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The body produces a number of chemicals called hormones which are essential for the regulation of various functions including growth and metabolism. These hormones are produced by endocrine glands which are located in various parts of the body. One such important gland is the pituitary gland which produces the important growth hormone. This is essential for regulating optimal growth during the growing years and for maintaining proper amounts of body fat, muscles, and bones in the later years of life.
Causes: Deficiency of the growth hormones can occur due to a number of causes, some of which are listed below. It can be congenital (present at birth) or acquired later in life.
The congenital issue could be due to problem in the pituitary gland structure, leading to complete absence or reduced secretion of the hormone.
With age, there is a decrease in the amount of secretion. However, infections, injuries, brain tumors, surgery and radiation can also lead to altered amounts of secretion.
Symptoms: While growth hormone deficiency can occur at any age, symptoms differ depending on the age when the deficiency sets in.
In the early ages:
- Lower rate of growth for a given age
- Delayed developmental milestones
- Delayed onset of puberty
- Short stature/reduced height
- Younger looking compared to other children their age
- Fat deposition around the waist
- Delayed dental development
When the deficiency sets in during the later years, there is
- Low energy levels, constant tiredness
- Decreased strength
- Decreased exercise tolerance
- Decreased overall muscle mass
- Thin and dry skin
- Increased fat deposition and weight gain around the waist
- Changes in social behavior including alternate cycles of anxiety and depression
- Lack of motivation
- History of pituitary tumors
- High levels of fat and cholesterol
The diagnosis depends on the age of the person
- Blood tests are carried out to check the hormone levels in circulation
- In children, in addition to the hormone levels, x-rays to see the status of growth plates is very helpful.
- An insulin hypoglycemia test where insulin is given intravenously to see the levels of the growth hormone after 30 minutes.
- Total cholesterol levels, low-density lipoprotein (LDL) cholesterol, apolipoprotein B, and triglyceride levels can be used to supplement the above tests.
- CT scan and/or MRI of the brain may be needed if tumors are suspected.
Treatment: Once diagnosed, replacement therapy is given as shots a few times a week under the skin. This restores normal growth and helps in controlling the symptoms in adults too.
In cases of tumor, radiation or surgery may be required, but most cases are managed with hormone replacement.
Watch out for the symptoms if your child has delayed developmental milestones and early intervention can help restore growth and function to normal levels. If you wish to discuss about any specific problem, you can consult an Endocrinologist.
Cushing’s syndrome occurs due to abnormally high levels of the hormone cortisol. This can happen for a variety of reasons. The most common cause is overuse of corticosteroid medications.
Your adrenal glands produce cortisol. It helps with a number of your body’s functions, including:
Regulating blood pressure and the cardiovascular system
Reducing the immune system’s inflammatory response
Converting carbohydrates, fats, and proteins into energy
Balancing the effects of insulin
Responding to stress
Your body may produce high levels of cortisol for a variety of reasons, including:
The most common cause of Cushing’s syndrome is the use of corticosteroid medications, such as prednisone, in high doses for a long period. High doses of injectable steroids for treatment of back pain can also cause this syndrome.
Other causes include:
A pituitary gland tumor in which the pituitary gland releases too much adrenocorticotropic hormone, which is also known as Cushing’s disease
Ectopic ACTH syndrome, which causes tumors that usually occur in the lung, pancreas, thyroid, or thymus gland
An adrenal gland abnormality or tumor
Symptoms of Cushing’s Syndrome:
The most common symptoms of this condition are:
- Weight gain
- Fatty deposits, especially in the midsection, the face and between the shoulders and the upper back (causing a buffalo hump)
- Purple stretch marks on the breasts, arms, abdomen, and thighs
- Thinning skin that bruises easily
- Skin injuries that are slow to heal
- Muscle weakness
- Increased thirst
- Increased urination
- Bone loss
- An increased incidence of infections
Women may also notice extra facial and body hair, as well as absent or irregular menstruation.
Men may also have: