Does your little one have a hormonal problem? Let's talk about a pediatric endocrinologist!

Sometimes when we think about the illnesses our little ones get, especially when they seem a little complicated, we feel a great burden on our hearts, don't we? Hormone-related problems are the same. But there is no need to worry. Because there are specialists who can help you and your child at times like these. That is the kind of person who is a pediatric endocrinologist , or as we say in English, a ``Pediatric Endocrinologist''. So today, let's talk a little more about this specialist.

Who is a Pediatric Endocrinologist?

Simply put, a pediatric hormone specialist is a doctor who diagnoses and treats hormone-related diseases in children and adolescents , that is, problems with the endocrine system. If your child is having problems with puberty , growth problems, conditions like diabetes , or any other condition related to hormones and the glands that produce them, this specialist can help.

So what is this endocrinology?

Endocrinology is the branch of medicine that studies the endocrine system in our body. This system is made up of endocrine glands, endocrine organs, and hormones. Think of it like a special way for our bodies to communicate messages.

Endocrine Glands

These are special tissues in our body that produce hormones and release them into the bloodstream. There are several main types of glands:

• Adrenal glands: These are two small glands located above our kidneys. They produce hormones that respond to stress, as well as hormones that control salt levels.
• Pituitary gland : This small, bone-like gland located just below the brain controls many other glands, so it is sometimes called the "master gland."
• Thyroid : This butterfly-shaped gland located in the front of the neck produces hormones that control the rate at which the body uses energy.
• Parathyroid glands: These four small glands located behind the thyroid gland control the calcium levels in the body.

Endocrine Organs

These organs also produce hormones and perform other specialized functions.

• Pancreas : This organ located in the upper abdomen is linked to diabetes.It produces the hormone insulin .
• Hypothalamus: This part of the brain controls the pituitary gland.
• Ovaries : Part of the female reproductive system that produces sex hormones.
• Testes : Part of the male reproductive system that produces sex hormones.

Hormones

Hormones are like chemical messengers in our bodies. They travel from one gland to another through the bloodstream and affect another target organ or tissue. Hormones affect many important processes in our bodies. Here are a few examples:

• Metabolism : The process by which the body converts food into energy and uses that energy.
• Growth: The way we grow taller and our bodies grow.
• Sexual reproduction : Things like puberty and the ability to reproduce.
• Sleep: Controlling our sleep and wake cycles.

What is the difference between a pediatric hormone specialist and a general hormone specialist?

This is a very important issue. Children are not little people. The way their bodies grow and the way their hormones work are very different from adults. The hormonal problems that children face can also be different from those that adults face. Pediatric hormone specialists are doctors who have received special training in how these hormonal problems relate to children's growth and development. Therefore, they can provide specific treatments for children.

What does a pediatric hormone specialist do? What conditions do they treat?

A pediatric endocrine specialist diagnoses, treats, and manages a variety of conditions that affect a child's endocrine system. Let's take a look at some of these conditions.

Adrenal gland disorders

Our adrenal glands produce many important hormones. Some of the problems that can occur with these glands include:

• Addison's disease: This occurs when the child's body does not produce enough of two hormones, cortisol (a hormone that responds to stress) and aldosterone (a hormone that controls salt levels).
• Congenital adrenal hyperplasia: This is a genetic condition that affects the child's production of the hormones cortisol, aldosterone, and androgen (a type of male hormone).
• Cushing's syndrome:This is also called `(Hypercortisolism)`. What happens here is that the child's body produces too much of the hormone `(Cortisol)`.

Bone and calcium conditions

Many hormones play a role in keeping our bones strong and maintaining proper calcium levels.

• Hypercalcemia: A condition in which the calcium level in a child's blood is higher than normal.
• Hypocalcemia: A condition in which the calcium level in a child's blood is lower than normal.
• Rickets: This is a disease caused by a deficiency of Vitamin D. This can cause children's bones to become weak and hunched over.

Diabetes and metabolic conditions

Pediatric hormone specialists also treat problems related to metabolism, which is how the body makes energy. Diabetes is a very common condition.

• Type 1 diabetes: This is when the child's own immune system (autoimmune attack) destroys the cells in the pancreas that make insulin. As a result, the pancreas is unable to make insulin.
• Type 2 diabetes: In this condition, the pancreas produces insulin, but the body cannot use it properly. This is often associated with obesity.
• Obesity: A complex, long-term condition in which excessive body fat accumulates and is detrimental to health. This can also be linked to hormonal imbalances.

Disorders of sex development

Sometimes, children may experience abnormalities in their sexual development. For example, a condition called atypical genitalia . This is a rare genetic condition. In this case, the child's external genitalia may not have the typical male or female appearance, but may appear somewhere in between. A pediatric hormone specialist can diagnose such conditions and provide the necessary advice and treatment.

Genetic endocrine disorders

Some hormonal problems can be caused by genetic factors.

• Turner syndrome: This condition affects only girls. One or all of their X chromosomes are missing. This affects things like growth and ovarian function.
• Prader-Willi syndrome: This is also a genetic condition. It affects the child's metabolism, causing physical and behavioral changes (e.g., excessive hunger, growth problems).

Growth and puberty related problems

Hormones are very important for a child's growth and development and for them to reach puberty at the right time. Problems that can arise in this regard include:

• Short stature:The child is shorter than 95% of other children of the same age and gender. There can be a number of reasons for this, one of which is hormonal deficiency.
• Precocious puberty : If a girl shows signs of puberty (e.g., breast development in girls, enlargement of testicles in boys) before the age of 8, or a boy before the age of 9, it is considered precocious puberty.
• Delayed puberty : If puberty does not begin until much later than normal, meaning that a girl has not yet shown signs of puberty by the age of 13 or a boy by the age of 14, it may be delayed puberty.

Pituitary gland disorders

As we have discussed before, the pituitary gland produces many important hormones. If there is a problem with the functioning of this gland, various symptoms can arise.

• Diabetes insipidus: This is not the same as diabetes. What happens here is that the body loses too much urine and is unable to retain water properly. Excessive thirst is also a symptom of this.
• Hypopituitarism: Underproduction of one or more hormones by the pituitary gland can affect growth, thyroid function, adrenal function, puberty, and thirst control.

Thyroid conditions

Problems arise whether the amount of hormones produced by the thyroid gland is low or high.

• Goiter: An enlarged thyroid gland. This can occur regardless of whether the hormone levels are normal, low, or high.
• Hypothyroidism: The thyroid gland does not release enough thyroid hormones into the blood. This can cause the body to slow down, cause weight gain, and cause constipation.
• Hyperthyroidism: A condition in which the thyroid gland produces too much thyroid hormone and releases it into the bloodstream. This can cause a rapid heartbeat, weight loss, and increased sweating.

What should you expect when you visit a pediatric hormone specialist for the first time?

When you and your child first meet a pediatric hormone specialist, the doctor will ask you a lot about your child's symptoms, family medical history, and medications your child is currently taking . He or she will also do a physical exam . Sometimes, blood tests and scans may be recommended. Don't worry, all of this is done to get a better idea of ​​your child's condition.

The most important thing is to tell the doctor every detail you know, no matter how small. It will help them make an accurate diagnosis.

How do you become a pediatric hormone specialist?

It is also good to know this. A pediatric endocrinologist is someone who first completes a general medical degree (4-5 years) and then undergoes specialized training in pediatrics (about 3 years). After that, they need to undergo another 3 years of specialized training (fellowship) in pediatric endocrinology, that is, pediatric hormonal diseases. This training must also be approved by a recognized medical education council (such as the Accreditation Council of Graduate Medical Education - ACGME). In addition, certification from recognized institutions such as the American Board of Pediatrics (ABP) also confirms their expertise. It is because of this long training that they gain in-depth knowledge of this complex field.

But in our country, that is, in Sri Lanka, the way to become a Consultant Paediatric Endocrinologist is a little different. It is done through the PGIM (Post Graduate Institute of Medicine) affiliated with the University of Colombo.

In Sri Lanka, this journey goes in this order:

1. Basic Qualifications (MBBS & Internship): First, you must obtain an MBBS degree from a medical school, complete a mandatory internship, and register with SLMC.

2. Entrance Exam (Selection Exam): Then you have to pass the "MD (Paediatrics) Selection Exam" conducted by PGIM. This is a competitive exam.

3. General Paediatrics Training - Registrar: Once you pass the exam, you will have about 3 years of training (Registrar period). In this, you will learn mostly about general paediatrics.

4. MD Examination: At the end of these 3 years, there is the "MD (Paediatrics) Exam". Passing this is the basic qualification to become a "specialist doctor".

5. Sub-specialty Selection: After passing the MD, one has to decide which direction to go. There, one has to choose the sub-specialty called "Paediatric Endocrinology" (child hormones). (This is available based on Merit and vacancies).

6. Post-MD Training - Senior Registrar: This is where specialized training in hormones begins. This usually takes about 2-3 years.

   • Local Training:You need to work for about a year in a pediatric hormone unit at a major hospital in Sri Lanka.

   • Overseas Training: You must receive training for a year or two abroad (often in the UK or Australia) at a recognized center.

7. Board Certification: Once all this is completed, you will be certified as a "Board Certified Consultant Paediatric Endocrinologist" by PGIM.

So, just like the general process mentioned earlier, in Sri Lanka too, this is a journey that requires a great deal of dedication for another 6-7 years after MBBS.

So, what is the most important thing to remember from what we have talked about? (Take-Home Message)

• If you think your child has a problem related to hormones, growth, puberty, or diabetes, first consult your family doctor or pediatrician.
• If they think it's necessary, they will refer you to a pediatric endocrinologist.
• These specialists are doctors who have specialized knowledge and training in hormonal problems in children. They can accurately diagnose a child's condition and provide the best treatment and management plans.
• Remember, hormonal issues in children are different from those in adults, so it's important to seek expert help.

So, if your child has any of these conditions, don't panic, and seek proper medical advice. There are solutions for everything! Hormones, Pediatrics, Growth, Puberty, Diabetes, Endocrine System, Pediatric Hormone Specialist