Hormone Disorders

MDNG EndocrinologyDecember 2010
Volume 12
Issue 8

//The Educated PatientTM

Growth Disorders

Direct any of your patients struggling with growth disorders to the Hormone Foundation’s growth disorders resource page. Here they make available fact sheets covering acromegaly, idiopathic short stature, growth hormone deficiency in adults, precocious puberty, Turner syndrome, and growth hormone use and abuse. The Foundation also provide a more in-depth look through a 16-page book titled Growth Hormone Issues in Children and Adults. The acromegaly, hormone use and abuse, precocious puberty, and Turner syndrome guides are also available in Spanish.



This medical reference from the University of Maryland Medical Center focuses on the treatment of hirsutism and introduces patients to causes of the disorder, signs and symptoms, risk factors, diagnosis, and treatment. The section on treatment covers both complementary and alternative medicine and hormone therapies such as birth spironolactone and eflorinithine.



Merck Manual of Patient Symptoms: Hirsutism

This discussion of the nature of hirsutism is presented as a conversation between Robert Porter, MD, editor of the Merck Manual Online, and senior assistant editor Justin Kaplan, MD. Over the course of 14 minutes, the two discuss how one can identify hirsutism, the differences between hirsutism and hyertrichosis, an explanation of the biological mechanisms behind hair growth, and more. There is no link to the actual podcast, but all you have to do when you get to the doubleTwist Podcasts page is scroll down about halfway.


//Online CME

Testosterone Deficiency and Men’s Health: A Crucial Connection

Credits: 0.75

Fee: None

Expiration Date: August 17, 2011

Multimedia: None

Authors André T. Guay, MD, Director, Center for Sexual Function/Endocrinology

Lahey Clinic Medical Center, and Martin Miner, MD, Co-director, The Men’s Health Center, The Miriam Hospital, wrote this activity in order to provide clinicians with the ability to better “identify symptoms of male hypogonadism” and “identify comorbid conditions associated with low levels of testosterone,” and do so by reviewing “recent literature,” a case study, and discussing “contemporary treatment and management options.”


Update on the Management of Hirsutism

Credits: 1.00

Fee: None

Expiration Date: May 31, 2011

Multimedia: None

To complete this activity, participants are required to read “Update on the Management of Hirsutism,” published in the June 2010 issue of the Cleveland Clinic Journal of Medicine (no subscription required). The article discusses, among other topics, the prevalence and impact of hirsutism, the effect of circulating androgens on hair follicles, idiopathic hirsutism, polycystic ovary syndrome, and the physical examination.


//Clinical Trials

Tweens to Teens Project at Penn State

Study Type: Observational

Age/Gender Requirements: 10-13 years (female)

Sponsor: Penn State University

Purpose: Penn State researchers are recruiting 300 adolescent girls with 21-hydroxylase deficiency congenital adrenal hyperplasia (CAH) and the “parent, guardian, or significant caretaker of girls with CAH” to complete questions and submit to phone interviews. The girls will “answer questions about activities and interests, school, feelings about being a girl, stage of physical development, and family relationships during a home interview , provide saliva samples, and participate in phone interviews to answer questions about daily activities.” The adult cohort will “complete questionnaires about their daughter's activities, interests, and behaviors, educational goals, family demographics and relationships, grades, diagnosis and treatment of her CAH, their own activities, interests, and thoughts and feelings about being male or female. Parents answer questions during phone interviews about their daughters daily activities..”


In Vitro Maturation for Polycystic Ovary Syndrome

Study Type: Interventional

Age/Gender Requirements: 18-34 years (female)

Sponsor: University Reproductive Associates

Purpose: Researchers will assess “the efficacy and safety of In-Vitro Maturation (IVM) for women with Polycystic Ovarian Syndrome (PCOS).” The primary outcome measure will be the “incidence of biochemical pregnancy (definded as a rising Beta-HCG level),” but researchers will also be looking at the “number of immature oocytes retrieved…rates of maturation and fertilization…incidence of Ovarian Hyperstimulation Syndrome…[and] live births.”


Maternal Hypothyroidism in Pregnancy

Study Type: Observational

Age/Gender Requirements: 17-44 years (female)

Sponsor: Women and Infants Hospital of Rhode Island

Purpose: Researchers are looking to recruit 176 pregnant women to take part in this study which “aims to replace case-finding with a routine blood test that is highly effective at detecting hypothyroidism, thereby allowing treatment to correct the deficiency.” Specifically, researchers wish to identify the percentage of women who develop permanent hypothyroidism and post-partum thyroid dysfunction.



Progesterone Increase Counteracts Aldosterone Action in a Pregnant Woman with Primary Aldosteronism

Journal:Clinical Endocrinology (November 5, 2010)

Authors: Ronconi V, Turchi F, Boscaro M, et al

Purpose: Because “pregnancies in patients with primary aldosteronism (PA) are often characterized by maternal and fetal complications,” the authors felt the need to report on the case of a woman diagnosed with primary aldosteronism who “gave birth to a healthy baby boy” following an “uncomplicated” pregnancy.

Results: After withdrawing “treatment with mineralocorticoid receptor antagonist” the patient was transitioned to “calcium channel blocker and potassium supplementations, with good control of high blood pressure and maintenance of normokalemia…. Despite progressive increase of aldosterone levels, blood pressure decreased to normal values so that she gradually discontinued antihypertensive treatment and continued only potassium supplementations.” The woman’s blood pressure began to rise after delivery and therapy was begun again four days later. The authors posit that “the progesterone/aldosterone ratio could be proposed as a prognostic factor for pregnancy outcome in patients with primary aldosteronism.”


Pharma Focus

Vitamin D


Vitamin D Status, Physical Performance and Body Mass in Patients Surgically Cured for Primary Hyperparathyroidism Compared with Healthy Controls

Journal: Clinical Endocrinology (November 2, 2010)

Authors: Amstrup A, Rejnmark L, Vestergaard P

Purpose: “Low plasma 25-hydroxyvitaminD (25OHD) levels, reduced muscle strength, and increased body mass index (BMI) are well-known characteristics of primary hyperparathyroidism (PHPT).” What is unknown, however, is whether muscle strength increase following surgical cure “corresponds to healthy controls’ performances.”

Results: The authors measured muscle strength via a number of maneuvers including “‘repeated chair stand’, ‘timed up and go’, muscle strength (hand grip, elbow flexion/extension and knee flexion/extension [60°/90°]), postural stability, biochemistry, and anthropometric indices.” They found that “former patients no longer differed from controls after adjustment for BM,” thus it would seem that “25OHD insufficiency is not a constitutional characteristics in patients with PHPT… Whether this is caused by decreased muscle strength or reduced muscular performance causes adiposity needs further investigations.”


Hypoparathyroidism after Total Parathyroidectomy plus Subcutaneous Autotransplantation for Secondary Hyperparathyroidism - Any Side Effects?

Journal: World Journal of Surgery (October 2010)

Authors: Chou F, Chi S, Hsieh K

Purpose: The authors undertook “this retrospective, case—control study… to find side effects of hypoparathyroidism after total parathyroidectomy plus autotransplantation.”

Results: The authors observed that “calcium, phosphate, and iPTH levels decreased significantly 1 week, 3 months, and 1 year after surgery, and Alk-ptase levels increased at 1 week and then decreased significantly 3 months and 1 year after surgery…Hypoparathyroid patients required significantly more calcium carbonate and vitamin D3 than nonhypoparathyroid patients did,” but “do not have any side effects.”


From the Network


TSH — Understanding Thyroid Function Tests

It’s really simple: An elevated TSH indicates an underactive thyroid or under-treated hypothyroid condition. A low, or suppressed, TSH indicates an overactive thyroid, or an over-treated hypothyroid state.


It Looks Like HGH Really Does Improve Performance

Until recently, there has really been no valid research showing whether Human Growth Hormone really helps athletes achieve better performance. New research published in the Annals of Internal Medicine, however, demonstrates that in trained recreational athletes there is a transient improvement in sprint performance in both men and women using HGH.


Pharmacy Times

Understanding and Managing Polycystic Ovarian Syndrome

While much has been learned about PCOS in the past few decades, there is still more to investigate, and increasing awareness about this syndrome is critical to the overall health of the millions afflicted with PCOS.


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