Endocrinology & Diabetes Q & A

Below are our archive of questions and answers in Endocrinology & Diabetes.

Question 5/16/2002: What is Elevator Palsy? Secondary Thyroid. Blood work Normal on Thyroid. How can the Thyroid cause double vision?
Answer: High or low thyroid levels do not usually cause double vision. One cause of hyperthyroidism (overactive thyroid) called Grave's disease is occasionally associated with swelling of the tissues behind and around the eyes and can cause vision problems, including double vision. It is rare to have the eye problems or Grave's disease with normal thyroid blood tests. NEA Clinic - (870) 935-4150 (for appointment)

Question 4/30/2002: I am an insulin dependent diabetic for 30 years and I just got a hemoglobin A1C done and it was over 8 when I fell I've been doing good and my avg blood sugars have been 120- 190 for the past year. I'm confused? Why the HGCL so high when I thought I was doing so well? What can I do to lower it? I watch my diet and exercise. What's up?
Answer: A HBA1C of 8 is too high. It is now recommended that the A1C be 6.5%. My question for you is how often are you checking you blood sugar and are you testing after meals? A large portion of the A1C is made up of 2-hour post meal blood sugars. I recommend checking before and 2 hours after at least 1 meal per day (a different meal each day). You should always test a fasting blood sugar, too. Yes, you need to be watching you diet, especially the carbohydrates in the diet (not the sugars). Males should not have more than 60gm of Carbs per meal unless they are on adjusted dose insulin. Every food you eat can effect the blood sugar in a different way, so it is a good idea to keep a food record for about a week while testing the before and after meal blood sugars. The other question is what kind of insulin do you take and how often? After doing the above, I would recommend you see a Certified Diabetes Educator, they are trained to look at blood sugars and diet, then! make recommendations based on the findings. You should always keep a log of your blood sugars and take them to your doctor visits with you.
NEA Clinic - (870) 935-4150 (for appointment)

Question 4/26/2002: My son is almost 13. Last night he told me that once when his nipple itched & he scratched it & fluid came out. He showed me what he meant. He squeezed his nipple & clear fluid came out. Is this normal with the onset of puberty? Please let me know as soon as possible because I am somewhat concerned.
Answer: A small amount of breast tissue swelling can be normal in many adolescent boys. This is sometimes accompanied by scant fluid production. If it persists or worsens, a brief exam by his family physician is worthwhile.
NEA Clinic - (870) 935-4150 (for appointment)

Question 4/12/2002: I am a 32-year-old female. I had a hysterectomy and cholecystectomy a few years back. My thyroid was and has been borderline. I now have problems of cold intolerance, forgetfulness, hair loss and thinning, dry skin, irritability, and excessive weight gain with no luck in any shape, fashion or form to get rid of it. I take Celebrex for RA and Asachol for Ulcerative Colitis. Can you be clinically symptomatic of thyroid problems and your blood results within normal limits? If so, what do you do?
Answer: Other serious medical conditions such as those you list can cause somewhat low thyroid levels as a natural response to chronic illness. It is possible but very uncommon to have normal thyroid test but a low thyroid state with symptoms. It would depend on what thyroid tests were performed. Some tests occasionally give misleading results.
NEA Clinic - (870) 935-4150 (for appointment)


Question 3/29/2002: I would like to know all about thyroid problems and what role they play in your body.
Answer: The thyroid gland is the most important gland in the body for metabolism. The thyroid gland produces the energy for the body in a way. The two basic diseases associated with the thyroid gland are Hypothyroidism (not enough thyroid), and Hyperthyroidism (too much thyroid). The symptoms of hypothyroidism include fatigue, weight gain, swelling, cold-intolerance, hoarseness, muscle pain, hair loss, and dry skin. Measuring the thyroid hormone levels plus the thyroid stimulating hormone level produced by the pituitary gland will usually make the diagnosis. Replacing the hormone with synthetic hormones will restore the body levels and reverse the symptoms. Hyperthyroidism on the other hand may show signs of weight loss, fast heartbeats, hypertension, anxiety, tremor, and insomnia. Making this diagnosis requires a thyroid level plus a nuclear scan of the thyroid gland, and often an ultrasound of the gland itself. Depending on the cause of the increased hormone levels, treatment may consist of radioactive iodine, or surgery, or just medications. If you have these types of conditions, you may need to see an internist or an endocrinologist.
NEA Clinic - (870) 935-4150 (for appointment)

Question 2/7/2002: Why isn't there more help for diabetics around this area?
Answer: I'm not sure what kind of help you are looking for, but here are some of the areas of assistance we have in the Jonesboro are. There are several programs available for people with diabetes locally. The NEA Clinic has a Certified Diabetes Educator with information available and St. Bernard's has a Certified Diabetes Educator, as well. The Church Health Center is also available with a wealth of information and has multiple physicians who volunteer their time taking care of patients with diabetes, including our local endocrinologist, Dr. Kevin Ganong. Jonesboro will also be starting our own NEA Diabetes Council, which will be a local organization in which all funds stay in Jonesboro and aide people with limited funds. There is also the American Diabetes Association.
NEA Clinic (870) 935-4150 (for appointment)