The first hormone I want to mention is the thyroid hormone. The thyroid, found in the middle of the lower part of the neck, is controlled in turn by the pituitary, a master gland found in the brain. The thyroid hormone is responsible for controlling energy, metabolism, and growth. There is a devastating effect on the brain if the newborn’s thyroid does not function. That is why we test for thyroid function in the first week of life. The thyroid can malfunction at any time. Many people think that a low thyroid function results in obesity, but in fact, low energy and cold intolerance are more prominent. There may be some weight gain, but in the absence of other symptoms, obesity is unlikely to be caused by hypothyroidism. Some people make too much of the hormone. They, too, can have fatigue and difficulty concentrating as well as hair loss, anxiety, and frequent bowel movements. 

The pituitary has more functions than just controlling the thyroid. It is also responsible for growth and reproduction through the control of other hormones in the body. Pediatricians regularly monitor growth through growth charts. The change in height and weight as the child gets older is an important clue to the normal function of the pituitary hormone. Of course, the regular evaluation of children’s and young adolescents’ secondary sexual characteristics (changes in genitalia, breast development, body hair) is important for evaluating hormone function. 

The adrenal glands sit on top of the kidneys. “Renal” refers to the kidneys. “Ad,” tells us that the gland is on top of the kidney. What the adrenals do is a little complicated. One hormone regulates salt levels in the blood. One – epinephrine or Adrenaline – helps with blood pressure and the “fight or flight” reaction. The third hormone is the only source of “male” hormones in girls and women. Yes, all body hair that grows during puberty is stimulated by androgens, the “male” hormone. The vastly greater amount in boys leads to facial hair and a more muscular body. Some boys who have a special enzyme will change some of the androgens to estrogen and temporarily develop some breast tissue. 

The last hormone I will mention is insulin, which is made by the pancreas. Insulin is responsible for the control of sugar. There are actually three different diseases that use the word diabetes, and they’re all quite different. Diabetes mellitus is a well-known disorder of pancreatic failure. The cells responsible for making insulin are attacked and destroyed. The inability to make insulin results in symptoms of weight loss, hunger, thirst, and frequent urination. Eventually, the result is coma and death if the insulin isn’t replaced by injection. Type II diabetes is a condition caused by resistance to the effects of insulin. Large numbers of fat cells seem to lead to an inability to control the amount of sugar in the bloodstream. The most effective treatment for type II diabetes is reducing the amount of fat in the body and increasing the ability of the body to control blood sugar. Adding more insulin is generally not useful since the real problem isn’t insulin levels.  The third disease is called diabetes insipidus. The disorder we ordinarily call diabetes (diabetes mellitus) was named because of the frequency of urination. In diabetes insipidus, the only problem is too much urine, but it’s caused by a pituitary hormone that normally controls urine output. 

We’ve barely scratched the surface of hormone diseases. Still, if you are paying attention to the symptoms that we’ve described, you will prevent more serious complications. Remember, your job is to notice that there are problems. Your pediatricians will find out what the problem is and with the help of an endocrinologist, they will find the treatment.  

Robert B. Golenbock, MD, is currently retired. He has cared for children in the Danbury area for 43 years, including at the Center for Pediatric Medicine. The CPM is located at 107 Newtown Rd, #1D, Danbury, CT, 06810. For more information, please call (203) 790-0822 or visit https://centerforpediatricmedct.com.