape.com/article/122122-clinical 3. https://www.lifeextension.com/Protocols/Metabolic-Health/Hypoglycemia/Page-04 4. https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/diabetes-mellitus-dm-and-disorders-of-blood-sugar-metabolism/hypoglycemia 5. https://www.healthline.com/health/hypoglycemia READ MORE
What is the difference between Hashimoto's disease and hypothyroidism?
Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone. Thyroid hormone deficiency can lead to poor growth, low energy level, fatigue, dry skin, constipation, irregular periods, weight gain, cold intolerance, hair loss, joint pain, poor memory, depression etcetera. In America it is mostly caused by an autoimmune process called Hashimatos thyroiditis. Hashimotos thyroiditis is an autoimmune disease that damages the thyroid gland. It usually startes after the age of 5 years. It is more common in the older population. In children, the incidence rate of Hashimotos thyroiditis is about 1.5% per year while in adults it is about 3.5%. Hasimatos thyroiditis is an autoimmune destruction of the thyroid gland. This may lead to inadequate production of thyroid hormone, leading to hypothyroidism. This is not always true. You can have hashimatos thyroiditis but not develop hypothyroidism, though, hashimatos thyroiditis is the commmonest cause of hypothyriodism in the USA. Hashimotos thyroditis affects about 2% of the USA population. Hashimotos thyroiditis can affect many organs of the body with or without hypothyroidism. It can cause hives, encephalitis, encephalopathy, malaise, fatigue, brain fog, body aches, joint pain, muscle pain, low grade fevers, cold intolerance etc. There are also other caused of hypothyroid such as iodine deficiency (the commonest cause in 3rd world countries), after surgical removal or ablation of the thyroid for various reasons, hypopitiutarism, pregnancy, medications, congenital thyroid problems, etcetera. Hypothyroidism can emerge slowly from few months to many years. The prevalence of hypothyroidism is about 5% of the USA population. About 12% of the USA population have thyroud disorders with or without hypothyroidism such as goite, thyroid nodules, thyroid cysts, thyroid neoplasia etc. Hypothyroidism is more common in females than males and is more common in the older age. If frank hypothyroidism is left untreated it can lead to growth failure, abnormal period, heart problems, depression, chronic fatigue, joint pain, hair loss and many other medical issues including death. Hashimatos thyroiditis with or without causing hypothyroidism can lead to the above mentioned symptoms as well. Hashimatos thyroiditis may or may not cause hypothyroidis and hypothyroidism can occur independent of hashimatos thyroiditis without autoimmune process. The symptoms of hypothyroidism and hashimatos thyroiditis should be treated well. Even though some hypothyroid patients may go in to remission after some time, the true hypothyroid patients need to be treated life time. Treatment is essential to maintain a healthy body and prevent the above mentioned complications. Good Luck READ MORE
What happens if hypothyroidism is left untreated?
Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone. Thyroid hormone deficiency can lead to poor growth, low energy level, fatigue, dry skin, constipation, irregular periods, weight gain, cold intolerance, hair loss, joint pain, poor memory, depression etcetera. In America it is mostly caused by an autoimmune process called Hashimatos thyroiditis. There are also other caused of hypothyroid such as iodine deficiency, after surgical removal or ablation of the thyroid for various reasons, hypopitiutarism, pregnancy, medications, congenital thyroid problems, etcetera. Hypothyroidism can emerge slowly from few months to many years. Hypothyroidism is more common in females than males and is more common in the older age. If frank hypothyroidism is left untreated it can lead to growth failure, abnormal period, heart problems, depression, chronic fatigue, joint pain, hair loss and many other medical issues including death. Even though some hypothyroid patients may go in to remission after some time, the true hypothyroid patients need to be treated life time. Treatment is essential to maintain a healthy body and prevent the above mentioned complications. Good Luck. READ MORE
How to help a child with type 1 diabetes?
Type 1 diabetes is the commonest metabolic disorder and the second commonest chronic disease of childhood. About 90% of type 1 diabetes (type A) is an autoimmune disease were as the 10% is idiopathic type 1 diabetes (type B). There are about 200,000 children with type 1 diabetes in America. It is increasing by about 3% annually. It will triple in the next 30 years to 600,000 children in America, with an incidence rate of about 20,000 newly diagnosed type 1 diabetes children in America. Type 1 diabetes is a constand challenge that reguires balancing of insulin injections, physical activity and food consumption especialy the carbohydrates. Even under best circustances blood sugar levels can out of the desired range. Even though this may lead to frustration, you can still find success by balancing your insulin needs, and adhering to your daily exercise routine and meal plan. Once type 1 diabetes shows up in your life, overcome the challenges by seeking help from any one who is in a position to help. The following are some of the resources. 1) Your family; you need them for support 2) Caregivers; You will need them for support and help you manage the diabetes at least untill you are comfortable to manage the diabetes on your oun. 3) Any one who lives with type 1 diabetes with good experience and who is willing to help. 4) Your Doctor. feel free to ask the doctor of his diabetes staff to get all the resources you want. The team will be very helpful not only to educate you but to give you enough resources. 5) Your diabetes educators. The diabetes educators will be very helpful not only for education but also to guide you where to get the resources. 6) Dieticians: They will guide you about nutritional resources better than any one. 7) Look on online diabetes educational materials and resources such as the websites by various diabetes centers in America Including the Joseline diabetes center, Barbra Davis diabetes center, stanford diabetes center, UCSF diabetes center and many other centers.. 8) American Diabetes Association type 1 resources page. 9) NIH clincal tools and patient education resources. 10) Juvenile diabetes resources center 12) Type 1 diabetes TrialNet; These people conduct prevention studies. Type 1 diabetes is a life long disease until a cure is discovered. It should be managed well with insulin diet and regular physical activity. Good luck READ MORE
How to calm a child through blood work?
Trypanophobia or Needle Phobia. Fear is a perception of danger. It is one of the primitive reflexes used by humans either to confront or flee from the danger. Most fears have rational bases while some fears are irrational. When the fear is irrational it becomes a phobia. Phobias can be specific like to sharp objects, such as hypodermic needles and surgical instruments (Trypanophobia or needle phobia) or generalized. Phobias can have genetic bases or can be acquired after traumatic events. Most phobias may stem from traumatic experience such as skin puncture by a needle (needle phobia). About 20% of Americans do not like needles or sharp objects. About 10% have some degree of needle phobia. Of the people with needle phobia about 20% will go to extreme to avoid any medical procedures or doctor visits even though they may be in a bad situation. Needle phobia is therefore very real in many children and may be a source of stress and avoidance of doctor visits. Needle phobias can be managed by various ways; 1) Cognitive behavioral therapy; is effective treatment of phobia. The technic involves systemic desensitization using various degrees of exposure to the needle to eventually tolerate the needle injections. Initially they get exposed to the plastic syringe with out the needle, and slowly with the syringe and the needle on it, and eventually they practice with needle injections. 2) Use of skin numbing creams such as EMLA cream, Syneral patch, Ametop gel etc are very helpful. 3) Use of freezing agents such as Ethyl chloride spray to provide superficial skin pain is also helpful. 4) Laughing Gas can also be used with some success in some conditions. 5) Sedating agents such as Xanax, Valium, Ativan, and klonapinn can be used with good succes. Between 0.5 to 1 mg of these sedating agens can be administered 1 hour before the procedure to calm down the person. 6) In the worst case scenarios general anesthesia can be used to perform certain procedure. If your son has extreme needle phobia seeing a psychologist for cognitive behavioral therapy through systemic desensitization technics will be a good choice followed by use of local anesthetic creams. The sedating agents mentioned above could also be used. Good Luck. READ MORE
What are the early signs of diabetes?
Diabetes is a common metabolic disorder. It is caused by either insulin deficiency or insulin resistance. Most children will have type 1 diabetes which is a state of absolute insulin deficiency. It is mainly an autoimmune process where by insulin producing cells called beta cells are destroyed in the process. It is more common in the Caucasian children. Type 2 diabetes is also becoming more common in children due to the epidemics of obesity which results in insulin resistance. The incidence of type 2 diabetes is more common in the minority population than the caucasian population. Diabetes (type 1 and type 2) can be diagnosed clinically and biochemically. 1) Any person with symptoms of excessive urination, excessive thirsty, bed wetting, nocturia, weight loss and abnormal blood sugars above 200mg/dl have diabetes unless proven otherwise. 2) Any random blood sugar greater than 200 mg/dl at more than one occasion. 3) Any fasting blood sugar (at least after 8 hrs. fasting) >126 mg/dl at more than one occasion. 4) Any blood sugar >200 mg/dl on more than one occasion using the 2 hour standard glucola test of 75 gm. ( 1.75 mg/kg up to 75 grams) performed after 8 hours of fasting on more than one occasion. 5) Hemoglobin A1c greater or equal to 6.5% Another entity call a prediabetes state can also be established using blood sugar reference ranges if the individual is at risk for diabetes. Biochemically, a prediabetes state can be established as follows: 1) Fasting blood sugars between 99-126mg/dl at least in more than one occasion. 2) Blood sugars between 140-200 mg/dl in the standard 2 hour glucola test on more than one occasion. 3) Hemoglobin A1c between 5.7-6.4% The earlies signs of diabetes for both type 1 and type 2, are therefore; (biochemical markers) such as, abnormal blood sugars and abnormal hemoglobin A1c, followed by clinical signs, such as, excessive drinking, excessive urination, bed wetting, nocturia, weight loss etc. Again the first one to be abnormal are the biochemical markers before the emergence of the clinical signs and symptoms.` If you suspect your daughter has symptoms of diabetes or if she is at high risk for diabetes, you should check her blood sugars fasting and random (if you have access to glucometer). If you get >200mg/dl persistently with or with out frank symptoms of diabetes, you may take her to her doctor promptly. If you do not get high blood sugars you may be dealing with other conditions that share similar symptoms. If you do not have an access to glucometer and you suspect diabetes you should take her to her doctor or to the emergency room. Good luck. READ MORE
How long does a person live with type 1 diabetes?
What's the life expectancy of a child with type 1 diabetes? Type 1 diabetes is the commonest metabolic disorder and the second commonest chronic disease of childhood. About 90% of type 1 diabetes (type A) is an autoimmune disease were as the 10% is idiopathic type 1 diabetes (type B). There are about 200,000 children with type 1 diabetes in America. It is increasing by about 3% annually. It will triple in the next 30 years to 600,000 children in America, with an incidence rate of about 20,000 newly diagnosed type 1 diabetes children in America. Type 1 diabetes is based on genetic susceptibly and strong environmental triggers. Genetic susceptibility is conferred by about 40 genes. About 50% of genetic susceptibility is conferred by a gene that control the a Major histocompatibity ll molecule (MHC ll) also known as human leukocyte antigen (HLA). When insulin was discovered in 1921 it was made commercially available globally in a short period of time. Before the discovery of insulin type 1 diabetes was managed by carbohydrate restriction (literally starvation therapy). The life expectancy was only few weeks to few months and some survived up to 3 years with starvation therapy. But thy literally died slowly as emaciated ghosts. After the introduction of insulin a disease that was a death sentence (terminal illness) became a disease with grave acute and chronic complications. The life expectance however was improved dramatically. In the early years of insulin therapy acute complications from severe hypoglycemia were very common cause of death. Dehydration from hyperglycemia, and diabetes acidosis and diabetes coma were also common cause of death. Chronic complications such as eye disease, kidney disease, nerve disease and cardiovascular disease (heat disease, heart attack, stroke and arterial diseases) start to develop in 10-15 years after diagnosis. These diabetes related comorbidities became the commonest killers of type 1 diabetes in the 1950's. Due to these acute and chronic complications the life expectancy of type 1 diabetics was much shorter. In the 1950's and 1960's (i.e 20-30 years after the introduction of insulin about 35% of patients with type 1 diabetes died of diabetes related complications. There were about 90% eye disease, 25% kidney disease, over 40% cardiovascular disease. Over 12% of blindness in America was from diabetes. In the first 20-30 years after insulin production the insulin was crude as it have so much impurities. It caused more side effects such as skin atrophies and very erratic blood sugars. different short acting, intermediate acting and long acting insulin were advanced, though they have impurities. However as our understanding diabetes, insulin and much more technological advances were made mortality from acute and chronic complications start to slow down. In 1972 blood sugar testing glucometer was commercially available in the hospital setting and in 1982 self blood sugar monitors were commercially available for patients. The 1980's saw one of the greatest technological advancement. Pure Human insulin was synthesized and was made commercially available. Both short acting and long acting insulin became pure and less immunogenic with the human insulin. Diabetics start to monitor their blood sugars at home as often as they need and glycemic control improved much better leading to less complications and longer life expectancy. Insulin pumps, blood sugar sensors and various advanced blood glucose monitors made management of diabetes much better and brought better quality of life and the life expectancy got longer. A large multicenter trail called the DCCT trail conducted between 1983-1993 demonstrated that tight glycemic control lowered all forms of chronic complications by almost 40% (eye disease, kidney disease, and Cardiovascular disease) These was done in over 1400 type 1 diabetic patients over a span of 10 years. This was a great paradigm shift in the management of diabetes that intensification of insulin in type 1 diabetes showed great improvement in all forms of chronic complications of diabetes. Today intensive insulin therapy using fast acting and long acting insulin or insulin pumps with frequent blood sugar monitoring or using sensors has become a standard of care. And as such, chronic and acute complications of diabetes are much lower than the 1970-1990. The quality of life and life expectancy have dramatically improved though there is about 3-4 fold more risk of dying from diabetes related complications compared to the general population. The commonest cause of death for type 1 diabetes are from complications of diabetes such as high cholesterol(cardiovascular disease), inflammation, metabolic syndrome, hypertension, endothelial dysfunction oxidative stress, metabolic syndrome and Advanced glycation end products from chronic hyperglycemia leading to cardiovascular disease, kidney disease eye disease and nerve disease. Without this complications life expectance with well controlled diabetes would be close to the normal population. Out of all the comorbidities the commonest cause of death in diabetes is heart disease. Currently the mortality rate of type 1 diabetes is about 7% in 25 years of having diabetes. So the over all life expectancy of a diabetic patient is about 13 years shorter for women and 11 years shorter for men. Patients diagnosed with type 1 diabetes have shorter life expectancy than type 2 diabetes, because type 2 diabetes is mostly diagnosed in later years and their comorbidities (HTN, dyslipidemia, metabolic syndrome, inflammation) are treated earlier, though, it is not fare to compare both of them because both suffer all the complications of diabetes. Some studies show that type 2 diabetes have a bout 10 years shorter life expectance and type 1 about 20 years shorter. The Canadian study puts the average life expectancy about 55 years. In the USA the average life expectancy for a woman with diabetes is 68 years (13 years shorter) Vs. 81 years and for men 66 years (11 years shorter) vs. 77 years. In children the younger the age of diagnoses the shorter the life span is. If a person is diagnosed before the age of 10 years the life expectancy is shorter by 14 for boys and 18 years for girls. If it is greater than the age of 14 years the life expectancy is higher lower than diagnosed in their 20's or 30's because they have more exposure to hyperglycemia that causes glycemic load leading to inflammation, HTN, heart disease , kidney disease, eye disease, nerve disease and metabolic syndrome. Diabetic patients would have life expectancy if they would maintain good glycemic control and prevent the comorbidities or aggressively treat them early. However 50% are non-complaint and only 30% of diabetic patients have good glycemic control. Most type 1 diabetic patients do not get treated for the most of the comorbidities and that is why they develop more chronic complications. Before the age of 40years acute complications are the commonest cause of death in type 1 diabetes. After the age of 40 years chronic complications are more common cause of death. Poorly controlled diabetics have persistent hyperglycemia. Hyperglycemia overtime causes elevation in advanced glycation end products (AGE). Glucose reacts with proteins, fats and nucleic acids to form glycated products. When excess glycated products are produced they can advance to become oxidizing agent that free radicals and reactive oxygen species. These AGE can cause alteration in cell receptors, cause inflammation (through releasing inflammatory cytokines) and denature proteins and disrupt cell function. They cause faster aging and dyslipidemia, atherosclerosis heart disease, HTN, kidney and eye disease, degenerative diseases, through their oxidative stress. These can lead to shortened life expectancy. Children with early onset diabetes especially before the age of 10 years will spend may years with more glycemic load. This glycemic load leads to metabolic or oxidative stress through the formation of AGE. This leads to chronic complications of diabetes intern increasing morbidity and mortality. life expectancy will be expected to shorten by about 10-16 years in those with history of poor glycemic control and genetic susceptibility to develop chronic complications. Therefore good glycemic control can avoid complications of diabetes. This can lead into a healthy long life with normal life expectancy. Longevity could be achieved by: Eating healthy balance diet Obtaining good glycemic control Regular doctor visit Exercise regularly Avoid stress Sleep well Check HbA1C regularly Remember that diabetics die not because they have diabetes but they die from diabetes related complication such as heart disease (cardiovascular disease), kidney disease, HTN, chronic inflammation to leads to atherosclerosis. Preventing or treating these early enough will prolong life expectancy. Going back to your friend. I am assuming your friend was diagnosed with type 1 diabetes as a child. Your friend should check her/his blood glucose as often as necessary without additional stress. She/he needs to get her/his insulin appropriate to the food eaten and correct blood sugars that are out of range without causing hypoglycemia. Maintain blood sugars between 70-140 about 75% of the time. Maintain HA1c <7.5%. Let her/him exercise regularly. She/he needs to eat healthy and balanced diet. Maintain ideal weight if possible. She/he needs to have regular check up for HBA1c, urine microalbumine, let her/him get regular eye exam and lipid profile should be monitored on regular basis. Any comorbidities such as high lipids, HTN, nerve disease and urine microalbumine should be treated early and aggressively. If she/he maintains good glycemic control until there is a cure she/he should be able to enjoy a happy normal life with normal longevity comparable to the general population. But if the glycemic control is poor and the comorbidities are not prevented or not treated early and aggressively the life expectancy with diabetes from the age of 10 years is about 14-18 years shorter than average. However this is a statistical probability (relative risk not an absolute risk) since she/he may not have any complications at this time and therefore may not develop them in the future. The most important issue right now is to take good care of her/his diabetes and maintain good glycemic control and not worry about (statistical probability) future complications since we would not know for sure if she/she will develop complications of diabetes that will cut her/his life expectancy shorter. She/he should enjoy normal life with normal life expectancy as long as she/he is in good glycemic control. He/she should work with his/he doctor closely, and utilize any of the available diabetes gadgets including insulin pumps and blood glucose sensors, if you are comfortable using them. He/she should also remain hopeful that a cure may be on horizon soon. Until then a good glycemic control is the rule of the thumb. Good Luck READ MORE
How is diabetes diagnosed in children?
Diabetes is a common metabolic disorder. It is caused by either insulin deficiency or insulin resistance. Most children will have type 1 diabetes which is a state of absolute insulin deficiency. It is mainly an autoimmune process where by insulin producing cells called beta cells are destroyed in the process. Diabetes can be diagnosed clinically and biochemically. 1) Any person with symptoms of excessive urination, excessive thirsty, bed wetting, weight loss and abnormal blood sugars above 200mg/dl have diabetes unless proven otherwise. 2) Any random blood sugar greater than 200 mg/dl at more than one occasion. 3) Any fasting blood sugar (at least after 8 hrs. fasting) >126 mg/dl at more than one occasion. 4) Any blood sugar >200 mg/dl on more than one occasion using the 2 hour standard glucola test of 75 gm. ( 1.75 mg/kg up to 75 grams) performed after 8 hours of fasting on more than one occasion. 5) Hemoglobin A1c greater or equal to 6.5% Another entity call a prediabetes state can also be established using blood sugar reference ranges if the individual is at risk for diabetes. Biochemically, a prediabetes state can be established as follows: 1) Fasting blood sugars between 99-126mg/dl at least in more than one occasion. 2) Blood sugars between 140-200 mg/dl in the standard 2 hour glucola test on more than one occasion. 3) Hemoglobin A1c between 5.7-6.4% Gestational diabetes has slightly deferent reference ranges than the above classification. If you suspect your son has symptoms of diabetes or if he is at high risk for diabetes, you should check his blood sugars fasting and random (if you have access to glucometer). If you get >200mg/dl persistently with or with out frank symptoms of diabetes, you may take him to his doctor promptly. If you do not get high blood sugars you may be dealing with other conditions that share similar symptoms. If you do not have an access to glucometer and you suspect diabetes you should take him to his doctor or to the emergency room. Good luck. READ MORE
How is hypothyroidism detected in children?
Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone. Thyroid hormone deficiency can lead to poor growth, low energy level, fatigue, dry skin, constipation, irregular periods, weight gain, cold intolerance, hair loss, joint pain, poor memory, depression etcetera. In America it is mostly caused by an autoimmune process called Hashimatos thyroiditis. There are also other caused of hypothyroid such as iodine deficiency, after surgical removal or ablation of the thyroid for various reasons, hypopitiutarism, pregnancy, medications, congenital thyroid problems, etcetera. Hypothyroidism can emerge slowly from few months to many years. Hypothyroidism is more common in females than males and is more common in the older age. If hypothyroidism is left untreated it can lead to growth failure, abnormal period, heart problems, depression, chronic fatigue, joint pain, hair loss and many other medical issues. Hypothyroidism can be suspected from clinical presentation. But is mainly diagnosed by laboratory results showing low thyroid hormone levels. An imaging study may be necessary if there is a suspicion of a thyroid nodule/s. However laboratory demonstration of low thyroid hormone level is necessary to establish the diagnosis of hypothyroidism. Hypothyroidism should be treated properly and promptly. Good luck. READ MORE
What doctor do you see for a hormone imbalance?
Hormone disorders and a Pediatric Endocrinologist: Hormones are signaling chemicals produced by glands of the body. They are transported via the systemic circulation to distant target organs to control the physiology and behavior of the body. Some of the important hormones in the human body are; thyroid hormone, growth hormone, progesterone, estrogen, insulin, cortisol, prolactin, testosterone, antidiuretic hormone, parathyroid hormone, etc. The glands that produce hormones are called the endocrine gland. The endocrine glands comprise the endocrine system. The field of the study of the endocrine systems is called Endocrinology. The doctors who manage the endocrine (hormone) disorders are called endocrinologists. There are two kinds of clinical endocrinologists (adult and pediatric endocrinologists). Adult endocrinologists mainly take care of adult patients with hormone disorders while children who have hormone abnormalities are taken care by Pediatric Endocrinologists, though both of them can take care of any endocrine (hormone) disorder. However, since you child is in the pediatric age group, the right doctor to see will be a Pediatric Endocrinologist. Good luck. READ MORE
How to treat a swollen thyroid gland?
The thyroid gland is a small but a vital gland at the base of the neck, below the adams apple. It is responsible for energy production, metabolism, mood, growth and development. It also supports brain development and cardiovascular health. In children the the thyroid gland is at various sizes becuase children are going through a process of growth and development. In adults the thyroid gland measures about 4-6 cm . It weighs about 20 grams. The thyroid gland produces three major hormones namely thyroxine (T4), triiodothyronine (T3), and calcitonine. If your thyroid gland does not make these hormones especially T3 and T4 you may develop a codition called hypothyroidism (low thyroid hormone) and when the thyroid makes excess of these hormones (over active thyroid) a codition called thyrotoxicosis or hyperthyroidism sets in. Calcitonin suppots bone health. In hypothyroidism (under active thyroid) the person may experience the symptoms of sadness, weight gain, poor energy level, dry skin, constipation, hair loss and fatigue. When the thyroid gland is over active, the person may experience, weight loss, fatigue, palpitations, heat intolerance, excessive sweating, irritability, frequent bowel movement and insomnia. The thyroid function test is a necessary blood test in the evaluation of the status of the the thyroid gland, in the production of the thyroid hormones. This test will determine whether the thyroid gland is working well or not. Based on the thyroid function test, further work up may be performed to pin point the cause of thyroid disorder (low or high thyroid hormone). The further work up may include blood work for iodine and various antibodies or imaging studies such as Ultrasound or uptake and scan of the thyroid gland. If the thyroid gland gets larger than normal, it becomes a goiter. It may also contain a nodule or multiple nodules. If there is a lump on the neck (goiter) a thyroid ultrasoud is performed to determine if there is a nodule or nodules. The thyroid gland may have normal, under-active or over active function regardless of the presence of a goiter or nodules. If there is a goiter (thyroid enlargement) and the thyroid gland is functioning properly only a watchful waiting is recommended. But is there is a nodule/s then the size of the nodule and the condition of the nodule should be analysed. If the nodule is >1cm or if there are calcifications or other suspicious characteristics a fine needle aspiration biopsy should be performed to determine for malignancy. If there is malignancy the one side or both sides of the gland should be removed depending on the situation. If the nodules are benign watchful monitoring is recommended. Going back to your son; Your son has a goiter (lump on the neck).Your son could have underactive thyroid, over-active thyroid, or nodule/s regardless of his goiter (lump on the neck). You need to see a pediatric endocrinologist for that. depending on his situation the doctor will decide the proper work ups and diagnostic steps. Once the diagnosis is established the doctor will determine the treatment options.These could be hormonal replacement or treatment with antithyroid agents or surgical intervation. It depends on his thyroid condition. You need to ask your son's doctor for a referal to see a pediatic endocrinologist aroud your area. Good luck. READ MORE
My son's pituitary glands are malfunctioning?
The pituitary gland is a pea-sized gland found at the base of the brain. It is contained within a bony frame work called the sella turcica (the Turkish saddle). It is about 12.5 mm in size and about 0.5 grams in the average adult. It is smaller in children. The pituitary gland is divided in to two portions or lobes. The larger front one is called anterior pituitary (80%) and the back or posterior pituitary is smaller (20%). It produces several important hormones. The anterior pituitary produces 7 or more important hormones. The posterior pituitary gland stores 2 important hormones. The anterior pituitary produces hormones while the posterior pituitary only stores and releases hormones made in the hypothalamus. The anterior and posterior pituitary are connected to the hypothalamus by a bundle of blood vessels and nerve fibers called the pituitary stalk. The anterior pituitary is controlled from hormones of the hypothalamus. The hypothalamic hormones can have stimulatory or inhibitory effect on the pituitary hormones. The posterior pituitary is controlled by hypothalamic nerve fibers. It does not produce hormones. It is only storage of hormones made in the hypothalamus. Pituitary hormones have circadian rhythm. Most hormones are released in pulses every 1-3 hours and may only last up to 20 minutes per pulse. There is also duirenal change in the hormone levels. Most pituitary hormones are high before awakening in the morning and hit nadir just after bed time. The anterior pituitary hormones are: 1) Prolactin (Pr); involved the breasts milk production. It is controlled by dopamine 2) Growth hormone (GH); mainly controls growth and bone health and muscle mass. 3) Adrenocorticotropic hormone ( ACTH); controls the adrenal glands to produce cortisol and androgens. 4) Thyroid-stimulating hormone (TSH); This hormone controls the thyroid gland. It is essential in brain growth, bodies energy and metabolic systems. 5) Follicle-stimulating hormone (FSH); It stimulates ovarian folliculogenesis and testicular spermatogenesis. 6) Luteinizing hormone (LH); Stimulates ovaries to produce estrogen and progesterone and mediates ovulation. In the testis it stimulates production of testosterone. FSH and LH are called gonadotropins. 7) Other hormones such as beta-melanocyte stimulating hormone, enkephalins and endorphins. and ones that inhibit pain sensations ( and and help control the immune system (endorphins). These hormones control skin pigmentation and pain sensation. Posterior pituitary hormones are; 1) Oxytocin; is involved in milk let down (milk ejection from the nipples and helps in uterine contraction during labor to prevent excess bleeding. 2) Vasopressin; also known as antidiuretic hormone controls water loss in the kidneys through the kidneys aquapores in the distal collecting tubes. It maintains blood volume and blood pressure and electrolytes. Abnormalities of the pituitary gland: The pituitary gland could malfunction in many ways: 1) Adenomals or noncancerous tumors. This adenomas can be small <10 mm or large >10mm. They can be functional or non functional. Functional is when they are producing excess of one or more hormone. They can also produce one or more excess hormones and suppress other hormones through mass effect. None functioning adenomas can cause suppression of the function of one or more hormones through their mass effect. Adenomas may also involve in visual problems as they can press on the optic nerve under them. They may cause various degrees of headaches. 2) Suprasellar tumors: can cause pituitary hormone deficiencies, headaches and visual field defects. 3) Leaking or filling of the pituitary gland with cerebrospinal fluid depress the pituitary gland and may cause empty sell syndrome. 4) Congenital anomalies including septooptic dysplasia, hypoplastic pituitary gland can cause pituitary hormone deficiencies. 5) Pituitary apoplexy or bleeding in to the pituitary gland can cause pituitary hormone deficiencies. 6) Ischimia or interruption of blood supply can cause pituitary hormone deficiencies. 7) Infections, abscess, or cysts may cause pituitary hormone deficiencies. 8) Surgical procedures: If surgical procedure of the pituitary is performed for pituitary adenomal, few or all of the pituitary hormones may be abnormal. Diseases of the pituitary hormone Abnormalities: 1) Growth hormone deficiency causes growth failure. 2) Gigantism; due to growth hormone excess in children 3) Acromegaly; causes excess growth in adults 4) Galactorrhea; Milk production in non pregnancy due to excess prolactin. 5) Gynecomastia: overproduction of prolactin may cause enlarged breast tissue in children and adults. 6) Precocious puberty: Early sexual development due to excess gonadotropins (LHand FSH) 7) Delayed puberty low gonadotropins 8) Hypogonadism; due to low gonadotropins 9) Erectile dysfunction; due to low testosterone or gonadotropins 10) infertility; Due to low gonadotropins 11) Amenorrhea: due to gonadotropins 12) Central hypothyroidism: due to low TSH 13) Central diabetes insipidus: due to low antidiuretic hormone 14) Adrenal insufficiency: due to low ACTH. 15) panhypopitiutarism: due to multiple pituitary hormone deficiencies. If the person is suspecting pituitary hormone problems his/her doctor can run simple blood test such as Comprehensive metabolic panel, IGF1, TSH, FT4, LH, FSH, cortisol, estrogen, serum and urine osmolality, prolactin and testosterone. The selection of the test for hormone levels can be determined by the doctor based on the presenting symptoms age and gender of the patient. Imaging studies such as MRI of the pituitary gland can be determined by the doctor as well. Good luck. READ MORE
What is the normal range for blood sugar?
Normal range of blood sugars: Blood sugars are mainly controlled by a hormone called insulin, though, other hormones such as adrenalin, glucagon, cortisol and growth hormone are involved to various extents in the maintainance of normoglycemia. Abnormality in these hormones can lead to either high blood sugars (diabetes) or low blood sugars (hypoglycemia). Abnormal blood sugars can be evaluated by using; 1) Fasting blood sugars 2) Standard glucola 75 grams for adults and 75-100grams for pregnant women 3) Heavy carbohydrate meals Normal blood sugars are defined differently based on wheter it is fasting blood sugar or non fasting blood sugar. When a person with out diabetes fasts for 8 hours the blood sugar should be less than 100mg/dl. On the other hand if the person eats food especially high in carbohydrates or standard glucola, the blood sugars should be less than 140mg/dl at 2 hours after eating a meal or glucola. Three hours after eating a meal a normal person should have blood sugars less than 100mg/dl. In a healthy person an hour after eating a big meal, the blood sugars should not be greater than 180mg/dl. In a non diabetic patient the normal fasting blood sugars are between 70-100mg/dl. Any blood sugar below 70mg/dl is defined as hypoglycemia. And any fasting blood sugar greater than 100mg/dl is defined as hyperglycemia. Fasting blood sugars between 100-125mg/dl are defined prediabetes. Fasting blood sugars greater than 126mg/dl is considered diabetes. We can also measure the status of blood sugars in a non diabetic patient using Hemoglobin A1c. Normal hemoglobin A1c is 4.5-5.6%. HBA1c between 5.7-6.4% is considered prediabetes and greater than 6.5% is demeed diabetes. In diabetic patients HBA1c is used to monitor the progress of the treament of the diabetes while in healthy patients it can be used to diagnose diabetes. Good Luck READ MORE
A 12 year old with lower back pain?
Back Pain: The back is supported by a bony structure call the vertebral column. The vertabral column is made of 33 bones stuctures. The first 24 vertabrae are separated by a discs (cushions) that prevents friction or crashingn and alows flexibility of the bones. The last 9 vertabrae (sacrum and coccyx) are fused with out a disc. The spinal vertebrae houses the spinal nerve (spinal cord) and spinal fliud that baths the these nerves. The back bone (vertebrae) supports the the body above the hips. Any process that would affect this supporting stracture may cuase pain. Back pain is a very common phenomenon. Most back pain are self limitted. Over 50% of children age 10-18 years will have back pain at verious times. Most of these complaints are not serious. And most of the back pain are self limited though they may reoccur from time to time. The most common cause of back pain in children and adolescents are due to muscle strain or sprain of ligaments, most likely due to injury, over use or carrying heavy backpack. Inactivity, poor conditioning and excessive weight gain may contribute to back pain as well. Causes of back pain are; 1. Muscle strain or ligament sprain (non specific) mostly from injuries or stress. 2. spondylosis (bone fracture, spur formation, disc degeneration, disc herniation etc) from injury or stress. These may lead to nerve compression. 3. Spondylolisthesis ( a vertebrae slips forward in to the bone below) 4. Alignment or Postural imbalance (anomalis) such as scoliosis and kyphosis. 5. stenosis of vertebral canal. This restricts nerve and causes nerve pain. 6. Ankylosis or anchilosing spondylitis ( fusion of vertebrae from inflamation such as arthritis. 7. Various cancers or tumors that either originate or spread to the spinal vertebrae. 8. Congenital or hematologis disorders. Most back pain are not serious. They will improve with; 1. Application of heat 2. pain killers 3. Streching and strengthening excercise. 4. By remaining active such as swiming, walking, bicycling etc. 5. Bed rest is not a solution unless there is a serious back pain such as fractures 6. Always movement is the solution Signs of serious back pain 1.Persistent and prolonged back pain 2. Night pain that awakens you from sleep 3. persistent back pain in very young children 4.Generalized sickness 5. Fever, chills or malaise 6. Unexplained weight loss. 7. Weakness 8. Leg pain, tingling sensation or extremity numbness. The above symptoms should be considered serious and a medical help should be sought proptly. A bed rest is recommended on these instances until a medical professional determines the best treatment options. There are few ways or tests to determine the seriousness of the pain or the cause of the pain. 1. Adams forward bending test: The child is standing with his feet together and his knees are straight, and the person bend forward. If the spinal column are curved or the rib cage is asymmetry the test will be cosidered positive. 2. Straight leg raise test: The child will be in a supine position (laying on his back) and the leg is raised will the knee is striaght. Raising the leg while the hip is flexed between 30-70% pain will be felt on the back for the test to be positive. 3. Faber test; lying on supin position the knee if flexed at 90 degree and the hip is pushed and externaly rotated while the pelvic is stabilized with the other hand. The test will be positive if pain is felt buttock, groin or pelvic joint. 4.Trendelenburg test: The child will stand on one legm and the pelvis position is observed. A positive test cosistent with a droping of the other side of the pelvic. Generally in children the majority of pack pain are from musle strain due to injury of stress or postural imbalance. they can be managed as discussed above. Few cases may need medical attention if they show some of the above mentioned worning signs. Going back to your son: Your son is not physically active. That in itself may cause back pain. If he is not active he may be overweight which can cause back pain. It is also possible that your son may be carrying a heavy backpack. These things can contribute to back pain. In the majority of children back pain is not serious and is due to mascle stain or ligamnet sprain due to fall or stress from repetetive activity. These conditions can be managed conservatively with proper physical activity with streching and strengthening activities, pain killers, warm compressors etc. Inactivity is not good to any child. Inactivity can predispose to frequent back pain. Over weight and carrying large backpacks may also cause back pain. Your son should participate in a structured physical activity on regular basis. The recommendation is atleast over an hour a day for 6 days a week of moderate to vigorous physical activity with 10-20 minutes of balance or strength training with each activity. He should maintain healthy weight appropraite for his age and gender. He should not carry large backpack for a prolonged time when he does not have a meaningful sports activity. You should also make sure that he does not have the warning signs of serious back pain such as prologed back pain, fever, unxplained weight loss, leg pain, numbness, tingling senssation or extremity weakness. If he has any of the above warning signs, you should seek immediate medical help. Please discuss these issues with his primary care doctor and get more advice on these issues. Good Luck. READ MORE
Dr. Tseghai Berhe MD's Practice location
HOFFMAN ESTATES, IL 60169Get Direction
Dr. Tseghai Berhe MD's reviews
Write ReviewPatient Experience with Dr. Berhe
Media Releases
Get to know Endocrinologist Dr. Tseghai Berhe, who serves the population of Illinois. Dr. Berhe graduated with his Medical Degree from the Spartan Health Sciences University in Brooklyn, NY, in 2000 giving him nearly two decades of experience in his field. After obtaining his Medical Degree he completed his Pediatrics residency with Howard University Hospital. Wanting to further his training he then completed his Pediatric Endocrinology Fellowship with the National Institute Of Health/Bethesda Graduate Medical Education. Dr. Berhe is dual certified in pediatrics and Pediatric Endocrinology by the American Board of Pediatrics. He currently practices as a Endocrinologist within his private practice Midwest Pediatric Endocrinology, and remains affiliated with AMITA Health Saint Joseph Medical Center Joliet, Advocate Sherman Hospital, and Provena St Joseph Medical Center. Endocrinology is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. It is also concerned with the integration of developmental events proliferation, growth, and differentiation, and the psychological or behavioral activities of metabolism, growth and development, tissue function, sleep, digestion, respiration, excretion, mood, stress, lactation, movement, reproduction, and sensory perception caused by hormones. Specializations include behavioral endocrinology and comparative endocrinology. The endocrine system consists of several glands, all in different parts of the body, that secrete hormones directly into the blood rather than into a duct system. Hormones have many different functions and modes of action; one hormone may have several effects on different target organs, and, conversely, one target organ may be affected by more than one hormone.
Recommended Articles
![]()
Diabetes vs. Science: Who’s Winning?What Is Diabetes?Diabetes is a serious chronic illness that could affect 552 million people by the year 2030, according to the International Diabetes Federation (IDF). A person suffering from diabetes is at a much greater risk of heart attack, kidney damage, or stroke. Therefore, we are now putting...
![]()
Teenagers with Type 1 Diabetes May Face Body Image ProblemsDiabetes is a disease that affects an estimated one million people or more in the United states alone. It’s a disease that’s characterized by the body’s inability to make, process or use insulin sufficiently. Diabetes can affect just about anyone but there are risk factors that make some more...
![]()
Hypothyroidism: Why Am I Always Exhausted?Hypothyroidism is a common condition in which the thyroid gland is underactive and does not produce enough hormones. These hormones are very important in maintaining the metabolism of the body. Metabolism refers to the process by which cells produce and utilize energy from food. A reduction in the...
![]()
What Is Metabolism?IntroductionMetabolism is a complex biochemical process that is needed to maintain life. Availability of nutrients and nutrition are closely associated with metabolism since metabolism is a process that involves the conversion of food into energy, which is used to fuel the body's cells. The basal...
![]()
Glucose Monitor May Eliminate Need for Finger StickA novel system that has already been approved has a revolutionary technology to monitor blood sugar levels. It works with a small sensor that is placed on the arm of the person being monitored and gives reports minute by minute.Glucose monitoring is something that people with diabetes should do...
![]()
What is Apert Syndrome?Apert syndrome, named after the French physician who described the condition for the first time, is a genetic disorder characterized by several birth defects. Children with this syndrome will have an abnormally developed face and skull. This syndrome is rare and in most cases, it develops even when...
Nearby Providers
![]()
Dr. Kristen Renata Hendrix M.D.1555 BARRINGTON RD HOFFMAN ESTATES IL 60169
Nearest Hospitals
ALEXIAN BROTHERS MEDICAL CENTER 1l
800 W BIESTERFIELD RD ELK GROVE VILLAGE IL 60007ST ALEXIUS MEDICAL CENTERl
1555 N BARRINGTON RD HOFFMAN ESTATES IL 60194