Endocrine Program

The Endocrine Program at Miller Children’s treats patients with a variety of disorders of the endocrine system. Various hormones in the endocrine system can effect a person’s growth and development, tissue function and metabolism, sexual function and reproductive processes. Endocrinologists and the endocrine, diabetes specialty care team work with children and their parents to diagnose, treat and manage conditions affecting the endocrine system, including disorders of the hypothalamus, pituitary gland, thyroid gland, parathyroid glands, adrenal glands, ovaries/testes pancreas.

Evaluation

A primary care physician refers a patient to a pediatric endocrinologist for evaluation of the function of the endocrine glands. The endocrine glands are responsible for the secretion of hormones throughout the body.  Too much or too little of a hormone may be harmful to a person’s body. Consultation with a pediatric endocrinologist includes a recount of the history, physical examination, and appropriate diagnostic evaluation. Diagnostic studies may include radiographic or laboratory evaluation in order to determine if the child’s endocrine glands are functioning properly.

Treatment & Condition Management

The replacement or reduction of specific hormones within the body can treat and effectively manage many endocrine disorders. Early and timely treatment with medication or surgery if needed, is necessary and effective to help manage the child’s hormonal condition and minimize future complications. Continued follow-up visits will ensure hormone regulation continues.

Pituitary Disorders
The pituitary gland is referred to as the master gland because it controls many other glands in the body.  The pituitary makes several important hormones. Over or under production of pituitary hormones can lead to any one or combination of these disorders: precocious puberty, lack of puberty, infertility, growth disorders, thyroid abnormalities, adrenal abnormalities, and diabetes insipidus (a condition when the body is not able to control water loss). The abnormal production of  pituitary hormones may be caused by an abnormality in the size and/or location of the pituitary gland, or by a growth or tumor affecting the gland. Endocrinologists manage these conditions by controlling the amount of pituitary hormone with medications and, if needed, surgery. 

Adrenal Disorders
The most common disorder of the adrenal gland in childhood is congenital adrenal hyperplasia. This disorder is characterized by a lack of or decreased production of cortisol (the stress hormone), with or without production of aldosterone (the salt retaining hormone). Instead, other hormones including the male hormone testosterone are produced which can lead to a disorder of sexual development. In order to reduce complications associated with this disease, cortisol and aldosterone are replaced in the form of a medication by mouth. Other disorders of the adrenal gland include Addison disease (an acquired defect in cortisol and/or aldosterone production), Conn disease (excess production of aldosterone), Cushing disease (excess production of cortisol), and various other adrenal problems. These disorders can be managed with medication and/or surgery.

Thyroid Disorders
Thyroid hormone plays a major role in the body’s metabolism and overall well-being. Too much thyroid hormone due to an overactive thyroid gland can lead to weight loss, diarrhea, nervousness, difficulty with sleep and a fast heart rate. An underactive thyroid gland produces too little thyroid hormone and can lead to weight gain, constipation and excessive fatigue. In children, low levels of thyroid hormone can lead to poor growth. Endocrinologists treat patients with thyroid disorders by replacing or reducing the amount of thyroid hormone in the body. Endocrinologists also receive special training to manage patients with thyroid nodules or thyroid cancer.

Puberty Disorders
The Endocrine program treats male and female patients with a wide range of disorders of puberty.  Puberty can occur too early, too late, or not at all.  Early puberty  is referred to as precocious puberty.  Late puberty is most commonly due to a benign condition referred to as constitutional delay of growth and puberty.  However, there are other causes of early and late puberty that require further evaluation.  Pediatric endocrinologists evaluate and manage these disorders with medication.

Approved CCS Center

The Endocrine Center at Miller Children’s is a California Children’s Services (CCS) approved Special Care Center (SCC). This means a specially designated multidisciplinary care team is responsible for all care coordination and case management of a patient in this program. Patients typically qualify for the Endocrine CCS Special Care Center by medical diagnosis, complexity of their disease and financial status.