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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Be aware of hormone problems

Dr. Alisa Hideg

When we think of hormones, we often think of menopause, teenage body changes or premenstrual syndrome (PMS). Hormones are chemicals made in the glands (endocrine glands) and organs throughout your body, and they do more than cause acne, moodiness, hair growth and hot flashes.

Hormones affect growth, weight, digestion, bowel function, kidney function, breathing, circulation, body temperature, hunger, thirst, other bodily functions and even how we feel.

Too much or too little of any one hormone you produce can cause problems in areas you might not expect.

Hormone issues can result from damage, tumors or other problems within the brain, a gland or an organ. How the body uses the hormone, an infection or a problem with the hormone the gland is producing can also cause troubles. What we do with our bodies, including diet, exercise, medications and supplements, also makes some hormones go up and down.

For instance, did you know that Type 2 diabetes is the most common hormone problem in the United States and that it is related to other hormone problems?

If you have Type 2 diabetes, your pancreas (an endocrine gland and a digestive organ) may not be producing enough of the hormone insulin and/or the cells of your body have become resistant to insulin’s effects, which makes your pancreas try to pump out more insulin. Insulin’s job is to help glucose (blood sugar) get into cells for energy now and be stored for energy later. If insulin levels are too low or cells are resistant to insulin, more glucose stays in the bloodstream.

Many people show signs of insulin resistance long before they develop full-blown diabetes. Polycystic ovarian syndrome (PCOS) is a hormone problem related to diabetes and insulin resistance.

In PCOS the ovaries make more androgens (male sex hormones) than they normally should, sometimes making a woman’s monthly cycle longer or heavier and causing multiple large cysts to form on the ovaries. Cells in the ovaries are sensitive to the higher insulin levels of people with insulin resistance, which makes the problem worse.

PCOS can cause infertility, acne, heavy or irregular periods, excessive facial hair and difficulty with weight loss. Sometimes young women are advised to go on birth control pills for these symptoms. It is important to find out if the symptoms are caused by PCOS, because insulin resistance, heavy periods and other effects can cause long-term health concerns.

Low testosterone in men happens when the testicles do not produce enough testosterone. This may be because of an issue with the testicles themselves or because the pituitary gland or hypothalamus (parts of your brain with endocrine functions) are not signaling them to produce testosterone.

In boys, low testosterone can cause decreased hair, breast enlargement, muscle loss and sexual problems. In men, low testosterone can cause erectile dysfunction, decreased libido, low energy, muscle loss and weight gain. Low testosterone is common in men who have insulin resistance or obesity.

It is also sometimes seen as a result of thyroid gland dysfunction. Just as in PCOS, it is important to determine the cause of low testosterone and treat the root cause of it rather than just the symptoms. Diet changes and exercise lower insulin and blood sugar levels for people with diabetes and other conditions associated with insulin resistance, but medications may also be recommended.

For many hormones, a small change in levels can cause big changes in how you feel. The thyroid is a small gland on the front of your neck that produces the thyroid hormone. If the gland does not work and there is no hormone replacement, you may feel tired, gain weight, have altered levels of other hormones, lose hair, have a slow heart rate and get muscle cramps.

It becomes more serious the longer it goes on without treatment. These symptoms improve when a small dose of the hormone is taken daily.

Most common hormone problems are easily diagnosed and treated by your primary care provider. However, if your diagnosis is complicated or you need specialized treatment, you may be referred to an endocrinologist, a specialist in hormone issues.

No matter how you are treated, it is important to follow up with your health care provider and follow through on recommendations so you can feel better.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Send your questions and comments to drhideg@ghc.org.