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| What causes What I need to know about Gestational Diabetes ? | Gestational diabetes happens when your body can't make enough insulin during pregnancy. Insulin is a hormone made in your pancreas, an organ located behind your stomach. Insulin helps your body use glucose for energy and helps control your blood glucose levels.
During pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body's cells to use insulin less effectively, a condition called insulin resistance. Insulin resistance increases your body's need for insulin. If your pancreas can't make enough insulin, you will have gestational diabetes.
All pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before they get pregnant, usually because they are overweight. These women start pregnancy with an increased need for insulin and are more likely to have gestational diabetes.
What are my chances of getting gestational diabetes? Your chances of getting gestational diabetes are higher if you - are overweight - have had gestational diabetes before - have given birth to a baby weighing more than 9 pounds - have a parent, brother, or sister with type 2 diabetes - have prediabetes, meaning your blood glucose levels are higher than normal yet not high enough for a diagnosis of diabetes - are African American, American Indian, Asian American, Hispanic/Latina, or Pacific Islander American - have a hormonal disorder called polycystic ovary syndrome, also known as PCOS |
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| What is (are) What I need to know about Gestational Diabetes ? | Your chances of getting gestational diabetes are higher if you
- are overweight - have had gestational diabetes before - have given birth to a baby weighing more than 9 pounds - have a parent, brother, or sister with type 2 diabetes - have prediabetes, meaning your blood glucose levels are higher than normal yet not high enough for a diagnosis of diabetes - are African American, American Indian, Asian American, Hispanic/Latina, or Pacific Islander American - have a hormonal disorder called polycystic ovary syndrome, also known as PCOS |
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| How to diagnose What I need to know about Gestational Diabetes ? | Doctors use blood tests to diagnose gestational diabetes. All diabetes blood tests involve drawing blood at a doctor's office or a commercial facility. Blood samples are sent to a lab for analysis.
Screening Glucose Challenge Test
For this test, you will drink a sugary beverage and have your blood glucose level checked an hour later. This test can be done at any time of the day. If the results are above normal, you may need to have an oral glucose tolerance test.
Oral Glucose Tolerance Test
You will need to fast for at least 8 hours before the test. Fasting means having nothing to eat or drink except water. Your doctor will give you other instructions to follow before the test.
Your fasting blood glucose level will be checked before the test begins. Then you will drink a sugary beverage. Your blood glucose levels will be checked 1 hour, 2 hours, and possibly 3 hours later. Your doctor will use your test results to find out whether you have gestational diabetes. |
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| How to diagnose What I need to know about Gestational Diabetes ? | If you have gestational diabetes, your doctor may recommend that you have some extra tests to check your baby's health, such as
- ultrasound exams, which use sound waves to make images that show your baby's growth and whether your baby is larger than normal - a nonstress test, which uses a monitor placed on your abdomen to check whether your baby's heart rate increases as it should when your baby is active - kick counts to check the time between your baby's movements |
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| What are the treatments for What I need to know about Gestational Diabetes ? | Treating gestational diabetes means taking steps to keep your blood glucose levels in a target range. Targets are numbers you aim for. Your doctor will help you set your targets. You will learn how to control your blood glucose using
- healthy eating - physical activity - insulin shots, if needed |
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| What to do for What I need to know about Gestational Diabetes ? | Your health care team will help you make a healthy eating plan with food choices that are good for both you and your baby. These choices are good for you to follow throughout pregnancy and after, as you raise your family.
Using a healthy eating plan will help your blood glucose stay in your target range. The plan will help you know which foods to eat, how much to eat, and when to eat. Food choices, amounts, and timing are all important in keeping your blood glucose levels in your target range.
More information is provided in the NIDDK health topic, What I need to know about Eating and Diabetes.
Physical Activity
Physical activity can help you reach your blood glucose targets. Talk with your doctor about the type of activity that is best for you. If you are already active, tell your doctor what you do. Being physically active will also help lower your chances of having type 2 diabetesand its problemsin the future. Now is the time to develop good habits for you and your baby.
For more information about physical activity and pregnancy, visit www.womenshealth.gov/pregnancy.
Insulin Shots
If you have trouble meeting your blood glucose targets, you may need to take a medicine called insulin, along with following a healthy meal plan and being physically active. Your health care team will show you how to give yourself insulin shots. Insulin will not harm your baby. |
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| How to diagnose What I need to know about Gestational Diabetes ? | Your health care team may teach you how to test for chemicals called ketones in your morning urine or in your blood. High levels of ketones are a sign that your body is using your body fat for energy instead of the food you eat. Using fat for energy is not recommended during pregnancy. Ketones may be harmful for your baby.
If your ketone levels are high, your doctor may suggest that you change the type or amount of food you eat. Or you may need to change your meal or snack times. |
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| How to prevent What I need to know about Gestational Diabetes ? | You can do a lot to prevent or delay type 2 diabetes by making these lifestyle changes:
- Reach and stay at a healthy weight. Try to reach your prepregnancy weight 6 to 12 months after your baby is born. Then, if you still weigh too much, work to lose at least 5 to 7 percent of your body weight and keep it off. For example, if you weigh 200 pounds, losing 10 to 14 pounds can greatly reduce your chance of getting diabetes. - Be physically active for at least 30 minutes most days of the week. - Follow a healthy eating plan. Eat more grains, fruits, and vegetables. Cut down on fat and calories. Your health care team can help you design a meal plan. - Ask your doctor if you should take the diabetes medicine metformin. Metformin can lower your chances of having type 2 diabetes, especially if you are younger and heavier and have prediabetes or if you have had gestational diabetes.
These changes can help you enjoy a longer, healthier life. Your health care team can give you information and support to help you make these changes.
By delaying or preventing type 2 diabetes, you will also lower your chances of having heart and blood vessel disease and other problems as you get older.
Talk with your doctor if you are thinking about having another baby. For the safety of your baby, your blood glucose needs to be at healthy levels before you get pregnant again. Your doctor can help ensure you are ready for your next child. |
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| What to do for What I need to know about Gestational Diabetes ? | - Gestational diabetes is a type of diabetes that develops only during pregnancy. Diabetes means your blood glucose, also called blood sugar, is too high. - Gestational diabetes happens when your body can't make enough insulin during pregnancy. Insulin is a hormone made in your pancreas, an organ located behind your stomach. Insulin helps your body use glucose for energy and helps control your blood glucose levels. - You will probably be tested for gestational diabetes between weeks 24 and 28 of your pregnancy. If you have a higher chance of getting gestational diabetes, your doctor may test you for diabetes during your first visit after you become pregnant. - If you have high blood glucose levels because your gestational diabetes is not under control, your baby will also have high blood glucose. - Untreated or uncontrolled gestational diabetes can cause problems for your baby. - Treating gestational diabetes means taking steps to keep your blood glucose levels in a target range. - Even if your blood glucose levels return to normal after your pregnancy, your chances of getting diabetesusually type 2 diabeteslater in life are high. Therefore, you should be tested at least every 3 years for diabetes or prediabetes. - You can give your baby a healthy start by breastfeeding. - You can help your child be healthy by showing your child how to make healthy lifestyle choices, including being physically active, limiting screen time in front of the TV or video games, eating a healthy diet, and staying at a healthy weight. |
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| What is (are) Prevent diabetes problems: Keep your kidneys healthy ? | Your kidneys are two bean-shaped organs, each about the size of a fist. They are located just below your rib cage, one on each side of your spine. Every day, your two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine. Urine flows from your kidneys to your bladder through tubes called ureters. Your bladder stores urine until releasing it through urination. |
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| What is (are) Prevent diabetes problems: Keep your kidneys healthy ? | Blood pressure is the force of blood flow inside your blood vessels. Blood pressure is written with two numbers separated by a slash. For example, a blood pressure result of 130/80 is said as 130 over 80. The first number is the pressure in your blood vessels as your heart beats and pushes blood through your blood vessels. The second number is the pressure as your blood vessels relax between heartbeats.
High blood pressure forces your heart to work harder to pump blood. High blood pressure can strain your heart, damage your blood vessels, and increase your risk of heart attack, stroke, eye problems, and kidney problems. |
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| What are the symptoms of Prevent diabetes problems: Keep your kidneys healthy ? | In the early stages, diabetic kidney disease does not have any symptoms. Kidney disease happens so slowly that you may not feel sick at all for many years. You may not feel sick even when your kidneys do only half the job of healthy kidneys. Only your doctor can tell if you have kidney disease by checking the protein, or albumin, level in your urine at least once a year.
The first symptom of diabetic kidney disease is often swelling in parts of your body, such as your hands, face, feet, or ankles. Also, large amounts of protein in your urine may cause urine to look foamy. Once your kidney function starts to decrease, other symptoms may include
- increased or decreased urination - feeling drowsy or tired - feeling itchy or numb - dry skin - headaches - weight loss - not feeling hungry - feeling sick to your stomach - vomiting - sleep problems - trouble staying focused - darkened skin - muscle cramps |
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| What to do for Prevent diabetes problems: Keep your kidneys healthy ? | Your dietitian or doctor may suggest a special eating plan for you. You may have to avoid a diet high in protein, fat, sodium, and potassium.
- Cut back on protein, especially animal products such as meat. Damaged kidneys may fail to remove protein waste products from your blood. Diets high in protein make your kidneys work harder and fail sooner. - Avoid a high-fat diet. High-fat diets are high in cholesterol. Cholesterol is a type of fat found in your bodys cells, blood, and many foods. Your body needs some cholesterol to work the right way. For example, your body uses cholesterol to make certain essential hormones and maintain nerve function. However, your body makes all the cholesterol it needs. If you often eat foods that are high in cholesterol, or if high cholesterol runs in your family, extra cholesterol in your blood can build up over time in the walls of your blood vessels and arteries. High blood cholesterol can lead to heart disease and stroke, some of the biggest health problems for people with diabetes. - Avoid high-sodium foods. Sodium is a mineral found in salt and other foods. High levels of sodium may raise your blood pressure. Some high-sodium foods include canned food, frozen dinners, and hot dogs. The amount of sodium is listed on the food label, so you can see which foods have the highest levels. Try to limit your sodium to less than a teaspoon a day, or about 2,300 milligrams (mg) a day. If you have high blood pressure or are African American, middle-aged, or older, aim for no more than 1,500 mg of sodium per day. Ask your doctor or your dietitian about how much sodium you can have. - Ask your doctor about the amount of potassium you need. Potassium is a mineral that helps your heartbeat stay regular and muscles work right. Healthy kidneys keep the right amount of potassium in your body. However, if you have severe kidney damage, high levels of potassium may cause an abnormal heart rhythm or even make your heart stop, called cardiac arrest. Some high-potassium foods include apricots, bananas, oranges, and potatoes.
More information about healthy eating and kidney disease is provided in the NIDDK health topics: - Eat Right to Feel Right on Hemodialysis - Nutrition for Advanced Chronic Kidney Disease in Adults - Nutrition for Early Chronic Kidney Disease in Adults - What I need to know about Eating and Diabetes |
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| What is (are) Prevent diabetes problems: Keep your kidneys healthy ? | Kidney failure, also called end-stage kidney disease or ESRD, means your kidneys no longer work well enough to do their job. You will need treatment to replace the work your kidneys have stopped doing. |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What is (are) Causes of Diabetes ? | Diabetes is a complex group of diseases with a variety of causes. People with diabetes have high blood glucose, also called high blood sugar or hyperglycemia.
Diabetes is a disorder of metabolismthe way the body uses digested food for energy. The digestive tract breaks down carbohydratessugars and starches found in many foodsinto glucose, a form of sugar that enters the bloodstream. With the help of the hormone insulin, cells throughout the body absorb glucose and use it for energy. Diabetes develops when the body doesnt make enough insulin or is not able to use insulin effectively, or both.
Insulin is made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells called islets. Beta cells within the islets make insulin and release it into the blood.
If beta cells dont produce enough insulin, or the body doesnt respond to the insulin that is present, glucose builds up in the blood instead of being absorbed by cells in the body, leading to prediabetes or diabetes. Prediabetes is a condition in which blood glucose levels or A1C levelswhich reflect average blood glucose levelsare higher than normal but not high enough to be diagnosed as diabetes. In diabetes, the bodys cells are starved of energy despite high blood glucose levels.
Over time, high blood glucose damages nerves and blood vessels, leading to complications such as heart disease, stroke, kidney disease, blindness, dental disease, and amputations. Other complications of diabetes may include increased susceptibility to other diseases, loss of mobility with aging, depression, and pregnancy problems. No one is certain what starts the processes that cause diabetes, but scientists believe genes and environmental factors interact to cause diabetes in most cases.
The two main types of diabetes are type 1 diabetes and type 2 diabetes. A third type, gestational diabetes, develops only during pregnancy. Other types of diabetes are caused by defects in specific genes, diseases of the pancreas, certain drugs or chemicals, infections, and other conditions. Some people show signs of both type 1 and type 2 diabetes. |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What causes Causes of Diabetes ? | Type 1 diabetes is caused by a lack of insulin due to the destruction of insulin-producing beta cells in the pancreas. In type 1 diabetesan autoimmune diseasethe bodys immune system attacks and destroys the beta cells. Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. But in autoimmune diseases, the immune system attacks the bodys own cells. In type 1 diabetes, beta cell destruction may take place over several years, but symptoms of the disease usually develop over a short period of time.
Type 1 diabetes typically occurs in children and young adults, though it can appear at any age. In the past, type 1 diabetes was called juvenile diabetes or insulin-dependent diabetes mellitus.
Latent autoimmune diabetes in adults (LADA) may be a slowly developing kind of type 1 diabetes. Diagnosis usually occurs after age 30. In LADA, as in type 1 diabetes, the bodys immune system destroys the beta cells. At the time of diagnosis, people with LADA may still produce their own insulin, but eventually most will need insulin shots or an insulin pump to control blood glucose levels.
Genetic Susceptibility
Heredity plays an important part in determining who is likely to develop type 1 diabetes. Genes are passed down from biological parent to child. Genes carry instructions for making proteins that are needed for the bodys cells to function. Many genes, as well as interactions among genes, are thought to influence susceptibility to and protection from type 1 diabetes. The key genes may vary in different population groups. Variations in genes that affect more than 1 percent of a population group are called gene variants.
Certain gene variants that carry instructions for making proteins called human leukocyte antigens (HLAs) on white blood cells are linked to the risk of developing type 1 diabetes. The proteins produced by HLA genes help determine whether the immune system recognizes a cell as part of the body or as foreign material. Some combinations of HLA gene variants predict that a person will be at higher risk for type 1 diabetes, while other combinations are protective or have no effect on risk.
While HLA genes are the major risk genes for type 1 diabetes, many additional risk genes or gene regions have been found. Not only can these genes help identify people at risk for type 1 diabetes, but they also provide important clues to help scientists better understand how the disease develops and identify potential targets for therapy and prevention.
Genetic testing can show what types of HLA genes a person carries and can reveal other genes linked to diabetes. However, most genetic testing is done in a research setting and is not yet available to individuals. Scientists are studying how the results of genetic testing can be used to improve type 1 diabetes prevention or treatment.
Autoimmune Destruction of Beta Cells
In type 1 diabetes, white blood cells called T cells attack and destroy beta cells. The process begins well before diabetes symptoms appear and continues after diagnosis. Often, type 1 diabetes is not diagnosed until most beta cells have already been destroyed. At this point, a person needs daily insulin treatment to survive. Finding ways to modify or stop this autoimmune process and preserve beta cell function is a major focus of current scientific research.
Recent research suggests insulin itself may be a key trigger of the immune attack on beta cells. The immune systems of people who are susceptible to developing type 1 diabetes respond to insulin as if it were a foreign substance, or antigen. To combat antigens, the body makes proteins called antibodies. Antibodies to insulin and other proteins produced by beta cells are found in people with type 1 diabetes. Researchers test for these antibodies to help identify people at increased risk of developing the disease. Testing the types and levels of antibodies in the blood can help determine whether a person has type 1 diabetes, LADA, or another type of diabetes.
Environmental Factors
Environmental factors, such as foods, viruses, and toxins, may play a role in the development of type 1 diabetes, but the exact nature of their role has not been determined. Some theories suggest that environmental factors trigger the autoimmune destruction of beta cells in people with a genetic susceptibility to diabetes. Other theories suggest that environmental factors play an ongoing role in diabetes, even after diagnosis.
Viruses and infections. A virus cannot cause diabetes on its own, but people are sometimes diagnosed with type 1 diabetes during or after a viral infection, suggesting a link between the two. Also, the onset of type 1 diabetes occurs more frequently during the winter when viral infections are more common. Viruses possibly associated with type 1 diabetes include coxsackievirus B, cytomegalovirus, adenovirus, rubella, and mumps. Scientists have described several ways these viruses may damage or destroy beta cells or possibly trigger an autoimmune response in susceptible people. For example, anti-islet antibodies have been found in patients with congenital rubella syndrome, and cytomegalovirus has been associated with significant beta cell damage and acute pancreatitisinflammation of the pancreas. Scientists are trying to identify a virus that can cause type 1 diabetes so that a vaccine might be developed to prevent the disease.
Infant feeding practices. Some studies have suggested that dietary factors may raise or lower the risk of developing type 1 diabetes. For example, breastfed infants and infants receiving vitamin D supplements may have a reduced risk of developing type 1 diabetes, while early exposure to cows milk and cereal proteins may increase risk. More research is needed to clarify how infant nutrition affects the risk for type 1 diabetes.
Read more in the Centers for Disease Control and Preventions (CDCs) publication National Diabetes Statistics Report, 2014 at www.cdc.gov for information about research studies related to type 1 diabetes. |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What causes Causes of Diabetes ? | Type 2 diabetesthe most common form of diabetesis caused by a combination of factors, including insulin resistance, a condition in which the bodys muscle, fat, and liver cells do not use insulin effectively. Type 2 diabetes develops when the body can no longer produce enough insulin to compensate for the impaired ability to use insulin. Symptoms of type 2 diabetes may develop gradually and can be subtle; some people with type 2 diabetes remain undiagnosed for years.
Type 2 diabetes develops most often in middle-aged and older people who are also overweight or obese. The disease, once rare in youth, is becoming more common in overweight and obese children and adolescents. Scientists think genetic susceptibility and environmental factors are the most likely triggers of type 2 diabetes.
Genetic Susceptibility
Genes play a significant part in susceptibility to type 2 diabetes. Having certain genes or combinations of genes may increase or decrease a persons risk for developing the disease. The role of genes is suggested by the high rate of type 2 diabetes in families and identical twins and wide variations in diabetes prevalence by ethnicity. Type 2 diabetes occurs more frequently in African Americans, Alaska Natives, American Indians, Hispanics/Latinos, and some Asian Americans, Native Hawaiians, and Pacific Islander Americans than it does in non-Hispanic whites.
Recent studies have combined genetic data from large numbers of people, accelerating the pace of gene discovery. Though scientists have now identified many gene variants that increase susceptibility to type 2 diabetes, the majority have yet to be discovered. The known genes appear to affect insulin production rather than insulin resistance. Researchers are working to identify additional gene variants and to learn how they interact with one another and with environmental factors to cause diabetes.
Studies have shown that variants of the TCF7L2 gene increase susceptibility to type 2 diabetes. For people who inherit two copies of the variants, the risk of developing type 2 diabetes is about 80 percent higher than for those who do not carry the gene variant.1 However, even in those with the variant, diet and physical activity leading to weight loss help delay diabetes, according to the Diabetes Prevention Program (DPP), a major clinical trial involving people at high risk.
Genes can also increase the risk of diabetes by increasing a persons tendency to become overweight or obese. One theory, known as the thrifty gene hypothesis, suggests certain genes increase the efficiency of metabolism to extract energy from food and store the energy for later use. This survival trait was advantageous for populations whose food supplies were scarce or unpredictable and could help keep people alive during famine. In modern times, however, when high-calorie foods are plentiful, such a trait can promote obesity and type 2 diabetes.
Obesity and Physical Inactivity
Physical inactivity and obesity are strongly associated with the development of type 2 diabetes. People who are genetically susceptible to type 2 diabetes are more vulnerable when these risk factors are present.
An imbalance between caloric intake and physical activity can lead to obesity, which causes insulin resistance and is common in people with type 2 diabetes. Central obesity, in which a person has excess abdominal fat, is a major risk factor not only for insulin resistance and type 2 diabetes but also for heart and blood vessel disease, also called cardiovascular disease (CVD). This excess belly fat produces hormones and other substances that can cause harmful, chronic effects in the body such as damage to blood vessels.
The DPP and other studies show that millions of people can lower their risk for type 2 diabetes by making lifestyle changes and losing weight. The DPP proved that people with prediabetesat high risk of developing type 2 diabetescould sharply lower their risk by losing weight through regular physical activity and a diet low in fat and calories. In 2009, a follow-up study of DPP participantsthe Diabetes Prevention Program Outcomes Study (DPPOS)showed that the benefits of weight loss lasted for at least 10 years after the original study began.2
Read more about the DPP, funded under National Institutes of Health (NIH) clinical trial number NCT00004992, and the DPPOS, funded under NIH clinical trial number NCT00038727 in Diabetes Prevention Program.
Insulin Resistance
Insulin resistance is a common condition in people who are overweight or obese, have excess abdominal fat, and are not physically active. Muscle, fat, and liver cells stop responding properly to insulin, forcing the pancreas to compensate by producing extra insulin. As long as beta cells are able to produce enough insulin, blood glucose levels stay in the normal range. But when insulin production falters because of beta cell dysfunction, glucose levels rise, leading to prediabetes or diabetes.
Abnormal Glucose Production by the Liver
In some people with diabetes, an abnormal increase in glucose production by the liver also contributes to high blood glucose levels. Normally, the pancreas releases the hormone glucagon when blood glucose and insulin levels are low. Glucagon stimulates the liver to produce glucose and release it into the bloodstream. But when blood glucose and insulin levels are high after a meal, glucagon levels drop, and the liver stores excess glucose for later, when it is needed. For reasons not completely understood, in many people with diabetes, glucagon levels stay higher than needed. High glucagon levels cause the liver to produce unneeded glucose, which contributes to high blood glucose levels. Metformin, the most commonly used drug to treat type 2 diabetes, reduces glucose production by the liver.
The Roles of Insulin and Glucagon in Normal Blood Glucose Regulation
A healthy persons body keeps blood glucose levels in a normal range through several complex mechanisms. Insulin and glucagon, two hormones made in the pancreas, help regulate blood glucose levels:
- Insulin, made by beta cells, lowers elevated blood glucose levels. - Glucagon, made by alpha cells, raises low blood glucose levels.
- Insulin helps muscle, fat, and liver cells absorb glucose from the bloodstream, lowering blood glucose levels. - Insulin stimulates the liver and muscle tissue to store excess glucose. The stored form of glucose is called glycogen. - Insulin also lowers blood glucose levels by reducing glucose production in the liver.
- Glucagon signals the liver and muscle tissue to break down glycogen into glucose, which enters the bloodstream and raises blood glucose levels. - If the body needs more glucose, glucagon stimulates the liver to make glucose from amino acids.
Metabolic Syndrome
Metabolic syndrome, also called insulin resistance syndrome, refers to a group of conditions common in people with insulin resistance, including
- higher than normal blood glucose levels - increased waist size due to excess abdominal fat - high blood pressure - abnormal levels of cholesterol and triglycerides in the blood
Cell Signaling and Regulation
Cells communicate through a complex network of molecular signaling pathways. For example, on cell surfaces, insulin receptor molecules capture, or bind, insulin molecules circulating in the bloodstream. This interaction between insulin and its receptor prompts the biochemical signals that enable the cells to absorb glucose from the blood and use it for energy.
Problems in cell signaling systems can set off a chain reaction that leads to diabetes or other diseases. Many studies have focused on how insulin signals cells to communicate and regulate action. Researchers have identified proteins and pathways that transmit the insulin signal and have mapped interactions between insulin and body tissues, including the way insulin helps the liver control blood glucose levels. Researchers have also found that key signals also come from fat cells, which produce substances that cause inflammation and insulin resistance.
This work holds the key to combating insulin resistance and diabetes. As scientists learn more about cell signaling systems involved in glucose regulation, they will have more opportunities to develop effective treatments.
Beta Cell Dysfunction
Scientists think beta cell dysfunction is a key contributor to type 2 diabetes. Beta cell impairment can cause inadequate or abnormal patterns of insulin release. Also, beta cells may be damaged by high blood glucose itself, a condition called glucose toxicity.
Scientists have not determined the causes of beta cell dysfunction in most cases. Single gene defects lead to specific forms of diabetes called maturity-onset diabetes of the young (MODY). The genes involved regulate insulin production in the beta cells. Although these forms of diabetes are rare, they provide clues as to how beta cell function may be affected by key regulatory factors. Other gene variants are involved in determining the number and function of beta cells. But these variants account for only a small percentage of type 2 diabetes cases. Malnutrition early in life is also being investigated as a cause of beta cell dysfunction. The metabolic environment of the developing fetus may also create a predisposition for diabetes later in life.
Risk Factors for Type 2 Diabetes
People who develop type 2 diabetes are more likely to have the following characteristics:
- age 45 or older - overweight or obese - physically inactive - parent or sibling with diabetes - family background that is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American - history of giving birth to a baby weighing more than 9 pounds - history of gestational diabetes - high blood pressure140/90 or aboveor being treated for high blood pressure - high-density lipoprotein (HDL), or good, cholesterol below 35 milligrams per deciliter (mg/dL), or a triglyceride level above 250 mg/dL - polycystic ovary syndrome, also called PCOS - prediabetesan A1C level of 5.7 to 6.4 percent; a fasting plasma glucose test result of 100125 mg/dL, called impaired fasting glucose; or a 2-hour oral glucose tolerance test result of 140199, called impaired glucose tolerance - acanthosis nigricans, a condition associated with insulin resistance, characterized by a dark, velvety rash around the neck or armpits - history of CVD
The American Diabetes Association (ADA) recommends that testing to detect prediabetes and type 2 diabetes be considered in adults who are overweight or obese and have one or more additional risk factors for diabetes. In adults without these risk factors, testing should begin at age 45. |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What causes Causes of Diabetes ? | Insulin Resistance and Beta Cell Dysfunction
Hormones produced by the placenta and other pregnancy-related factors contribute to insulin resistance, which occurs in all women during late pregnancy. Insulin resistance increases the amount of insulin needed to control blood glucose levels. If the pancreas cant produce enough insulin due to beta cell dysfunction, gestational diabetes occurs.
As with type 2 diabetes, excess weight is linked to gestational diabetes. Overweight or obese women are at particularly high risk for gestational diabetes because they start pregnancy with a higher need for insulin due to insulin resistance. Excessive weight gain during pregnancy may also increase risk.
Family History
Having a family history of diabetes is also a risk factor for gestational diabetes, suggesting that genes play a role in its development. Genetics may also explain why the disorder occurs more frequently in African Americans, American Indians, and Hispanics/Latinos. Many gene variants or combinations of variants may increase a womans risk for developing gestational diabetes. Studies have found several gene variants associated with gestational diabetes, but these variants account for only a small fraction of women with gestational diabetes.
Future Risk of Type 2 Diabetes
Because a womans hormones usually return to normal levels soon after giving birth, gestational diabetes disappears in most women after delivery. However, women who have gestational diabetes are more likely to develop gestational diabetes with future pregnancies and develop type 2 diabetes.3 Women with gestational diabetes should be tested for persistent diabetes 6 to 12 weeks after delivery and at least every 3 years thereafter.
Also, exposure to high glucose levels during gestation increases a childs risk for becoming overweight or obese and for developing type 2 diabetes later on. The result may be a cycle of diabetes affecting multiple generations in a family. For both mother and child, maintaining a healthy body weight and being physically active may help prevent type 2 diabetes. |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What causes Causes of Diabetes ? | Other types of diabetes have a variety of possible causes.
Genetic Mutations Affecting Beta Cells, Insulin, and Insulin Action
Some relatively uncommon forms of diabetes known as monogenic diabetes are caused by mutations, or changes, in a single gene. These mutations are usually inherited, but sometimes the gene mutation occurs spontaneously. Most of these gene mutations cause diabetes by reducing beta cells ability to produce insulin.
The most common types of monogenic diabetes are neonatal diabetes mellitus (NDM) and MODY. NDM occurs in the first 6 months of life. MODY is usually found during adolescence or early adulthood but sometimes is not diagnosed until later in life. More information about NDM and MODY is provided in the NIDDK health topic, Monogenic Forms of Diabetes.
Other rare genetic mutations can cause diabetes by damaging the quality of insulin the body produces or by causing abnormalities in insulin receptors.
Other Genetic Diseases
Diabetes occurs in people with Down syndrome, Klinefelter syndrome, and Turner syndrome at higher rates than the general population. Scientists are investigating whether genes that may predispose people to genetic syndromes also predispose them to diabetes.
The genetic disorders cystic fibrosis and hemochromatosis are linked to diabetes. Cystic fibrosis produces abnormally thick mucus, which blocks the pancreas. The risk of diabetes increases with age in people with cystic fibrosis. Hemochromatosis causes the body to store too much iron. If the disorder is not treated, iron can build up in and damage the pancreas and other organs.
Damage to or Removal of the Pancreas
Pancreatitis, cancer, and trauma can all harm the pancreatic beta cells or impair insulin production, thus causing diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells.
Endocrine Diseases
Endocrine diseases affect organs that produce hormones. Cushings syndrome and acromegaly are examples of hormonal disorders that can cause prediabetes and diabetes by inducing insulin resistance. Cushings syndrome is marked by excessive production of cortisolsometimes called the stress hormone. Acromegaly occurs when the body produces too much growth hormone. Glucagonoma, a rare tumor of the pancreas, can also cause diabetes. The tumor causes the body to produce too much glucagon. Hyperthyroidism, a disorder that occurs when the thyroid gland produces too much thyroid hormone, can also cause elevated blood glucose levels.
Autoimmune Disorders
Rare disorders characterized by antibodies that disrupt insulin action can lead to diabetes. This kind of diabetes is often associated with other autoimmune disorders such as lupus erythematosus. Another rare autoimmune disorder called stiff-man syndrome is associated with antibodies that attack the beta cells, similar to type 1 diabetes.
Medications and Chemical Toxins
Some medications, such as nicotinic acid and certain types of diuretics, anti-seizure drugs, psychiatric drugs, and drugs to treat human immunodeficiency virus (HIV), can impair beta cells or disrupt insulin action. Pentamidine, a drug prescribed to treat a type of pneumonia, can increase the risk of pancreatitis, beta cell damage, and diabetes. Also, glucocorticoidssteroid hormones that are chemically similar to naturally produced cortisolmay impair insulin action. Glucocorticoids are used to treat inflammatory illnesses such as rheumatoid arthritis, asthma, lupus, and ulcerative colitis.
Many chemical toxins can damage or destroy beta cells in animals, but only a few have been linked to diabetes in humans. For example, dioxina contaminant of the herbicide Agent Orange, used during the Vietnam Warmay be linked to the development of type 2 diabetes. In 2000, based on a report from the Institute of Medicine, the U.S. Department of Veterans Affairs (VA) added diabetes to the list of conditions for which Vietnam veterans are eligible for disability compensation. Also, a chemical in a rat poison no longer in use has been shown to cause diabetes if ingested. Some studies suggest a high intake of nitrogen-containing chemicals such as nitrates and nitrites might increase the risk of diabetes. Arsenic has also been studied for possible links to diabetes.
Lipodystrophy
Lipodystrophy is a condition in which fat tissue is lost or redistributed in the body. The condition is associated with insulin resistance and type 2 diabetes. |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What causes Causes of Diabetes ? | Other types of diabetes have a variety of possible causes.
Genetic Mutations Affecting Beta Cells, Insulin, and Insulin Action
Some relatively uncommon forms of diabetes known as monogenic diabetes are caused by mutations, or changes, in a single gene. These mutations are usually inherited, but sometimes the gene mutation occurs spontaneously. Most of these gene mutations cause diabetes by reducing beta cells ability to produce insulin.
The most common types of monogenic diabetes are neonatal diabetes mellitus (NDM) and MODY. NDM occurs in the first 6 months of life. MODY is usually found during adolescence or early adulthood but sometimes is not diagnosed until later in life. More information about NDM and MODY is provided in the NIDDK health topic, Monogenic Forms of Diabetes.
Other rare genetic mutations can cause diabetes by damaging the quality of insulin the body produces or by causing abnormalities in insulin receptors.
Other Genetic Diseases
Diabetes occurs in people with Down syndrome, Klinefelter syndrome, and Turner syndrome at higher rates than the general population. Scientists are investigating whether genes that may predispose people to genetic syndromes also predispose them to diabetes.
The genetic disorders cystic fibrosis and hemochromatosis are linked to diabetes. Cystic fibrosis produces abnormally thick mucus, which blocks the pancreas. The risk of diabetes increases with age in people with cystic fibrosis. Hemochromatosis causes the body to store too much iron. If the disorder is not treated, iron can build up in and damage the pancreas and other organs.
Damage to or Removal of the Pancreas
Pancreatitis, cancer, and trauma can all harm the pancreatic beta cells or impair insulin production, thus causing diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells.
Endocrine Diseases
Endocrine diseases affect organs that produce hormones. Cushings syndrome and acromegaly are examples of hormonal disorders that can cause prediabetes and diabetes by inducing insulin resistance. Cushings syndrome is marked by excessive production of cortisolsometimes called the stress hormone. Acromegaly occurs when the body produces too much growth hormone. Glucagonoma, a rare tumor of the pancreas, can also cause diabetes. The tumor causes the body to produce too much glucagon. Hyperthyroidism, a disorder that occurs when the thyroid gland produces too much thyroid hormone, can also cause elevated blood glucose levels.
Autoimmune Disorders
Rare disorders characterized by antibodies that disrupt insulin action can lead to diabetes. This kind of diabetes is often associated with other autoimmune disorders such as lupus erythematosus. Another rare autoimmune disorder called stiff-man syndrome is associated with antibodies that attack the beta cells, similar to type 1 diabetes.
Medications and Chemical Toxins
Some medications, such as nicotinic acid and certain types of diuretics, anti-seizure drugs, psychiatric drugs, and drugs to treat human immunodeficiency virus (HIV), can impair beta cells or disrupt insulin action. Pentamidine, a drug prescribed to treat a type of pneumonia, can increase the risk of pancreatitis, beta cell damage, and diabetes. Also, glucocorticoidssteroid hormones that are chemically similar to naturally produced cortisolmay impair insulin action. Glucocorticoids are used to treat inflammatory illnesses such as rheumatoid arthritis, asthma, lupus, and ulcerative colitis.
Many chemical toxins can damage or destroy beta cells in animals, but only a few have been linked to diabetes in humans. For example, dioxina contaminant of the herbicide Agent Orange, used during the Vietnam Warmay be linked to the development of type 2 diabetes. In 2000, based on a report from the Institute of Medicine, the U.S. Department of Veterans Affairs (VA) added diabetes to the list of conditions for which Vietnam veterans are eligible for disability compensation. Also, a chemical in a rat poison no longer in use has been shown to cause diabetes if ingested. Some studies suggest a high intake of nitrogen-containing chemicals such as nitrates and nitrites might increase the risk of diabetes. Arsenic has also been studied for possible links to diabetes.
Lipodystrophy
Lipodystrophy is a condition in which fat tissue is lost or redistributed in the body. The condition is associated with insulin resistance and type 2 diabetes. |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What to do for Causes of Diabetes ? | - Diabetes is a complex group of diseases with a variety of causes. Scientists believe genes and environmental factors interact to cause diabetes in most cases. - People with diabetes have high blood glucose, also called high blood sugar or hyperglycemia. Diabetes develops when the body doesnt make enough insulin or is not able to use insulin effectively, or both. - Insulin is a hormone made by beta cells in the pancreas. Insulin helps cells throughout the body absorb and use glucose for energy. If the body does not produce enough insulin or cannot use insulin effectively, glucose builds up in the blood instead of being absorbed by cells in the body, and the body is starved of energy. - Prediabetes is a condition in which blood glucose levels or A1C levels are higher than normal but not high enough to be diagnosed as diabetes. People with prediabetes can substantially reduce their risk of developing diabetes by losing weight and increasing physical activity. - The two main types of diabetes are type 1 diabetes and type 2 diabetes. Gestational diabetes is a third form of diabetes that develops only during pregnancy. - Type 1 diabetes is caused by a lack of insulin due to the destruction of insulin-producing beta cells. In type 1 diabetesan autoimmune diseasethe bodys immune system attacks and destroys the beta cells. - Type 2 diabetesthe most common form of diabetesis caused by a combination of factors, including insulin resistance, a condition in which the bodys muscle, fat, and liver cells do not use insulin effectively. Type 2 diabetes develops when the body can no longer produce enough insulin to compensate for the impaired ability to use insulin. - Scientists believe gestational diabetes is caused by the hormonal changes and metabolic demands of pregnancy together with genetic and environmental factors. Risk factors for gestational diabetes include being overweight and having a family history of diabetes. - Monogenic forms of diabetes are relatively uncommon and are caused by mutations in single genes that limit insulin production, quality, or action in the body. - Other types of diabetes are caused by diseases and injuries that damage the pancreas; certain chemical toxins and medications; infections; and other conditions. |
On this page: Hypothyroidism, also called underactive thyroid, is when the thyroid gland doesn’t make enough thyroid hormones to meet your body’s needs. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. Without enough thyroid hormones, many of your body’s functions slow down. Nearly 5 out of 100 Americans ages 12 years and older have hypothyroidism, although most cases are mild or have few obvious symptoms.1 Women are much more likely than men to develop hypothyroidism. The disease is also more common among people older than age 60.1 You are more likely to have hypothyroidism if you Your thyroid is also more likely to be underactive if you have other health problems, including Left untreated, hypothyroidism during pregnancy can affect both mother and baby. However, thyroid medicines can help prevent problems and are safe to take during pregnancy. Many women taking thyroid hormone medicine need a higher dose during pregnancy, so contact your doctor right away if you find out you’re pregnant. Hypothyroidism can contribute to high cholesterol. If you have high cholesterol, you should get tested for hypothyroidism. Rarely, severe untreated hypothyroidism may lead to myxedema coma, an extreme form of hypothyroidism in which the body’s functions slow to a life-threatening point. Myxedema coma requires immediate medical treatment. Hypothyroidism has many symptoms that can vary from person to person. Some common symptoms of hypothyroidism include Because hypothyroidism develops slowly, you may not notice symptoms of the disease for months or even years. Many of these symptoms, especially fatigue and weight gain, are common and do not necessarily mean you have a thyroid problem. Hypothyroidism has several causes, including Less often, hypothyroidism is caused by too much or too little iodine in the diet or by disorders of the pituitary gland or hypothalamus.1 Iodine deficiency, however, is extremely rare in the United States. Hashimoto’s disease, an autoimmune disorder, is the most common cause of hypothyroidism. With this disease, your immune system attacks the thyroid. The thyroid becomes inflamed and can’t make enough thyroid hormones. Thyroiditis, an inflammation of your thyroid, causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage increases your blood’s hormone levels, leading to thyrotoxicosis, a condition in which thyroid hormone levels are too high. The thyrotoxicosis may last for many months. After that, your thyroid may become underactive and, over time, the condition may become permanent, requiring thyroid hormone replacement. Three types of thyroiditis can cause thyrotoxicosis followed by hypothyroidism.2 Some babies are born with a thyroid that is not fully developed or does not work properly. If untreated, congenital hypothyroidism can lead to intellectual disability and growth failure—when a baby doesn’t grow as expected. Early treatment can prevent these problems. That’s why most newborns in the United States are tested for hypothyroidism. When surgeons remove part of the thyroid, the remaining part may produce normal amounts of thyroid hormone. But some people who have this surgery may develop hypothyroidism. Removing the entire thyroid always results in hypothyroidism. Surgeons may remove part or all of the thyroid as a treatment for Radioactive iodine, a common treatment for hyperthyroidism, gradually destroys thyroid cells. If you receive radioactive iodine treatment, you probably will eventually develop hypothyroidism. Doctors also treat people who have head or neck cancers with external radiation therapy, which can also damage the thyroid if it is included in the treatment. Some medicines can interfere with thyroid hormone production and lead to hypothyroidism, including certain Several recently developed cancer medicines, in particular, can either affect the thyroid directly or affect it indirectly by damaging the pituitary gland. Your doctor will take your medical history and perform a physical exam. A hypothyroidism diagnosis can’t be based on symptoms alone because many of its symptoms are the same as those of other diseases.1 That’s why your doctor may use several thyroid blood tests and imaging tests to confirm the diagnosis and find its cause. Because hypothyroidism can cause fertility problems, women who have trouble getting pregnant often get tested for thyroid problems. Hypothyroidism is treated by replacing the hormones that your own thyroid can no longer make. You will take levothyroxine, a thyroid hormone medicine identical to a hormone a healthy thyroid makes.3 Usually prescribed in pill form, this medicine is also available as a liquid and as a soft gel capsule. These newer formulas may help people with digestive problems to absorb the thyroid hormone. Your doctor may recommend taking the medicine in the morning before eating. Your doctor will give you a blood test about 6 to 8 weeks after you begin taking the medicine, adjusting your dose if needed. Each time your dose is adjusted, you’ll have another blood test. Once you’ve reached a dose that’s working for you, your doctor will probably repeat the blood test in 6 months and then once a year. Your hypothyroidism most likely can be completely controlled with thyroid hormone medicine, as long as you take the recommended dose as instructed. Never stop taking your medicine without talking with your doctor first. Taking too much thyroid hormone medicine can cause serious problems, such as atrial fibrillation or osteoporosis.1 Your thyroid uses iodine to make thyroid hormones. However, if you have Hashimoto’s disease or other types of autoimmune thyroid disorders, you may be sensitive to iodine’s harmful side effects. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hypothyroidism. Taking iodine supplements can have the same effect. Talk with members of your health care team If you are pregnant, you need more iodine because the baby gets iodine from your diet. Talk with your doctor about how much iodine you need. The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of hypothyroidism, such as Find out if clinical studies are right for you. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on hypothyroidism that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Patil N, Rehman A, Jialal I. Hypothyroidism. In: StatPearls [Internet]. StatPearls Publishing; 2020. Updated August 10, 2020. Accessed January 5, 2021. www.ncbi.nlm.nih.gov/books/NBK519536 [2] Pearce EN, Farwell AP, Braverman LE. Thyroiditis. New England Journal of Medicine. 2003;348(26):2646–2655. doi: 10.1056/NEJMra021194. Erratum in: New England Journal of Medicine. 2003;349(6):620. www.nejm.org/doi/10.1056/NEJMra021194 [3] Jonklaas J, Bianco AC, Bauer AJ, et al; American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24(12):1670–1751. doi: 10.1089/thy.2014.0028
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
| What is (are) Hypothyroidism ? | Hypothyroidism is a disorder that occurs when the thyroid gland does not make enough thyroid hormone to meet the bodys needs. Thyroid hormone regulates metabolismthe way the body uses energyand affects nearly every organ in the body. Without enough thyroid hormone, many of the bodys functions slow down. About 4.6 percent of the U.S. population age 12 and older has hypothyroidism.1 |
On this page: Hypothyroidism, also called underactive thyroid, is when the thyroid gland doesn’t make enough thyroid hormones to meet your body’s needs. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. Without enough thyroid hormones, many of your body’s functions slow down. Nearly 5 out of 100 Americans ages 12 years and older have hypothyroidism, although most cases are mild or have few obvious symptoms.1 Women are much more likely than men to develop hypothyroidism. The disease is also more common among people older than age 60.1 You are more likely to have hypothyroidism if you Your thyroid is also more likely to be underactive if you have other health problems, including Left untreated, hypothyroidism during pregnancy can affect both mother and baby. However, thyroid medicines can help prevent problems and are safe to take during pregnancy. Many women taking thyroid hormone medicine need a higher dose during pregnancy, so contact your doctor right away if you find out you’re pregnant. Hypothyroidism can contribute to high cholesterol. If you have high cholesterol, you should get tested for hypothyroidism. Rarely, severe untreated hypothyroidism may lead to myxedema coma, an extreme form of hypothyroidism in which the body’s functions slow to a life-threatening point. Myxedema coma requires immediate medical treatment. Hypothyroidism has many symptoms that can vary from person to person. Some common symptoms of hypothyroidism include Because hypothyroidism develops slowly, you may not notice symptoms of the disease for months or even years. Many of these symptoms, especially fatigue and weight gain, are common and do not necessarily mean you have a thyroid problem. Hypothyroidism has several causes, including Less often, hypothyroidism is caused by too much or too little iodine in the diet or by disorders of the pituitary gland or hypothalamus.1 Iodine deficiency, however, is extremely rare in the United States. Hashimoto’s disease, an autoimmune disorder, is the most common cause of hypothyroidism. With this disease, your immune system attacks the thyroid. The thyroid becomes inflamed and can’t make enough thyroid hormones. Thyroiditis, an inflammation of your thyroid, causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage increases your blood’s hormone levels, leading to thyrotoxicosis, a condition in which thyroid hormone levels are too high. The thyrotoxicosis may last for many months. After that, your thyroid may become underactive and, over time, the condition may become permanent, requiring thyroid hormone replacement. Three types of thyroiditis can cause thyrotoxicosis followed by hypothyroidism.2 Some babies are born with a thyroid that is not fully developed or does not work properly. If untreated, congenital hypothyroidism can lead to intellectual disability and growth failure—when a baby doesn’t grow as expected. Early treatment can prevent these problems. That’s why most newborns in the United States are tested for hypothyroidism. When surgeons remove part of the thyroid, the remaining part may produce normal amounts of thyroid hormone. But some people who have this surgery may develop hypothyroidism. Removing the entire thyroid always results in hypothyroidism. Surgeons may remove part or all of the thyroid as a treatment for Radioactive iodine, a common treatment for hyperthyroidism, gradually destroys thyroid cells. If you receive radioactive iodine treatment, you probably will eventually develop hypothyroidism. Doctors also treat people who have head or neck cancers with external radiation therapy, which can also damage the thyroid if it is included in the treatment. Some medicines can interfere with thyroid hormone production and lead to hypothyroidism, including certain Several recently developed cancer medicines, in particular, can either affect the thyroid directly or affect it indirectly by damaging the pituitary gland. Your doctor will take your medical history and perform a physical exam. A hypothyroidism diagnosis can’t be based on symptoms alone because many of its symptoms are the same as those of other diseases.1 That’s why your doctor may use several thyroid blood tests and imaging tests to confirm the diagnosis and find its cause. Because hypothyroidism can cause fertility problems, women who have trouble getting pregnant often get tested for thyroid problems. Hypothyroidism is treated by replacing the hormones that your own thyroid can no longer make. You will take levothyroxine, a thyroid hormone medicine identical to a hormone a healthy thyroid makes.3 Usually prescribed in pill form, this medicine is also available as a liquid and as a soft gel capsule. These newer formulas may help people with digestive problems to absorb the thyroid hormone. Your doctor may recommend taking the medicine in the morning before eating. Your doctor will give you a blood test about 6 to 8 weeks after you begin taking the medicine, adjusting your dose if needed. Each time your dose is adjusted, you’ll have another blood test. Once you’ve reached a dose that’s working for you, your doctor will probably repeat the blood test in 6 months and then once a year. Your hypothyroidism most likely can be completely controlled with thyroid hormone medicine, as long as you take the recommended dose as instructed. Never stop taking your medicine without talking with your doctor first. Taking too much thyroid hormone medicine can cause serious problems, such as atrial fibrillation or osteoporosis.1 Your thyroid uses iodine to make thyroid hormones. However, if you have Hashimoto’s disease or other types of autoimmune thyroid disorders, you may be sensitive to iodine’s harmful side effects. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hypothyroidism. Taking iodine supplements can have the same effect. Talk with members of your health care team If you are pregnant, you need more iodine because the baby gets iodine from your diet. Talk with your doctor about how much iodine you need. The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of hypothyroidism, such as Find out if clinical studies are right for you. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on hypothyroidism that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Patil N, Rehman A, Jialal I. Hypothyroidism. In: StatPearls [Internet]. StatPearls Publishing; 2020. Updated August 10, 2020. Accessed January 5, 2021. www.ncbi.nlm.nih.gov/books/NBK519536 [2] Pearce EN, Farwell AP, Braverman LE. Thyroiditis. New England Journal of Medicine. 2003;348(26):2646–2655. doi: 10.1056/NEJMra021194. Erratum in: New England Journal of Medicine. 2003;349(6):620. www.nejm.org/doi/10.1056/NEJMra021194 [3] Jonklaas J, Bianco AC, Bauer AJ, et al; American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24(12):1670–1751. doi: 10.1089/thy.2014.0028
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
| What is (are) Hypothyroidism ? | The thyroid is a 2-inch-long, butterfly-shaped gland weighing less than 1 ounce. Located in the front of the neck below the larynx, or voice box, it has two lobes, one on each side of the windpipe. The thyroid is one of the glands that make up the endocrine system. The glands of the endocrine system produce and store hormones and release them into the bloodstream. The hormones then travel through the body and direct the activity of the bodys cells.
The thyroid gland makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). T3 is made from T4 and is the more active hormone, directly affecting the tissues. Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels. |
On this page: Hypothyroidism, also called underactive thyroid, is when the thyroid gland doesn’t make enough thyroid hormones to meet your body’s needs. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. Without enough thyroid hormones, many of your body’s functions slow down. Nearly 5 out of 100 Americans ages 12 years and older have hypothyroidism, although most cases are mild or have few obvious symptoms.1 Women are much more likely than men to develop hypothyroidism. The disease is also more common among people older than age 60.1 You are more likely to have hypothyroidism if you Your thyroid is also more likely to be underactive if you have other health problems, including Left untreated, hypothyroidism during pregnancy can affect both mother and baby. However, thyroid medicines can help prevent problems and are safe to take during pregnancy. Many women taking thyroid hormone medicine need a higher dose during pregnancy, so contact your doctor right away if you find out you’re pregnant. Hypothyroidism can contribute to high cholesterol. If you have high cholesterol, you should get tested for hypothyroidism. Rarely, severe untreated hypothyroidism may lead to myxedema coma, an extreme form of hypothyroidism in which the body’s functions slow to a life-threatening point. Myxedema coma requires immediate medical treatment. Hypothyroidism has many symptoms that can vary from person to person. Some common symptoms of hypothyroidism include Because hypothyroidism develops slowly, you may not notice symptoms of the disease for months or even years. Many of these symptoms, especially fatigue and weight gain, are common and do not necessarily mean you have a thyroid problem. Hypothyroidism has several causes, including Less often, hypothyroidism is caused by too much or too little iodine in the diet or by disorders of the pituitary gland or hypothalamus.1 Iodine deficiency, however, is extremely rare in the United States. Hashimoto’s disease, an autoimmune disorder, is the most common cause of hypothyroidism. With this disease, your immune system attacks the thyroid. The thyroid becomes inflamed and can’t make enough thyroid hormones. Thyroiditis, an inflammation of your thyroid, causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage increases your blood’s hormone levels, leading to thyrotoxicosis, a condition in which thyroid hormone levels are too high. The thyrotoxicosis may last for many months. After that, your thyroid may become underactive and, over time, the condition may become permanent, requiring thyroid hormone replacement. Three types of thyroiditis can cause thyrotoxicosis followed by hypothyroidism.2 Some babies are born with a thyroid that is not fully developed or does not work properly. If untreated, congenital hypothyroidism can lead to intellectual disability and growth failure—when a baby doesn’t grow as expected. Early treatment can prevent these problems. That’s why most newborns in the United States are tested for hypothyroidism. When surgeons remove part of the thyroid, the remaining part may produce normal amounts of thyroid hormone. But some people who have this surgery may develop hypothyroidism. Removing the entire thyroid always results in hypothyroidism. Surgeons may remove part or all of the thyroid as a treatment for Radioactive iodine, a common treatment for hyperthyroidism, gradually destroys thyroid cells. If you receive radioactive iodine treatment, you probably will eventually develop hypothyroidism. Doctors also treat people who have head or neck cancers with external radiation therapy, which can also damage the thyroid if it is included in the treatment. Some medicines can interfere with thyroid hormone production and lead to hypothyroidism, including certain Several recently developed cancer medicines, in particular, can either affect the thyroid directly or affect it indirectly by damaging the pituitary gland. Your doctor will take your medical history and perform a physical exam. A hypothyroidism diagnosis can’t be based on symptoms alone because many of its symptoms are the same as those of other diseases.1 That’s why your doctor may use several thyroid blood tests and imaging tests to confirm the diagnosis and find its cause. Because hypothyroidism can cause fertility problems, women who have trouble getting pregnant often get tested for thyroid problems. Hypothyroidism is treated by replacing the hormones that your own thyroid can no longer make. You will take levothyroxine, a thyroid hormone medicine identical to a hormone a healthy thyroid makes.3 Usually prescribed in pill form, this medicine is also available as a liquid and as a soft gel capsule. These newer formulas may help people with digestive problems to absorb the thyroid hormone. Your doctor may recommend taking the medicine in the morning before eating. Your doctor will give you a blood test about 6 to 8 weeks after you begin taking the medicine, adjusting your dose if needed. Each time your dose is adjusted, you’ll have another blood test. Once you’ve reached a dose that’s working for you, your doctor will probably repeat the blood test in 6 months and then once a year. Your hypothyroidism most likely can be completely controlled with thyroid hormone medicine, as long as you take the recommended dose as instructed. Never stop taking your medicine without talking with your doctor first. Taking too much thyroid hormone medicine can cause serious problems, such as atrial fibrillation or osteoporosis.1 Your thyroid uses iodine to make thyroid hormones. However, if you have Hashimoto’s disease or other types of autoimmune thyroid disorders, you may be sensitive to iodine’s harmful side effects. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hypothyroidism. Taking iodine supplements can have the same effect. Talk with members of your health care team If you are pregnant, you need more iodine because the baby gets iodine from your diet. Talk with your doctor about how much iodine you need. The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of hypothyroidism, such as Find out if clinical studies are right for you. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on hypothyroidism that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Patil N, Rehman A, Jialal I. Hypothyroidism. In: StatPearls [Internet]. StatPearls Publishing; 2020. Updated August 10, 2020. Accessed January 5, 2021. www.ncbi.nlm.nih.gov/books/NBK519536 [2] Pearce EN, Farwell AP, Braverman LE. Thyroiditis. New England Journal of Medicine. 2003;348(26):2646–2655. doi: 10.1056/NEJMra021194. Erratum in: New England Journal of Medicine. 2003;349(6):620. www.nejm.org/doi/10.1056/NEJMra021194 [3] Jonklaas J, Bianco AC, Bauer AJ, et al; American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24(12):1670–1751. doi: 10.1089/thy.2014.0028
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
| What causes Hypothyroidism ? | Hypothyroidism has several causes, including
- Hashimotos disease - thyroiditis, or inflammation of the thyroid - congenital hypothyroidism, or hypothyroidism that is present at birth - surgical removal of part or all of the thyroid - radiation treatment of the thyroid - some medications
Less commonly, hypothyroidism is caused by too much or too little iodine in the diet or by abnormalities of the pituitary gland.
Hashimotos Disease
Hashimotos disease, also called chronic lymphocytic thyroiditis, is the most common cause of hypothyroidism in the United States.1 Hashimotos disease is a form of chronic inflammation of the thyroid gland. Hashimotos disease is also an autoimmune disorder.
Normally, the immune system protects the body against foreign invaderssuch as viruses and bacteriathat can cause illness. But in autoimmune diseases, the immune system attacks the bodys own cells and organs. With Hashimotos disease, the immune system attacks the thyroid, causing inflammation and interfering with its ability to produce thyroid hormones.
More information is provided in the NIDDK health topic, Hashimotos Disease.
Thyroiditis
Thyroiditis causes stored thyroid hormone to leak out of the thyroid gland. At first, the leakage raises hormone levels in the blood, leading to hyperthyroidismwhen thyroid hormone levels are too highthat lasts for 1 or 2 months. Most people then develop hypothyroidism before the thyroid is completely healed.
Several types of thyroiditis can cause hyperthyroidism followed by hypothyroidism:
- Subacute thyroiditis. This condition involves painful inflammation and enlargement of the thyroid. Experts are not sure what causes subacute thyroiditis, but it may be related to a viral or bacterial infection. The condition usually goes away on its own in a few months. - Postpartum thyroiditis. This type of thyroiditis develops after a woman gives birth. For more information, see the section titled What happens with pregnancy and thyroid conditions? - Silent thyroiditis. This type of thyroiditis is called silent because it is painless, as is postpartum thyroiditis, even though the thyroid may be enlarged. Like postpartum thyroiditis, silent thyroiditis is probably an autoimmune condition and sometimes develops into permanent hypothyroidism.
Congenital Hypothyroidism
Some babies are born with a thyroid that is not fully developed or does not function properly. If untreated, congenital hypothyroidism can lead to mental retardation and growth failure. Early treatment can prevent these complications, so most newborns in the United States are screened for hypothyroidism.
Surgical Removal of the Thyroid
When part of the thyroid is removed, the remaining part may produce normal amounts of thyroid hormone, but some people who have this surgery develop hypothyroidism. Removal of the entire thyroid always results in hypothyroidism.
Part or all of the thyroid may be surgically removed as a treatment for
- hyperthyroidism - a large goiter, which is an enlarged thyroid that may cause the neck to appear swollen and can interfere with normal breathing and swallowing - thyroid nodules, which are noncancerous tumors, called adenomas, or lumps in the thyroid that can produce excess thyroid hormone - thyroid cancer
Radiation Treatment of the Thyroid
Radioactive iodine, a common treatment for hyperthyroidism, gradually destroys the cells of the thyroid. Most people who receive radioactive iodine treatment eventually develop hypothyroidism. People with Hodgkins disease, other lymphomas, and head or neck cancers are treated with radiation, which can also damage the thyroid.
Medications
Some drugs can interfere with thyroid hormone production and lead to hypothyroidism, including
- amiodarone, a heart medication - interferon alpha, a cancer medication - lithium, a bipolar disorder medication - interleukin-2, a kidney cancer medication |
On this page: Hypothyroidism, also called underactive thyroid, is when the thyroid gland doesn’t make enough thyroid hormones to meet your body’s needs. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. Without enough thyroid hormones, many of your body’s functions slow down. Nearly 5 out of 100 Americans ages 12 years and older have hypothyroidism, although most cases are mild or have few obvious symptoms.1 Women are much more likely than men to develop hypothyroidism. The disease is also more common among people older than age 60.1 You are more likely to have hypothyroidism if you Your thyroid is also more likely to be underactive if you have other health problems, including Left untreated, hypothyroidism during pregnancy can affect both mother and baby. However, thyroid medicines can help prevent problems and are safe to take during pregnancy. Many women taking thyroid hormone medicine need a higher dose during pregnancy, so contact your doctor right away if you find out you’re pregnant. Hypothyroidism can contribute to high cholesterol. If you have high cholesterol, you should get tested for hypothyroidism. Rarely, severe untreated hypothyroidism may lead to myxedema coma, an extreme form of hypothyroidism in which the body’s functions slow to a life-threatening point. Myxedema coma requires immediate medical treatment. Hypothyroidism has many symptoms that can vary from person to person. Some common symptoms of hypothyroidism include Because hypothyroidism develops slowly, you may not notice symptoms of the disease for months or even years. Many of these symptoms, especially fatigue and weight gain, are common and do not necessarily mean you have a thyroid problem. Hypothyroidism has several causes, including Less often, hypothyroidism is caused by too much or too little iodine in the diet or by disorders of the pituitary gland or hypothalamus.1 Iodine deficiency, however, is extremely rare in the United States. Hashimoto’s disease, an autoimmune disorder, is the most common cause of hypothyroidism. With this disease, your immune system attacks the thyroid. The thyroid becomes inflamed and can’t make enough thyroid hormones. Thyroiditis, an inflammation of your thyroid, causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage increases your blood’s hormone levels, leading to thyrotoxicosis, a condition in which thyroid hormone levels are too high. The thyrotoxicosis may last for many months. After that, your thyroid may become underactive and, over time, the condition may become permanent, requiring thyroid hormone replacement. Three types of thyroiditis can cause thyrotoxicosis followed by hypothyroidism.2 Some babies are born with a thyroid that is not fully developed or does not work properly. If untreated, congenital hypothyroidism can lead to intellectual disability and growth failure—when a baby doesn’t grow as expected. Early treatment can prevent these problems. That’s why most newborns in the United States are tested for hypothyroidism. When surgeons remove part of the thyroid, the remaining part may produce normal amounts of thyroid hormone. But some people who have this surgery may develop hypothyroidism. Removing the entire thyroid always results in hypothyroidism. Surgeons may remove part or all of the thyroid as a treatment for Radioactive iodine, a common treatment for hyperthyroidism, gradually destroys thyroid cells. If you receive radioactive iodine treatment, you probably will eventually develop hypothyroidism. Doctors also treat people who have head or neck cancers with external radiation therapy, which can also damage the thyroid if it is included in the treatment. Some medicines can interfere with thyroid hormone production and lead to hypothyroidism, including certain Several recently developed cancer medicines, in particular, can either affect the thyroid directly or affect it indirectly by damaging the pituitary gland. Your doctor will take your medical history and perform a physical exam. A hypothyroidism diagnosis can’t be based on symptoms alone because many of its symptoms are the same as those of other diseases.1 That’s why your doctor may use several thyroid blood tests and imaging tests to confirm the diagnosis and find its cause. Because hypothyroidism can cause fertility problems, women who have trouble getting pregnant often get tested for thyroid problems. Hypothyroidism is treated by replacing the hormones that your own thyroid can no longer make. You will take levothyroxine, a thyroid hormone medicine identical to a hormone a healthy thyroid makes.3 Usually prescribed in pill form, this medicine is also available as a liquid and as a soft gel capsule. These newer formulas may help people with digestive problems to absorb the thyroid hormone. Your doctor may recommend taking the medicine in the morning before eating. Your doctor will give you a blood test about 6 to 8 weeks after you begin taking the medicine, adjusting your dose if needed. Each time your dose is adjusted, you’ll have another blood test. Once you’ve reached a dose that’s working for you, your doctor will probably repeat the blood test in 6 months and then once a year. Your hypothyroidism most likely can be completely controlled with thyroid hormone medicine, as long as you take the recommended dose as instructed. Never stop taking your medicine without talking with your doctor first. Taking too much thyroid hormone medicine can cause serious problems, such as atrial fibrillation or osteoporosis.1 Your thyroid uses iodine to make thyroid hormones. However, if you have Hashimoto’s disease or other types of autoimmune thyroid disorders, you may be sensitive to iodine’s harmful side effects. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hypothyroidism. Taking iodine supplements can have the same effect. Talk with members of your health care team If you are pregnant, you need more iodine because the baby gets iodine from your diet. Talk with your doctor about how much iodine you need. The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of hypothyroidism, such as Find out if clinical studies are right for you. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on hypothyroidism that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Patil N, Rehman A, Jialal I. Hypothyroidism. In: StatPearls [Internet]. StatPearls Publishing; 2020. Updated August 10, 2020. Accessed January 5, 2021. www.ncbi.nlm.nih.gov/books/NBK519536 [2] Pearce EN, Farwell AP, Braverman LE. Thyroiditis. New England Journal of Medicine. 2003;348(26):2646–2655. doi: 10.1056/NEJMra021194. Erratum in: New England Journal of Medicine. 2003;349(6):620. www.nejm.org/doi/10.1056/NEJMra021194 [3] Jonklaas J, Bianco AC, Bauer AJ, et al; American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24(12):1670–1751. doi: 10.1089/thy.2014.0028
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
| What are the symptoms of Hypothyroidism ? | Hypothyroidism has many symptoms that can vary from person to person. Some common symptoms of hypothyroidism are
- fatigue - weight gain - a puffy face - cold intolerance - joint and muscle pain - constipation - dry skin - dry, thinning hair - decreased sweating - heavy or irregular menstrual periods and impaired fertility - depression - slowed heart rate
However, hypothyroidism develops slowly, so many people dont notice symptoms of the disease.
Symptoms more specific to Hashimotos disease are a goiter and a feeling of fullness in the throat.
Hypothyroidism can contribute to high cholesterol, so people with high cholesterol should be tested for hypothyroidism. Rarely, severe, untreated hypothyroidism may lead to myxedema coma, an extreme form of hypothyroidism in which the bodys functions slow to the point that it becomes life threatening. Myxedema requires immediate medical treatment. |
On this page: Hypothyroidism, also called underactive thyroid, is when the thyroid gland doesn’t make enough thyroid hormones to meet your body’s needs. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. Without enough thyroid hormones, many of your body’s functions slow down. Nearly 5 out of 100 Americans ages 12 years and older have hypothyroidism, although most cases are mild or have few obvious symptoms.1 Women are much more likely than men to develop hypothyroidism. The disease is also more common among people older than age 60.1 You are more likely to have hypothyroidism if you Your thyroid is also more likely to be underactive if you have other health problems, including Left untreated, hypothyroidism during pregnancy can affect both mother and baby. However, thyroid medicines can help prevent problems and are safe to take during pregnancy. Many women taking thyroid hormone medicine need a higher dose during pregnancy, so contact your doctor right away if you find out you’re pregnant. Hypothyroidism can contribute to high cholesterol. If you have high cholesterol, you should get tested for hypothyroidism. Rarely, severe untreated hypothyroidism may lead to myxedema coma, an extreme form of hypothyroidism in which the body’s functions slow to a life-threatening point. Myxedema coma requires immediate medical treatment. Hypothyroidism has many symptoms that can vary from person to person. Some common symptoms of hypothyroidism include Because hypothyroidism develops slowly, you may not notice symptoms of the disease for months or even years. Many of these symptoms, especially fatigue and weight gain, are common and do not necessarily mean you have a thyroid problem. Hypothyroidism has several causes, including Less often, hypothyroidism is caused by too much or too little iodine in the diet or by disorders of the pituitary gland or hypothalamus.1 Iodine deficiency, however, is extremely rare in the United States. Hashimoto’s disease, an autoimmune disorder, is the most common cause of hypothyroidism. With this disease, your immune system attacks the thyroid. The thyroid becomes inflamed and can’t make enough thyroid hormones. Thyroiditis, an inflammation of your thyroid, causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage increases your blood’s hormone levels, leading to thyrotoxicosis, a condition in which thyroid hormone levels are too high. The thyrotoxicosis may last for many months. After that, your thyroid may become underactive and, over time, the condition may become permanent, requiring thyroid hormone replacement. Three types of thyroiditis can cause thyrotoxicosis followed by hypothyroidism.2 Some babies are born with a thyroid that is not fully developed or does not work properly. If untreated, congenital hypothyroidism can lead to intellectual disability and growth failure—when a baby doesn’t grow as expected. Early treatment can prevent these problems. That’s why most newborns in the United States are tested for hypothyroidism. When surgeons remove part of the thyroid, the remaining part may produce normal amounts of thyroid hormone. But some people who have this surgery may develop hypothyroidism. Removing the entire thyroid always results in hypothyroidism. Surgeons may remove part or all of the thyroid as a treatment for Radioactive iodine, a common treatment for hyperthyroidism, gradually destroys thyroid cells. If you receive radioactive iodine treatment, you probably will eventually develop hypothyroidism. Doctors also treat people who have head or neck cancers with external radiation therapy, which can also damage the thyroid if it is included in the treatment. Some medicines can interfere with thyroid hormone production and lead to hypothyroidism, including certain Several recently developed cancer medicines, in particular, can either affect the thyroid directly or affect it indirectly by damaging the pituitary gland. Your doctor will take your medical history and perform a physical exam. A hypothyroidism diagnosis can’t be based on symptoms alone because many of its symptoms are the same as those of other diseases.1 That’s why your doctor may use several thyroid blood tests and imaging tests to confirm the diagnosis and find its cause. Because hypothyroidism can cause fertility problems, women who have trouble getting pregnant often get tested for thyroid problems. Hypothyroidism is treated by replacing the hormones that your own thyroid can no longer make. You will take levothyroxine, a thyroid hormone medicine identical to a hormone a healthy thyroid makes.3 Usually prescribed in pill form, this medicine is also available as a liquid and as a soft gel capsule. These newer formulas may help people with digestive problems to absorb the thyroid hormone. Your doctor may recommend taking the medicine in the morning before eating. Your doctor will give you a blood test about 6 to 8 weeks after you begin taking the medicine, adjusting your dose if needed. Each time your dose is adjusted, you’ll have another blood test. Once you’ve reached a dose that’s working for you, your doctor will probably repeat the blood test in 6 months and then once a year. Your hypothyroidism most likely can be completely controlled with thyroid hormone medicine, as long as you take the recommended dose as instructed. Never stop taking your medicine without talking with your doctor first. Taking too much thyroid hormone medicine can cause serious problems, such as atrial fibrillation or osteoporosis.1 Your thyroid uses iodine to make thyroid hormones. However, if you have Hashimoto’s disease or other types of autoimmune thyroid disorders, you may be sensitive to iodine’s harmful side effects. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hypothyroidism. Taking iodine supplements can have the same effect. Talk with members of your health care team If you are pregnant, you need more iodine because the baby gets iodine from your diet. Talk with your doctor about how much iodine you need. The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of hypothyroidism, such as Find out if clinical studies are right for you. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on hypothyroidism that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Patil N, Rehman A, Jialal I. Hypothyroidism. In: StatPearls [Internet]. StatPearls Publishing; 2020. Updated August 10, 2020. Accessed January 5, 2021. www.ncbi.nlm.nih.gov/books/NBK519536 [2] Pearce EN, Farwell AP, Braverman LE. Thyroiditis. New England Journal of Medicine. 2003;348(26):2646–2655. doi: 10.1056/NEJMra021194. Erratum in: New England Journal of Medicine. 2003;349(6):620. www.nejm.org/doi/10.1056/NEJMra021194 [3] Jonklaas J, Bianco AC, Bauer AJ, et al; American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24(12):1670–1751. doi: 10.1089/thy.2014.0028
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
| How to diagnose Hypothyroidism ? | Many symptoms of hypothyroidism are the same as those of other diseases, so hypothyroidism usually cannot be diagnosed based on symptoms alone. With suspected hypothyroidism, health care providers take a medical history and perform a thorough physical examination. Health care providers may then use several blood tests to confirm a diagnosis of hypothyroidism and find its cause:
TSH test. The ultrasensitive TSH test is usually the first test a health care provider performs. This test detects even tiny amounts of TSH in the blood and is the most accurate measure of thyroid activity available. Generally, a TSH reading above normal means a person has hypothyroidism and a reading below normal means a person has hyperthyroidism.
Mildly elevated TSH without symptoms indicates subclinical hypothyroidism. Some health care providers treat subclinical hypothyroidism immediately. Others prefer to leave it untreated but monitor their patients for signs that the condition is worsening.
Health care providers may conduct additional tests to help confirm the diagnosis or determine the cause of hypothyroidism.
T4 test. This test measures the actual amount of circulating thyroid hormone in the blood. In hypothyroidism, the level of T4 in the blood is lower than normal.
Thyroid autoantibody test. This test looks for the presence of thyroid autoantibodies. Most people with Hashimotos disease have these antibodies, but people whose hypothyroidism is caused by other conditions do not.
More information about testing for thyroid problems is provided in the NIDDK health topic, Thyroid Tests. |
On this page: Hypothyroidism, also called underactive thyroid, is when the thyroid gland doesn’t make enough thyroid hormones to meet your body’s needs. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. Without enough thyroid hormones, many of your body’s functions slow down. Nearly 5 out of 100 Americans ages 12 years and older have hypothyroidism, although most cases are mild or have few obvious symptoms.1 Women are much more likely than men to develop hypothyroidism. The disease is also more common among people older than age 60.1 You are more likely to have hypothyroidism if you Your thyroid is also more likely to be underactive if you have other health problems, including Left untreated, hypothyroidism during pregnancy can affect both mother and baby. However, thyroid medicines can help prevent problems and are safe to take during pregnancy. Many women taking thyroid hormone medicine need a higher dose during pregnancy, so contact your doctor right away if you find out you’re pregnant. Hypothyroidism can contribute to high cholesterol. If you have high cholesterol, you should get tested for hypothyroidism. Rarely, severe untreated hypothyroidism may lead to myxedema coma, an extreme form of hypothyroidism in which the body’s functions slow to a life-threatening point. Myxedema coma requires immediate medical treatment. Hypothyroidism has many symptoms that can vary from person to person. Some common symptoms of hypothyroidism include Because hypothyroidism develops slowly, you may not notice symptoms of the disease for months or even years. Many of these symptoms, especially fatigue and weight gain, are common and do not necessarily mean you have a thyroid problem. Hypothyroidism has several causes, including Less often, hypothyroidism is caused by too much or too little iodine in the diet or by disorders of the pituitary gland or hypothalamus.1 Iodine deficiency, however, is extremely rare in the United States. Hashimoto’s disease, an autoimmune disorder, is the most common cause of hypothyroidism. With this disease, your immune system attacks the thyroid. The thyroid becomes inflamed and can’t make enough thyroid hormones. Thyroiditis, an inflammation of your thyroid, causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage increases your blood’s hormone levels, leading to thyrotoxicosis, a condition in which thyroid hormone levels are too high. The thyrotoxicosis may last for many months. After that, your thyroid may become underactive and, over time, the condition may become permanent, requiring thyroid hormone replacement. Three types of thyroiditis can cause thyrotoxicosis followed by hypothyroidism.2 Some babies are born with a thyroid that is not fully developed or does not work properly. If untreated, congenital hypothyroidism can lead to intellectual disability and growth failure—when a baby doesn’t grow as expected. Early treatment can prevent these problems. That’s why most newborns in the United States are tested for hypothyroidism. When surgeons remove part of the thyroid, the remaining part may produce normal amounts of thyroid hormone. But some people who have this surgery may develop hypothyroidism. Removing the entire thyroid always results in hypothyroidism. Surgeons may remove part or all of the thyroid as a treatment for Radioactive iodine, a common treatment for hyperthyroidism, gradually destroys thyroid cells. If you receive radioactive iodine treatment, you probably will eventually develop hypothyroidism. Doctors also treat people who have head or neck cancers with external radiation therapy, which can also damage the thyroid if it is included in the treatment. Some medicines can interfere with thyroid hormone production and lead to hypothyroidism, including certain Several recently developed cancer medicines, in particular, can either affect the thyroid directly or affect it indirectly by damaging the pituitary gland. Your doctor will take your medical history and perform a physical exam. A hypothyroidism diagnosis can’t be based on symptoms alone because many of its symptoms are the same as those of other diseases.1 That’s why your doctor may use several thyroid blood tests and imaging tests to confirm the diagnosis and find its cause. Because hypothyroidism can cause fertility problems, women who have trouble getting pregnant often get tested for thyroid problems. Hypothyroidism is treated by replacing the hormones that your own thyroid can no longer make. You will take levothyroxine, a thyroid hormone medicine identical to a hormone a healthy thyroid makes.3 Usually prescribed in pill form, this medicine is also available as a liquid and as a soft gel capsule. These newer formulas may help people with digestive problems to absorb the thyroid hormone. Your doctor may recommend taking the medicine in the morning before eating. Your doctor will give you a blood test about 6 to 8 weeks after you begin taking the medicine, adjusting your dose if needed. Each time your dose is adjusted, you’ll have another blood test. Once you’ve reached a dose that’s working for you, your doctor will probably repeat the blood test in 6 months and then once a year. Your hypothyroidism most likely can be completely controlled with thyroid hormone medicine, as long as you take the recommended dose as instructed. Never stop taking your medicine without talking with your doctor first. Taking too much thyroid hormone medicine can cause serious problems, such as atrial fibrillation or osteoporosis.1 Your thyroid uses iodine to make thyroid hormones. However, if you have Hashimoto’s disease or other types of autoimmune thyroid disorders, you may be sensitive to iodine’s harmful side effects. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hypothyroidism. Taking iodine supplements can have the same effect. Talk with members of your health care team If you are pregnant, you need more iodine because the baby gets iodine from your diet. Talk with your doctor about how much iodine you need. The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of hypothyroidism, such as Find out if clinical studies are right for you. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on hypothyroidism that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Patil N, Rehman A, Jialal I. Hypothyroidism. In: StatPearls [Internet]. StatPearls Publishing; 2020. Updated August 10, 2020. Accessed January 5, 2021. www.ncbi.nlm.nih.gov/books/NBK519536 [2] Pearce EN, Farwell AP, Braverman LE. Thyroiditis. New England Journal of Medicine. 2003;348(26):2646–2655. doi: 10.1056/NEJMra021194. Erratum in: New England Journal of Medicine. 2003;349(6):620. www.nejm.org/doi/10.1056/NEJMra021194 [3] Jonklaas J, Bianco AC, Bauer AJ, et al; American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24(12):1670–1751. doi: 10.1089/thy.2014.0028
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
| What are the treatments for Hypothyroidism ? | Health care providers treat hypothyroidism with synthetic thyroxine, a medication that is identical to the hormone T4. The exact dose will depend on the patients age and weight, the severity of the hypothyroidism, the presence of other health problems, and whether the person is taking other drugs that might interfere with how well the body uses thyroid hormone.
Health care providers test TSH levels about 6 to 8 weeks after a patient begins taking thyroid hormone and make any necessary adjustments to the dose. Each time the dose is adjusted, the blood is tested again. Once a stable dose is reached, blood tests are normally repeated in 6 months and then once a year.
Hypothyroidism can almost always be completely controlled with synthetic thyroxine, as long as the recommended dose is taken every day as instructed. |
On this page: Hypothyroidism, also called underactive thyroid, is when the thyroid gland doesn’t make enough thyroid hormones to meet your body’s needs. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. Without enough thyroid hormones, many of your body’s functions slow down. Nearly 5 out of 100 Americans ages 12 years and older have hypothyroidism, although most cases are mild or have few obvious symptoms.1 Women are much more likely than men to develop hypothyroidism. The disease is also more common among people older than age 60.1 You are more likely to have hypothyroidism if you Your thyroid is also more likely to be underactive if you have other health problems, including Left untreated, hypothyroidism during pregnancy can affect both mother and baby. However, thyroid medicines can help prevent problems and are safe to take during pregnancy. Many women taking thyroid hormone medicine need a higher dose during pregnancy, so contact your doctor right away if you find out you’re pregnant. Hypothyroidism can contribute to high cholesterol. If you have high cholesterol, you should get tested for hypothyroidism. Rarely, severe untreated hypothyroidism may lead to myxedema coma, an extreme form of hypothyroidism in which the body’s functions slow to a life-threatening point. Myxedema coma requires immediate medical treatment. Hypothyroidism has many symptoms that can vary from person to person. Some common symptoms of hypothyroidism include Because hypothyroidism develops slowly, you may not notice symptoms of the disease for months or even years. Many of these symptoms, especially fatigue and weight gain, are common and do not necessarily mean you have a thyroid problem. Hypothyroidism has several causes, including Less often, hypothyroidism is caused by too much or too little iodine in the diet or by disorders of the pituitary gland or hypothalamus.1 Iodine deficiency, however, is extremely rare in the United States. Hashimoto’s disease, an autoimmune disorder, is the most common cause of hypothyroidism. With this disease, your immune system attacks the thyroid. The thyroid becomes inflamed and can’t make enough thyroid hormones. Thyroiditis, an inflammation of your thyroid, causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage increases your blood’s hormone levels, leading to thyrotoxicosis, a condition in which thyroid hormone levels are too high. The thyrotoxicosis may last for many months. After that, your thyroid may become underactive and, over time, the condition may become permanent, requiring thyroid hormone replacement. Three types of thyroiditis can cause thyrotoxicosis followed by hypothyroidism.2 Some babies are born with a thyroid that is not fully developed or does not work properly. If untreated, congenital hypothyroidism can lead to intellectual disability and growth failure—when a baby doesn’t grow as expected. Early treatment can prevent these problems. That’s why most newborns in the United States are tested for hypothyroidism. When surgeons remove part of the thyroid, the remaining part may produce normal amounts of thyroid hormone. But some people who have this surgery may develop hypothyroidism. Removing the entire thyroid always results in hypothyroidism. Surgeons may remove part or all of the thyroid as a treatment for Radioactive iodine, a common treatment for hyperthyroidism, gradually destroys thyroid cells. If you receive radioactive iodine treatment, you probably will eventually develop hypothyroidism. Doctors also treat people who have head or neck cancers with external radiation therapy, which can also damage the thyroid if it is included in the treatment. Some medicines can interfere with thyroid hormone production and lead to hypothyroidism, including certain Several recently developed cancer medicines, in particular, can either affect the thyroid directly or affect it indirectly by damaging the pituitary gland. Your doctor will take your medical history and perform a physical exam. A hypothyroidism diagnosis can’t be based on symptoms alone because many of its symptoms are the same as those of other diseases.1 That’s why your doctor may use several thyroid blood tests and imaging tests to confirm the diagnosis and find its cause. Because hypothyroidism can cause fertility problems, women who have trouble getting pregnant often get tested for thyroid problems. Hypothyroidism is treated by replacing the hormones that your own thyroid can no longer make. You will take levothyroxine, a thyroid hormone medicine identical to a hormone a healthy thyroid makes.3 Usually prescribed in pill form, this medicine is also available as a liquid and as a soft gel capsule. These newer formulas may help people with digestive problems to absorb the thyroid hormone. Your doctor may recommend taking the medicine in the morning before eating. Your doctor will give you a blood test about 6 to 8 weeks after you begin taking the medicine, adjusting your dose if needed. Each time your dose is adjusted, you’ll have another blood test. Once you’ve reached a dose that’s working for you, your doctor will probably repeat the blood test in 6 months and then once a year. Your hypothyroidism most likely can be completely controlled with thyroid hormone medicine, as long as you take the recommended dose as instructed. Never stop taking your medicine without talking with your doctor first. Taking too much thyroid hormone medicine can cause serious problems, such as atrial fibrillation or osteoporosis.1 Your thyroid uses iodine to make thyroid hormones. However, if you have Hashimoto’s disease or other types of autoimmune thyroid disorders, you may be sensitive to iodine’s harmful side effects. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hypothyroidism. Taking iodine supplements can have the same effect. Talk with members of your health care team If you are pregnant, you need more iodine because the baby gets iodine from your diet. Talk with your doctor about how much iodine you need. The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of hypothyroidism, such as Find out if clinical studies are right for you. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on hypothyroidism that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Patil N, Rehman A, Jialal I. Hypothyroidism. In: StatPearls [Internet]. StatPearls Publishing; 2020. Updated August 10, 2020. Accessed January 5, 2021. www.ncbi.nlm.nih.gov/books/NBK519536 [2] Pearce EN, Farwell AP, Braverman LE. Thyroiditis. New England Journal of Medicine. 2003;348(26):2646–2655. doi: 10.1056/NEJMra021194. Erratum in: New England Journal of Medicine. 2003;349(6):620. www.nejm.org/doi/10.1056/NEJMra021194 [3] Jonklaas J, Bianco AC, Bauer AJ, et al; American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24(12):1670–1751. doi: 10.1089/thy.2014.0028
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
| What to do for Hypothyroidism ? | Experts recommend that people eat a balanced diet to obtain most nutrients. More information about diet and nutrition can be found on the National Agricultural Library website at www.nutrition.gov.
Dietary Supplements
Iodine is an essential mineral for the thyroid. However, people with autoimmune thyroid disease may be sensitive to harmful side effects from iodine. Taking iodine drops or eating foods containing large amounts of iodinesuch as seaweed, dulse, or kelpmay cause or worsen hypothyroidism or hyperthyroidism. More information about iodine can be found in the National Library of Medicine fact sheet Iodine in diet, available at www.nlm.nih.gov/medlineplus/ency/article/002421.htm.
Women need more iodine when they are pregnantabout 250 micrograms a day because the baby gets iodine from the mothers diet. In the United States, about 7 percent of pregnant women may not get enough iodine in their diet or through prenatal vitamins.3 Choosing iodized salt salt supplemented with iodineover plain salt and prenatal vitamins containing iodine will ensure this need is met.
To help ensure coordinated and safe care, people should discuss their use of dietary supplements, such as iodine, with their health care provider. Tips for talking with health care providers are available through the National Center for Complementary and Integrative Health. |
On this page: Hypothyroidism, also called underactive thyroid, is when the thyroid gland doesn’t make enough thyroid hormones to meet your body’s needs. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. Without enough thyroid hormones, many of your body’s functions slow down. Nearly 5 out of 100 Americans ages 12 years and older have hypothyroidism, although most cases are mild or have few obvious symptoms.1 Women are much more likely than men to develop hypothyroidism. The disease is also more common among people older than age 60.1 You are more likely to have hypothyroidism if you Your thyroid is also more likely to be underactive if you have other health problems, including Left untreated, hypothyroidism during pregnancy can affect both mother and baby. However, thyroid medicines can help prevent problems and are safe to take during pregnancy. Many women taking thyroid hormone medicine need a higher dose during pregnancy, so contact your doctor right away if you find out you’re pregnant. Hypothyroidism can contribute to high cholesterol. If you have high cholesterol, you should get tested for hypothyroidism. Rarely, severe untreated hypothyroidism may lead to myxedema coma, an extreme form of hypothyroidism in which the body’s functions slow to a life-threatening point. Myxedema coma requires immediate medical treatment. Hypothyroidism has many symptoms that can vary from person to person. Some common symptoms of hypothyroidism include Because hypothyroidism develops slowly, you may not notice symptoms of the disease for months or even years. Many of these symptoms, especially fatigue and weight gain, are common and do not necessarily mean you have a thyroid problem. Hypothyroidism has several causes, including Less often, hypothyroidism is caused by too much or too little iodine in the diet or by disorders of the pituitary gland or hypothalamus.1 Iodine deficiency, however, is extremely rare in the United States. Hashimoto’s disease, an autoimmune disorder, is the most common cause of hypothyroidism. With this disease, your immune system attacks the thyroid. The thyroid becomes inflamed and can’t make enough thyroid hormones. Thyroiditis, an inflammation of your thyroid, causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage increases your blood’s hormone levels, leading to thyrotoxicosis, a condition in which thyroid hormone levels are too high. The thyrotoxicosis may last for many months. After that, your thyroid may become underactive and, over time, the condition may become permanent, requiring thyroid hormone replacement. Three types of thyroiditis can cause thyrotoxicosis followed by hypothyroidism.2 Some babies are born with a thyroid that is not fully developed or does not work properly. If untreated, congenital hypothyroidism can lead to intellectual disability and growth failure—when a baby doesn’t grow as expected. Early treatment can prevent these problems. That’s why most newborns in the United States are tested for hypothyroidism. When surgeons remove part of the thyroid, the remaining part may produce normal amounts of thyroid hormone. But some people who have this surgery may develop hypothyroidism. Removing the entire thyroid always results in hypothyroidism. Surgeons may remove part or all of the thyroid as a treatment for Radioactive iodine, a common treatment for hyperthyroidism, gradually destroys thyroid cells. If you receive radioactive iodine treatment, you probably will eventually develop hypothyroidism. Doctors also treat people who have head or neck cancers with external radiation therapy, which can also damage the thyroid if it is included in the treatment. Some medicines can interfere with thyroid hormone production and lead to hypothyroidism, including certain Several recently developed cancer medicines, in particular, can either affect the thyroid directly or affect it indirectly by damaging the pituitary gland. Your doctor will take your medical history and perform a physical exam. A hypothyroidism diagnosis can’t be based on symptoms alone because many of its symptoms are the same as those of other diseases.1 That’s why your doctor may use several thyroid blood tests and imaging tests to confirm the diagnosis and find its cause. Because hypothyroidism can cause fertility problems, women who have trouble getting pregnant often get tested for thyroid problems. Hypothyroidism is treated by replacing the hormones that your own thyroid can no longer make. You will take levothyroxine, a thyroid hormone medicine identical to a hormone a healthy thyroid makes.3 Usually prescribed in pill form, this medicine is also available as a liquid and as a soft gel capsule. These newer formulas may help people with digestive problems to absorb the thyroid hormone. Your doctor may recommend taking the medicine in the morning before eating. Your doctor will give you a blood test about 6 to 8 weeks after you begin taking the medicine, adjusting your dose if needed. Each time your dose is adjusted, you’ll have another blood test. Once you’ve reached a dose that’s working for you, your doctor will probably repeat the blood test in 6 months and then once a year. Your hypothyroidism most likely can be completely controlled with thyroid hormone medicine, as long as you take the recommended dose as instructed. Never stop taking your medicine without talking with your doctor first. Taking too much thyroid hormone medicine can cause serious problems, such as atrial fibrillation or osteoporosis.1 Your thyroid uses iodine to make thyroid hormones. However, if you have Hashimoto’s disease or other types of autoimmune thyroid disorders, you may be sensitive to iodine’s harmful side effects. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hypothyroidism. Taking iodine supplements can have the same effect. Talk with members of your health care team If you are pregnant, you need more iodine because the baby gets iodine from your diet. Talk with your doctor about how much iodine you need. The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of hypothyroidism, such as Find out if clinical studies are right for you. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on hypothyroidism that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Patil N, Rehman A, Jialal I. Hypothyroidism. In: StatPearls [Internet]. StatPearls Publishing; 2020. Updated August 10, 2020. Accessed January 5, 2021. www.ncbi.nlm.nih.gov/books/NBK519536 [2] Pearce EN, Farwell AP, Braverman LE. Thyroiditis. New England Journal of Medicine. 2003;348(26):2646–2655. doi: 10.1056/NEJMra021194. Erratum in: New England Journal of Medicine. 2003;349(6):620. www.nejm.org/doi/10.1056/NEJMra021194 [3] Jonklaas J, Bianco AC, Bauer AJ, et al; American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24(12):1670–1751. doi: 10.1089/thy.2014.0028
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
The NIDDK would like to thank:
Thanh D. Hoang, D.O., FACP, FACE, CAPTAIN (select), Walter Reed National Military Medical Center, and Henry B. Burch, M.D., Program Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK
| What to do for Hypothyroidism ? | - Hypothyroidism is a disorder that occurs when the thyroid gland does not make enough thyroid hormone to meet the bodys needs. Thyroid hormone regulates metabolism. Without enough thyroid hormone, many of the bodys functions slow down. - Hypothyroidism has several causes, including - Hashimotos disease - thyroiditis - congenital hypothyroidism - surgical removal of part or all of the thyroid - radiation treatment of the thyroid - some medications - Hypothyroidism has many symptoms that can vary from person to person. Some common symptoms of hypothyroidism are fatigue, weight gain, cold intolerance, constipation, impaired fertility, and depression. - Women are much more likely than men to develop hypothyroidism. - Women with hypothyroidism should discuss their condition with their health care provider before becoming pregnant. - Hypothyroidism can almost always be completely controlled with synthetic thyroxine, as long as the recommended dose is taken every day as instructed. |
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| What is (are) Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes ? | Type 2 diabetes, formerly called adult-onset diabetes, is the most common type of diabetes. About 95 percent of people with diabetes have type 2. People can develop type 2 diabetes at any age, even during childhood. However, this type of diabetes develops most often in middle-aged and older people. People who are overweight and inactive are also more likely to develop type 2 diabetes.
In type 2 and other types of diabetes, you have too much glucose, also called sugar, in your blood. People with diabetes have problems converting food to energy. After a meal, food is broken down into glucose, which is carried by your blood to cells throughout your body. With the help of the hormone insulin, cells absorb glucose from your blood and use it for energy. Insulin is made in the pancreas, an organ located behind the stomach.
Type 2 diabetes usually begins with insulin resistance, a condition linked to excess weight in which your bodys cells do not use insulin properly. As a result, your body needs more insulin to help glucose enter cells. At first, your pancreas keeps up with the added demand by producing more insulin. But in time, your pancreas loses its ability to produce enough insulin, and blood glucose levels rise.
Over time, high blood glucose damages nerves and blood vessels, leading to problems such as heart disease, stroke, kidney disease, blindness, dental disease, and amputations. Other problems of diabetes may include increased risk of getting other diseases, loss of mobility with aging, depression, and pregnancy problems.
Treatment includes taking diabetes medicines, making wise food choices, being physically active on a regular basis, controlling blood pressure and cholesterol, and for some, taking aspirin daily. |
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| How to prevent Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes ? | Yes. The results of the Diabetes Prevention Program (DPP) proved that weight loss through moderate diet changes and physical activity can delay or prevent type 2 diabetes. The DPP was a federally funded study of 3,234 people at high risk for diabetes. This study showed that a 5-to 7-percent weight loss, which for a 200-pound person would be 10 to 14 pounds, slowed development of type 2 diabetes.
People at High Risk for Diabetes
DPP study participants were overweight and had higher than normal levels of blood glucose, a condition called prediabetes. Many had family members with type 2 diabetes. Prediabetes, obesity, and a family history of diabetes are strong risk factors for type 2 diabetes. About half of the DPP participants were from minority groups with high rates of diabetes, including African Americans, Alaska Natives, American Indians, Asian Americans, Hispanics/Latinos, and Pacific Islander Americans.
DPP participants also included others at high risk for developing type 2 diabetes, such as women with a history of gestational diabetes and people age 60 and older.
Approaches to Preventing Diabetes
The DPP tested three approaches to preventing diabetes:
- Making lifestyle changes. People in the lifestyle change group exercised, usually by walking 5 days a week for about 30 minutes a day, and lowered their intake of fat and calories. - Taking the diabetes medicine metformin. Those who took metformin also received information about physical activity and diet. - Receiving education about diabetes. The third group only received information about physical activity and diet and took a placeboa pill without medicine in it.
People in the lifestyle change group showed the best outcomes. But people who took metformin also benefited. The results showed that by losing an average of 15 pounds in the first year of the study, people in the lifestyle change group reduced their risk of developing type 2 diabetes by 58 percent over 3 years. Lifestyle change was even more effective in those age 60 and older. People in this group reduced their risk by 71 percent. But people in the metformin group also benefited, reducing their risk by 31 percent. More information about the DPP, funded under National Institutes of Health (NIH) clinical trial number NCT00004992, is available at www.bsc.gwu.edu/dpp.
Lasting Results
The Diabetes Prevention Program Outcomes Study (DPPOS) has shown that the benefits of weight loss and metformin last for at least 10 years. The DPPOS has continued to follow most DPP participants since the DPP ended in 2001. The DPPOS showed that 10 years after enrolling in the DPP,
- people in the lifestyle change group reduced their risk for developing diabetes by 34 percent - those in the lifestyle change group age 60 or older had even greater benefit, reducing their risk of developing diabetes by 49 percent - participants in the lifestyle change group also had fewer heart and blood vessel disease risk factors, including lower blood pressure and triglyceride levels, even though they took fewer medicines to control their heart disease risk - the metformin group reduced the risk of developing diabetes by 18 percent
Even though controlling your weight with lifestyle changes is challenging, it produces long-term health rewards by lowering your risk for type 2 diabetes, lowering your blood glucose levels, and reducing other heart disease risk factors. More information about the DPPOS, funded under NIH clinical trial number NCT00038727, can be found at www.bsc.gwu.edu/dpp.
Other Types of Diabetes In addition to type 2, the other main types of diabetes are type 1 diabetes and gestational diabetes. Type 1 Diabetes Type 1 diabetes, formerly called juvenile diabetes, is usually first diagnosed in children, teenagers, and young adults. In this type of diabetes, your pancreas can no longer make insulin because your bodys immune system has attacked and destroyed the cells that make it. Treatment for type 1 diabetes includes taking insulin shots or using an insulin pump, making wise food choices, being physically active on a regular basis, controlling blood pressure and cholesterol, and, for some, taking aspirin daily. Gestational Diabetes Gestational diabetes is a type of diabetes that develops only during pregnancy. Hormones produced by your placenta and other pregnancy-related factors contribute to insulin resistance, which occurs in all women during late pregnancy. Insulin resistance increases the amount of insulin needed to control blood glucose levels. If your pancreas cant produce enough insulin, gestational diabetes occurs. As with type 2 diabetes, excess weight is linked to gestational diabetes. Overweight or obese women are at particularly high risk for gestational diabetes because they start pregnancy with a higher need for insulin due to insulin resistance. Excessive weight gain during pregnancy may also increase risk. Gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes. Although gestational diabetes usually goes away after the baby is born, a woman who has had gestational diabetes is more likely to develop type 2 diabetes later in life. Babies born to mothers who had gestational diabetes are also more likely to develop obesity and type 2 diabetes as they grow up. |
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| What is (are) Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes ? | In addition to type 2, the other main types of diabetes are type 1 diabetes and gestational diabetes.
Type 1 Diabetes
Type 1 diabetes, formerly called juvenile diabetes, is usually first diagnosed in children, teenagers, and young adults. In this type of diabetes, your pancreas can no longer make insulin because your bodys immune system has attacked and destroyed the cells that make it. Treatment for type 1 diabetes includes taking insulin shots or using an insulin pump, making wise food choices, being physically active on a regular basis, controlling blood pressure and cholesterol, and, for some, taking aspirin daily.
Gestational Diabetes
Gestational diabetes is a type of diabetes that develops only during pregnancy. Hormones produced by your placenta and other pregnancy-related factors contribute to insulin resistance, which occurs in all women during late pregnancy. Insulin resistance increases the amount of insulin needed to control blood glucose levels. If your pancreas cant produce enough insulin, gestational diabetes occurs.
As with type 2 diabetes, excess weight is linked to gestational diabetes. Overweight or obese women are at particularly high risk for gestational diabetes because they start pregnancy with a higher need for insulin due to insulin resistance. Excessive weight gain during pregnancy may also increase risk. Gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes.
Although gestational diabetes usually goes away after the baby is born, a woman who has had gestational diabetes is more likely to develop type 2 diabetes later in life. Babies born to mothers who had gestational diabetes are also more likely to develop obesity and type 2 diabetes as they grow up. |
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| What are the symptoms of Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes ? | The signs and symptoms of type 2 diabetes can be so mild that you might not even notice them. Nearly 7 million people in the United States have type 2 diabetes and dont know they have the disease. Many have no signs or symptoms. Some people have symptoms but do not suspect diabetes.
Symptoms include
- increased thirst - increased hunger - fatigue - increased urination, especially at night - unexplained weight loss - blurred vision - numbness or tingling in the feet or hands - sores that do not heal
Many people do not find out they have the disease until they have diabetes problems, such as blurred vision or heart trouble. If you find out early that you have diabetes, you can get treatment to prevent damage to your body. |
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| Who is at risk for Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes? ? | To find out your risk for type 2 diabetes, check each item that applies to you.
- I am age 45 or older. - I am overweight or obese. - I have a parent, brother, or sister with diabetes. - My family background is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American. - I have had gestational diabetes. - I gave birth to at least one baby weighing more than 9 pounds. - My blood pressure is 140/90 or higher, or I have been told that I have high blood pressure. - My cholesterol levels are higher than normal. My HDL, or good, cholesterol is below 35, or my triglyceride level is above 250. - I am fairly inactive. - I have polycystic ovary syndrome, also called PCOS. - On previous testing, I had prediabetesan A1C level of 5.7 to 6.4 percent, impaired fasting glucose (IFG), or impaired glucose tolerance (IGT). - I have other clinical conditions associated with insulin resistance, such as a condition called acanthosis nigricans, characterized by a dark, velvety rash around my neck or armpits. - I have a history of cardiovascular disease.
The more items you checked, the higher your risk.
Does sleep matter? Yes. Studies show that untreated sleep problems, especially sleep apnea, can increase the risk of type 2 diabetes. Sleep apnea is a common disorder in which you have pauses in breathing or shallow breaths while you sleep. Most people who have sleep apnea dont know they have it and it often goes undiagnosed. Night shift workers who have problems with sleepiness may also be at increased risk for obesity and type 2 diabetes. If you think you might have sleep problems, ask your doctor for help. More information about sleep problems is available from the National Heart Lung and Blood Institute at http://www.nhlbi.nih.gov/health/resources/sleep. |
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| Who is at risk for Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes? ? | You can do a lot to reduce your risk of getting type 2 diabetes. Being more physically active, reducing fat and calorie intake, and losing a little weight can help you lower your chances of developing type 2 diabetes. Taking the diabetes medicine metformin can also reduce risk, particularly in younger and heavier people with prediabetes and women who have had gestational diabetes. Lowering blood pressure and cholesterol levels also helps you stay healthy.
If you are overweight, then take these steps:
- Reach and maintain a reasonable body weight. Even a 10 or 15 pound weight loss makes a big difference. - Make wise food choices most of the time. - Be physically active every day.
If you are fairly inactive, then take this step:
- Be physically active every day.
If your blood pressure is too high, then take these steps:
- Reach and maintain a reasonable body weight. - Make wise food choices most of the time. - Reduce your sodium and alcohol intake. - Be physically active every day. - Talk with your doctor about whether you need medicine to control your blood pressure.
If your cholesterol or triglyceride levels are too high, then take these steps:
- Make wise food choices most of the time. - Be physically active every day. - Talk with your doctor about whether you need medicine to control your cholesterol levels. |
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| Who is at risk for Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes? ? | Making big changes in your life is hard, especially if you are faced with more than one change. You can make it easier by taking these steps:
- Make a plan to change behavior. - Decide exactly what you will do and give yourself a time frame. - Plan what you need to get ready. - Track your goals and activity on a food and activity tracker, available at http://www.niddk.nih.gov/health-information/health-communication-programs/ndep/health-care-professionals/game-plan/small-steps/Documents/GP_FoodActTracker.pdf (PDF, 349 KB) - Think about what might prevent you from reaching your goals. - Find family and friends who will support and encourage you. - Decide how you will reward yourselfa shopping trip, movie tickets, an afternoon in the parkwhen you do what you have planned.
Your doctor, a dietitian, or a counselor can help you make a plan.
Be Physically Active Every Day
Regular physical activity tackles several risk factors at once. Activity helps you lose weight; keeps your blood glucose, blood pressure, and cholesterol under control; and helps your body use insulin. People in the DPP who were physically active for 30 minutes a day, 5 days a week, reduced their risk of type 2 diabetes. Many chose brisk walking as their physical activity.
If you are not fairly active, you should start slowly. First, talk with your doctor about what kinds of physical activity are safe for you. Make a plan to increase your activity level toward the goal of being active at least 30 minutes a day most days of the week. You can increase your level of physical activity in two main ways:
1. Start an exercise program. 2. Increase your daily activity.
Start an exercise program. Pick exercises that suit you. Find a friend to walk with you or join an exercise class that will help you keep going.
- Do aerobic activities, which use your large muscles to make your heart beat faster. The large muscles are those of the upper and lower arms; upper and lower legs; and those that control head, shoulder, and hip movements. - Do activities to strengthen muscles and bone, such as lifting weights or sit-ups, two to three times a week. Find helpsuch as a video or a classto learn how to do these exercises properly.
Increase your daily activity. Choose activities you enjoy. You can work extra activity into your daily routine by doing the following:
- Increase daily activity by decreasing time spent watching TV or at the computer. Set up a reminder on your computer to take an activity break. - Take the stairs rather than an elevator or escalator. - Park at the far end of the parking lot and walk. - Get off the bus a few stops early and walk the rest of the way. - Walk or bicycle whenever you can.
Take Your Prescribed Medicines
Some people need medicine to help control their blood pressure or cholesterol levels. If you do, take your medicines as directed. Ask your doctor if you should take metformin to prevent type 2 diabetes. Metformin is a medicine that makes insulin work better and can reduce the risk of type 2 diabetes. |
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| What to do for Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes ? | Your eating, diet, and nutrition choices play an important role in preventing or delaying diabetes. Follow the suggestions below to reach and maintain a reasonable weight and make wise food choices most of the time. Remember that it can take time to change your habits and be patient with yourself. You can also get help from a dietitian or join a weight-loss program to support you while you reach your goals.
Reach and Maintain a Reasonable Body Weight
Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. Excess body weight can also cause high blood pressure. Every pound you lose lowers your risk of getting diabetes.
In addition to weight, the location of excess fat on the body can be important. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance and increases a persons risk for type 2 diabetes. This is true even if your BMI falls within the normal range.
Find Your BMI
The BMI is a measure of body weight relative to height. The BMI can help you find out whether you are normal weight, overweight, or obese. Use the table on pages 24 and 25 to find your BMI.
- Find your height in the left-hand column. - Move across in the same row to the number closest to your weight. - The number at the top of that column is your BMI. Check the word above your BMI to see whether you are normal weight, overweight, or obese.
The BMI has certain limitations. The BMI may overestimate body fat in athletes and others who have a muscular build and underestimate body fat in older adults and others who have lost muscle.
The BMI for children and teens must be determined based on age, height, weight, and sex. The Centers for Disease Control and Prevention (CDC) has information about BMI in children and teens, including a BMI calculator, at www.cdc.gov/nccdphp/dnpa/bmi. The CDC website also has a BMI calculator for adults. A BMI calculator from the NIH is available at www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm.
The NIH also has a free smartphone app for calculating BMI. You can search My BMI Calculator on your phone to find the app. The app also provides links to information about steps you can take to bring your BMI into a healthy range. |
If you have lactose intolerance, you have digestive symptoms—such as bloating, diarrhea, and gas—after you consume foods or drinks that contain lactose. Lactose intolerance may affect your health if it keeps you from getting enough nutrients, such as calcium and vitamin D. Symptoms of lactose intolerance may include bloating, diarrhea, gas, nausea, and pain in your abdomen. Lactose intolerance is caused by lactose malabsorption, a condition in which your small intestine makes low levels of lactase and can’t digest all the lactose you eat or drink. To diagnose lactose intolerance, your doctor will ask about your symptoms, family and medical history, and eating habits. Your doctor may perform a physical exam and tests to help diagnose lactose intolerance or to check for other health problems. You can manage lactose intolerance symptoms by changing your diet to limit or avoid foods that contain lactose. Some people may only need to limit lactose, while others may need to avoid lactose altogether. Using lactase products can help some people manage their symptoms. Talk with your doctor or a dietitian about changing your diet to help manage lactose intolerance symptoms and make sure you get enough nutrients. You may need to reduce the amount of lactose you eat or drink. Most people with lactose intolerance can eat or drink some lactose without symptoms. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.
New potential therapeutic target identified for Crohn’s disease
March 31, 2021
Potential therapeutic target identified to prevent severe diarrhea in children
Nov. 20, 2020
Mucus Keeps Gut Bacteria at Bay to Prevent Inflammation
Oct. 23, 2020
This content is also available in: See more about digestive diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
| What is (are) Lactose Intolerance ? | Lactose is a sugar found in milk and milk products. The small intestinethe organ where most food digestion and nutrient absorption take placeproduces an enzyme called lactase. Lactase breaks down lactose into two simpler forms of sugar: glucose and galactose. The body then absorbs these simpler sugars into the bloodstream. |
If you have lactose intolerance, you have digestive symptoms—such as bloating, diarrhea, and gas—after you consume foods or drinks that contain lactose. Lactose intolerance may affect your health if it keeps you from getting enough nutrients, such as calcium and vitamin D. Symptoms of lactose intolerance may include bloating, diarrhea, gas, nausea, and pain in your abdomen. Lactose intolerance is caused by lactose malabsorption, a condition in which your small intestine makes low levels of lactase and can’t digest all the lactose you eat or drink. To diagnose lactose intolerance, your doctor will ask about your symptoms, family and medical history, and eating habits. Your doctor may perform a physical exam and tests to help diagnose lactose intolerance or to check for other health problems. You can manage lactose intolerance symptoms by changing your diet to limit or avoid foods that contain lactose. Some people may only need to limit lactose, while others may need to avoid lactose altogether. Using lactase products can help some people manage their symptoms. Talk with your doctor or a dietitian about changing your diet to help manage lactose intolerance symptoms and make sure you get enough nutrients. You may need to reduce the amount of lactose you eat or drink. Most people with lactose intolerance can eat or drink some lactose without symptoms. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.
New potential therapeutic target identified for Crohn’s disease
March 31, 2021
Potential therapeutic target identified to prevent severe diarrhea in children
Nov. 20, 2020
Mucus Keeps Gut Bacteria at Bay to Prevent Inflammation
Oct. 23, 2020
This content is also available in: See more about digestive diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
| What is (are) Lactose Intolerance ? | Lactose intolerance is a condition in which people have digestive symptomssuch as bloating, diarrhea, and gasafter eating or drinking milk or milk products.
Lactase deficiency and lactose malabsorption may lead to lactose intolerance:
- Lactase deficiency. In people who have a lactase deficiency, the small intestine produces low levels of lactase and cannot digest much lactose. - Lactose malabsorption. Lactase deficiency may cause lactose malabsorption. In lactose malabsorption, undigested lactose passes to the colon. The colon, part of the large intestine, absorbs water from stool and changes it from a liquid to a solid form. In the colon, bacteria break down undigested lactose and create fluid and gas. Not all people with lactase deficiency and lactose malabsorption have digestive symptoms.
People have lactose intolerance when lactase deficiency and lactose malabsorption cause digestive symptoms. Most people with lactose intolerance can eat or drink some amount of lactose without having digestive symptoms. Individuals vary in the amount of lactose they can tolerate.
People sometimes confuse lactose intolerance with a milk allergy. While lactose intolerance is a digestive system disorder, a milk allergy is a reaction by the bodys immune system to one or more milk proteins. An allergic reaction to milk can be life threatening even if the person eats or drinks only a small amount of milk or milk product. A milk allergy most commonly occurs in the first year of life, while lactose intolerance occurs more often during adolescence or adulthood.1,2
Four Types of Lactase Deficiency Four types of lactase deficiency may lead to lactose intolerance: - Primary lactase deficiency, also called lactase nonpersistence, is the most common type of lactase deficiency. In people with this condition, lactase production declines over time. This decline often begins at about age 2; however, the decline may begin later. Children who have lactase deficiency may not experience symptoms of lactose intolerance until late adolescence or adulthood. Researchers have discovered that some people inherit genes from their parents that may cause a primary lactase deficiency. - Secondary lactase deficiency results from injury to the small intestine. Infection, diseases, or other problems may injure the small intestine. Treating the underlying cause usually improves the lactose tolerance. - Developmental lactase deficiency may occur in infants born prematurely. This condition usually lasts for only a short time after they are born. - Congenital lactase deficiency is an extremely rare disorder in which the small intestine produces little or no lactase enzyme from birth. Genes inherited from parents cause this disorder. |
If you have lactose intolerance, you have digestive symptoms—such as bloating, diarrhea, and gas—after you consume foods or drinks that contain lactose. Lactose intolerance may affect your health if it keeps you from getting enough nutrients, such as calcium and vitamin D. Symptoms of lactose intolerance may include bloating, diarrhea, gas, nausea, and pain in your abdomen. Lactose intolerance is caused by lactose malabsorption, a condition in which your small intestine makes low levels of lactase and can’t digest all the lactose you eat or drink. To diagnose lactose intolerance, your doctor will ask about your symptoms, family and medical history, and eating habits. Your doctor may perform a physical exam and tests to help diagnose lactose intolerance or to check for other health problems. You can manage lactose intolerance symptoms by changing your diet to limit or avoid foods that contain lactose. Some people may only need to limit lactose, while others may need to avoid lactose altogether. Using lactase products can help some people manage their symptoms. Talk with your doctor or a dietitian about changing your diet to help manage lactose intolerance symptoms and make sure you get enough nutrients. You may need to reduce the amount of lactose you eat or drink. Most people with lactose intolerance can eat or drink some lactose without symptoms. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.
New potential therapeutic target identified for Crohn’s disease
March 31, 2021
Potential therapeutic target identified to prevent severe diarrhea in children
Nov. 20, 2020
Mucus Keeps Gut Bacteria at Bay to Prevent Inflammation
Oct. 23, 2020
This content is also available in: See more about digestive diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
| What is (are) Lactose Intolerance ? | Four types of lactase deficiency may lead to lactose intolerance:
- Primary lactase deficiency, also called lactase nonpersistence, is the most common type of lactase deficiency. In people with this condition, lactase production declines over time. This decline often begins at about age 2; however, the decline may begin later. Children who have lactase deficiency may not experience symptoms of lactose intolerance until late adolescence or adulthood. Researchers have discovered that some people inherit genes from their parents that may cause a primary lactase deficiency. - Secondary lactase deficiency results from injury to the small intestine. Infection, diseases, or other problems may injure the small intestine. Treating the underlying cause usually improves the lactose tolerance. - Developmental lactase deficiency may occur in infants born prematurely. This condition usually lasts for only a short time after they are born. - Congenital lactase deficiency is an extremely rare disorder in which the small intestine produces little or no lactase enzyme from birth. Genes inherited from parents cause this disorder. |
If you have lactose intolerance, you have digestive symptoms—such as bloating, diarrhea, and gas—after you consume foods or drinks that contain lactose. Lactose intolerance may affect your health if it keeps you from getting enough nutrients, such as calcium and vitamin D. Symptoms of lactose intolerance may include bloating, diarrhea, gas, nausea, and pain in your abdomen. Lactose intolerance is caused by lactose malabsorption, a condition in which your small intestine makes low levels of lactase and can’t digest all the lactose you eat or drink. To diagnose lactose intolerance, your doctor will ask about your symptoms, family and medical history, and eating habits. Your doctor may perform a physical exam and tests to help diagnose lactose intolerance or to check for other health problems. You can manage lactose intolerance symptoms by changing your diet to limit or avoid foods that contain lactose. Some people may only need to limit lactose, while others may need to avoid lactose altogether. Using lactase products can help some people manage their symptoms. Talk with your doctor or a dietitian about changing your diet to help manage lactose intolerance symptoms and make sure you get enough nutrients. You may need to reduce the amount of lactose you eat or drink. Most people with lactose intolerance can eat or drink some lactose without symptoms. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.
New potential therapeutic target identified for Crohn’s disease
March 31, 2021
Potential therapeutic target identified to prevent severe diarrhea in children
Nov. 20, 2020
Mucus Keeps Gut Bacteria at Bay to Prevent Inflammation
Oct. 23, 2020
This content is also available in: See more about digestive diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
| What are the symptoms of Lactose Intolerance ? | Common symptoms of lactose intolerance include
- abdominal bloating, a feeling of fullness or swelling in the abdomen - abdominal pain - diarrhea - gas - nausea
Symptoms occur 30 minutes to 2 hours after consuming milk or milk products. Symptoms range from mild to severe based on the amount of lactose the person ate or drank and the amount a person can tolerate. |
If you have lactose intolerance, you have digestive symptoms—such as bloating, diarrhea, and gas—after you consume foods or drinks that contain lactose. Lactose intolerance may affect your health if it keeps you from getting enough nutrients, such as calcium and vitamin D. Symptoms of lactose intolerance may include bloating, diarrhea, gas, nausea, and pain in your abdomen. Lactose intolerance is caused by lactose malabsorption, a condition in which your small intestine makes low levels of lactase and can’t digest all the lactose you eat or drink. To diagnose lactose intolerance, your doctor will ask about your symptoms, family and medical history, and eating habits. Your doctor may perform a physical exam and tests to help diagnose lactose intolerance or to check for other health problems. You can manage lactose intolerance symptoms by changing your diet to limit or avoid foods that contain lactose. Some people may only need to limit lactose, while others may need to avoid lactose altogether. Using lactase products can help some people manage their symptoms. Talk with your doctor or a dietitian about changing your diet to help manage lactose intolerance symptoms and make sure you get enough nutrients. You may need to reduce the amount of lactose you eat or drink. Most people with lactose intolerance can eat or drink some lactose without symptoms. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.
New potential therapeutic target identified for Crohn’s disease
March 31, 2021
Potential therapeutic target identified to prevent severe diarrhea in children
Nov. 20, 2020
Mucus Keeps Gut Bacteria at Bay to Prevent Inflammation
Oct. 23, 2020
This content is also available in: See more about digestive diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
| How to diagnose Lactose Intolerance ? | A health care provider makes a diagnosis of lactose intolerance based on
- medical, family, and diet history, including a review of symptoms - a physical exam - medical tests
Medical, family, and diet history. A health care provider will take a medical, family, and diet history to help diagnose lactose intolerance. During this discussion, the health care provider will review a patients symptoms. However, basing a diagnosis on symptoms alone may be misleading because digestive symptoms can occur for many reasons other than lactose intolerance. For example, other conditions such as irritable bowel syndrome, celiac disease, inflammatory bowel disease, or small bowel bacterial overgrowth can cause digestive symptoms.
Physical exam. A physical exam may help diagnose lactose intolerance or rule out other conditions that cause digestive symptoms. During a physical exam, a health care provider usually
- checks for abdominal bloating - uses a stethoscope to listen to sounds within the abdomen - taps on the abdomen to check for tenderness or pain
A health care provider may recommend eliminating all milk and milk products from a persons diet for a short time to see if the symptoms resolve. Symptoms that go away when a person eliminates lactose from his or her diet may confirm the diagnosis of lactose intolerance.
Medical tests. A health care provider may order special tests to provide more information. Health care providers commonly use two tests to measure how well a person digests lactose:
- Hydrogen breath test. This test measures the amount of hydrogen in a persons breath. Normally, only a small amount of hydrogen is detectable in the breath when a person eats or drinks and digests lactose. However, undigested lactose produces high levels of hydrogen. For this test, the patient drinks a beverage that contains a known amount of lactose. A health care provider asks the patient to breathe into a balloon-type container that measures breath hydrogen level. In most cases, a health care provider performs this test at a hospital, on an outpatient basis. Smoking and some foods and medications may affect the accuracy of the results. A health care provider will tell the patient what foods or medications to avoid before the test. - Stool acidity test. Undigested lactose creates lactic acid and other fatty acids that a stool acidity test can detect in a stool sample. Health care providers sometimes use this test to check acidity in the stools of infants and young children. A child may also have glucose in his or her stool as a result of undigested lactose. The health care provider will give the childs parent or caretaker a container for collecting the stool specimen. The parent or caretaker returns the sample to the health care provider, who sends it to a lab for analysis. |
If you have lactose intolerance, you have digestive symptoms—such as bloating, diarrhea, and gas—after you consume foods or drinks that contain lactose. Lactose intolerance may affect your health if it keeps you from getting enough nutrients, such as calcium and vitamin D. Symptoms of lactose intolerance may include bloating, diarrhea, gas, nausea, and pain in your abdomen. Lactose intolerance is caused by lactose malabsorption, a condition in which your small intestine makes low levels of lactase and can’t digest all the lactose you eat or drink. To diagnose lactose intolerance, your doctor will ask about your symptoms, family and medical history, and eating habits. Your doctor may perform a physical exam and tests to help diagnose lactose intolerance or to check for other health problems. You can manage lactose intolerance symptoms by changing your diet to limit or avoid foods that contain lactose. Some people may only need to limit lactose, while others may need to avoid lactose altogether. Using lactase products can help some people manage their symptoms. Talk with your doctor or a dietitian about changing your diet to help manage lactose intolerance symptoms and make sure you get enough nutrients. You may need to reduce the amount of lactose you eat or drink. Most people with lactose intolerance can eat or drink some lactose without symptoms. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.
New potential therapeutic target identified for Crohn’s disease
March 31, 2021
Potential therapeutic target identified to prevent severe diarrhea in children
Nov. 20, 2020
Mucus Keeps Gut Bacteria at Bay to Prevent Inflammation
Oct. 23, 2020
This content is also available in: See more about digestive diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
| What are the treatments for Lactose Intolerance ? | Many people can manage the symptoms of lactose intolerance by changing their diet. Some people may only need to limit the amount of lactose they eat or drink. Others may need to avoid lactose altogether. Using lactase products can help some people manage their symptoms.
For people with secondary lactase deficiency, treating the underlying cause improves lactose tolerance. In infants with developmental lactase deficiency, the ability to digest lactose improves as the infants mature. People with primary and congenital lactase deficiency cannot change their bodys ability to produce lactase. |
If you have lactose intolerance, you have digestive symptoms—such as bloating, diarrhea, and gas—after you consume foods or drinks that contain lactose. Lactose intolerance may affect your health if it keeps you from getting enough nutrients, such as calcium and vitamin D. Symptoms of lactose intolerance may include bloating, diarrhea, gas, nausea, and pain in your abdomen. Lactose intolerance is caused by lactose malabsorption, a condition in which your small intestine makes low levels of lactase and can’t digest all the lactose you eat or drink. To diagnose lactose intolerance, your doctor will ask about your symptoms, family and medical history, and eating habits. Your doctor may perform a physical exam and tests to help diagnose lactose intolerance or to check for other health problems. You can manage lactose intolerance symptoms by changing your diet to limit or avoid foods that contain lactose. Some people may only need to limit lactose, while others may need to avoid lactose altogether. Using lactase products can help some people manage their symptoms. Talk with your doctor or a dietitian about changing your diet to help manage lactose intolerance symptoms and make sure you get enough nutrients. You may need to reduce the amount of lactose you eat or drink. Most people with lactose intolerance can eat or drink some lactose without symptoms. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.
New potential therapeutic target identified for Crohn’s disease
March 31, 2021
Potential therapeutic target identified to prevent severe diarrhea in children
Nov. 20, 2020
Mucus Keeps Gut Bacteria at Bay to Prevent Inflammation
Oct. 23, 2020
This content is also available in: See more about digestive diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
| What to do for Lactose Intolerance ? | People may find it helpful to talk with a health care provider or a registered dietitian about a dietary plan. A dietary plan can help people manage the symptoms of lactose intolerance and make sure they get enough nutrients. Parents, caretakers, childcare providers, and others who serve food to children with lactose intolerance should follow the dietary plan recommended by the childs health care provider or registered dietitian.
Milk and milk products. Gradually introducing small amounts of milk or milk products may help some people adapt to them with fewer symptoms. Often, people can better tolerate milk or milk products by having them with meals, such as having milk with cereal or having cheese with crackers. People with lactose intolerance are generally more likely to tolerate hard cheeses, such as cheddar or Swiss, than a glass of milk. A 1.5ounce serving of low-fat hard cheese has less than 1 gram of lactose, while a 1-cup serving of low-fat milk has about 11 to 13 grams of lactose.2
However, people with lactose intolerance are also more likely to tolerate yogurt than milk, even though yogurt and milk have similar amounts of lactose.2
Lactose-free and lactose-reduced milk and milk products. Lactose-free and lactose-reduced milk and milk products are available at most supermarkets and are identical nutritionally to regular milk and milk products. Manufacturers treat lactose-free milk with the lactase enzyme. This enzyme breaks down the lactose in the milk. Lactose-free milk remains fresh for about the same length of time or, if it is ultra-pasteurized, longer than regular milk. Lactose-free milk may have a slightly sweeter taste than regular milk.
Lactase products. People can use lactase tablets and drops when they eat or drink milk products. The lactase enzyme digests the lactose in the food and therefore reduces the chances of developing digestive symptoms. People should check with a health care provider before using these products because some groups, such as young children and pregnant and breastfeeding women, may not be able to use them. |
If you have lactose intolerance, you have digestive symptoms—such as bloating, diarrhea, and gas—after you consume foods or drinks that contain lactose. Lactose intolerance may affect your health if it keeps you from getting enough nutrients, such as calcium and vitamin D. Symptoms of lactose intolerance may include bloating, diarrhea, gas, nausea, and pain in your abdomen. Lactose intolerance is caused by lactose malabsorption, a condition in which your small intestine makes low levels of lactase and can’t digest all the lactose you eat or drink. To diagnose lactose intolerance, your doctor will ask about your symptoms, family and medical history, and eating habits. Your doctor may perform a physical exam and tests to help diagnose lactose intolerance or to check for other health problems. You can manage lactose intolerance symptoms by changing your diet to limit or avoid foods that contain lactose. Some people may only need to limit lactose, while others may need to avoid lactose altogether. Using lactase products can help some people manage their symptoms. Talk with your doctor or a dietitian about changing your diet to help manage lactose intolerance symptoms and make sure you get enough nutrients. You may need to reduce the amount of lactose you eat or drink. Most people with lactose intolerance can eat or drink some lactose without symptoms. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.
New potential therapeutic target identified for Crohn’s disease
March 31, 2021
Potential therapeutic target identified to prevent severe diarrhea in children
Nov. 20, 2020
Mucus Keeps Gut Bacteria at Bay to Prevent Inflammation
Oct. 23, 2020
This content is also available in: See more about digestive diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research
| What to do for Lactose Intolerance ? | - Lactose is a sugar found in milk and milk products. - Lactose intolerance is a condition in which people have digestive symptomssuch as bloating, diarrhea, and gasafter eating or drinking milk or milk products. - A health care provider makes a diagnosis of lactose intolerance based on medical, family, and diet history, including a review of symptoms; a physical exam; and medical tests. - Basing a diagnosis on symptoms alone may be misleading because digestive symptoms can occur for many reasons other than lactose intolerance. - Most people with lactose intolerance can tolerate some amount of lactose in their diet and do not need to avoid milk or milk products completely. However, individuals vary in the amount of lactose they can tolerate. - Research suggests that adults and adolescents with lactose malabsorption could eat or drink at least 12 grams of lactose in one sitting without symptoms or with only minor symptoms. This amount is the amount of lactose in 1 cup of milk. - Many people can manage the symptoms of lactose intolerance by changing their diet. Some people may only need to limit the amount of lactose they eat or drink. Others may need to avoid lactose altogether. - People may find it helpful to talk with a health care provider or a registered dietitian to determine if their diet provides adequate nutrients including calcium and vitamin D. To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements, with their health care provider. - Lactose is in all milk and milk products. Manufacturers also often add milk and milk products to boxed, canned, frozen, packaged, and prepared foods. People can check the ingredients on food labels to find possible sources of lactose in food products. |
On this page: Nephrotic syndrome is a group of symptoms that indicate the kidneys are not working properly. These symptoms include The kidneys are made up of about a million filtering units called nephrons. Each nephron includes a filter, called the glomerulus, and a tubule. The glomerulus filters the blood, and the tubule returns needed substances to the blood and removes wastes and extra water, which become urine. Nephrotic syndrome usually happens when the glomeruli are damaged, allowing too much protein to leak from the blood into the urine. Health care professionals use different terms to refer to nephrotic syndrome in children, depending on Nephrotic syndrome is not very common in children. On average, fewer than 5 in 100,000 children worldwide develop nephrotic syndrome each year.1
Children of all ages can develop nephrotic syndrome. But the condition most often affects children who are 2 to 7 years old, particularly boys.2 Losing too much protein in the urine can lead to many complications, including3
Swelling around the eyes is the most common sign of nephrotic syndrome in children.3 The swelling is usually greater in the morning and, when mild, may be confused with seasonal allergies.
Other common symptoms include2,3
Some children with nephrotic syndrome may also have
Kidney disease that affects a kidney’s filtering system is the most common cause of nephrotic syndrome in children. Other causes can include diseases that affect other parts of the body, infections, some medicines, and genetics.
Four types of kidney disease can cause primary nephrotic syndrome in children and adolescents.2
Other causes of primary nephrotic syndrome are uncommon.
Causes of secondary nephrotic syndrome in children include3
Among newborns and infants younger than 12 months old, the two most common causes of nephrotic syndrome are4
Nephrotic syndrome in children is diagnosed with
Additional tests to identify the cause of nephrotic syndrome may include3
Many children with nephrotic syndrome will not need a kidney biopsy. The test is usually reserved for children who have complex disease, who have low kidney function, or who are 12 years old or older.3
Nephrotic syndrome in children is most often treated with medicines.
Corticosteroids. Corticosteroids, or steroids, are the medicines most often used to treat children with primary nephrotic syndrome. These medicines suppress the immune system, reduce the amount of protein passed into the urine, and decrease swelling.
In most children, treatment with corticosteroids will make nephrotic syndrome improve—also called “remission.” If symptoms return, called a “relapse,” the health care professional may prescribe a shorter course of corticosteroids until the disease goes into remission again. Although children may have multiple relapses, they often recover without long-term kidney damage. In most cases, relapses happen less often as children get older.3
Although corticosteroids effectively treat nephrotic syndrome in many children, using these medicines for long periods of time can cause side effects, such as impaired growth, obesity, high blood pressure, eye problems, and bone loss.3 Other common side effects include anxiety, depression, and aggressive behavior. These problems are more likely to develop with larger doses and longer use.
In some cases, nephrotic syndrome may not improve with corticosteroids. Cases of nephrotic syndrome that don’t respond to corticosteroids are more difficult to treat than those that do. They are also more likely to progress to end-stage kidney disease.3
Other medicines that suppress the immune system. If corticosteroids are not working or are causing harmful side effects, your child’s health care professional may prescribe other medicines that reduce the activity of the immune system. In some cases, your child may take these medicines together with low-dose corticosteroids.
Medicines for managing symptoms and complications. Health care professionals may also prescribe other medicines to help your child manage the symptoms and complications of nephrotic syndrome. Examples include Children with nephrotic syndrome should get the pneumococcal vaccine and yearly flu shots to prevent viral and bacterial infections. They should also get age-appropriate vaccinations. But the health care professional may delay certain “live” vaccines—vaccines that use weakened forms of a virus—while your child is taking certain medicines.
Treatment focuses on the cause of nephrotic syndrome. For example, the health care professional may
Your child’s health care professional may also prescribe the same medicines used to manage the symptoms and complications of primary nephrotic syndrome.
Treatment varies depending on whether the cause is genetic or an infection.
Genetic. Your child’s treatment will depend on the type of genetic mutation that is causing nephrotic syndrome and how bad the symptoms and complications are. Many children will lose kidney function over time and ultimately need a kidney transplant. To keep your child healthy until the transplant, the health care professional may recommend4,5
Infection. When nephrotic syndrome is caused by a congenital infection, such as syphilis or toxoplasmosis, it will usually go away when the infection is treated.4
Researchers have not found a way to prevent nephrotic syndrome in children. Knowing the symptoms can help you get your child treated early and reduce the risk of complications.
Children who have nephrotic syndrome may need to change what they eat and drink, such as In some cases, the child’s health care professional may recommend other dietary changes. Parents or other caregivers should talk with their child’s health care professional before making any changes to the child’s diet.
The NIDDK conducts and supports clinical trials in many diseases and conditions, including kidney diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Children respond to medicines and treatments differently than adults. The way to get the best treatments for children is through research designed specifically for them.
We have already made great strides in improving children's health outcomes through clinical trials—and other types of clinical studies. Vaccines, treatments for children with cancer, and interventions for premature babies are just a few examples of how this targeted research can help. However, we still have many questions to answer and more children waiting to benefit.
The data gathered from trials and studies involving children help doctors and researchers
We understand you have many questions, want to weigh the pros and cons, and need to learn as much as possible. Deciding to enroll in a study can be life changing for you and for your child. Depending on the outcome of the study, your child may find relief from their condition, see no benefit, or help to improve the health of future generations.
Talk with your child and consider what would be expected. What could be the potential benefit or harm? Would you need to travel? Is my child well enough to participate? While parents or guardians must give their permission, or consent, for their children to join a study, the children must also agree to participate, if they are capable (verbal). In the end, no choice is right or wrong. Your decision is about what is best for your child.
The National Institutes of Health (NIH) is committed to ensuring you get all the information you need to feel comfortable and make informed decisions. The safety of children remains the utmost priority for all NIH research studies. For more resources to help decide if clinical trials are right for your child, visit Clinical Trials and You: For Parents and Children.
Researchers study many aspects of nephrotic syndrome in children, such as the kidney diseases that can cause nephrotic syndrome in children and the genetic factors that can cause congenital nephrotic syndrome.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
You can view a filtered list of clinical studies on nephrotic syndrome in children that are federally funded, open, and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the NIH does not review these studies and cannot ensure they are safe. If you find a trial you think may be right for your child, talk with your child’s doctor about how to enroll.
1. Downie ML, Gallibois C, Parekh RS, Noone DG. Nephrotic syndrome in infants and children: pathophysiology and management. Paediatrics and International Child Health. 2017;37(4):248–258. doi: 10.1080/20469047.2017.1374003 2. Wang CS, Greenbaum LA. Nephrotic syndrome. Pediatric Clinics of North America. 2019;66(1):73–85. doi: 10.1016/j.pcl.2018.08.006 3. Noone DG, Iijima K, Parekh R. Idiopathic nephrotic syndrome in children. Lancet. 2018;392(10141):61–74. doi: 10.1016/S0140-6736(18)30536-1 4. Reynolds BC, Oswald RJA. Diagnostic and management challenges in congenital nephrotic syndrome. Pediatric Health, Medicine, and Therapeutics. 2019;10:157–167. doi: 10.2147/PHMT.S193684 5. Hölttä T, Jalanko H. Congenital nephrotic syndrome: is early aggressive treatment needed? Yes. Pediatric Nephrology. 2020;35(10):1985–1990. doi: 10.1007/s00467-020-04578-4
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
| What is (are) Childhood Nephrotic Syndrome ? | Childhood nephrotic syndrome is not a disease in itself; rather, it is a group of symptoms that
- indicate kidney damageparticularly damage to the glomeruli, the tiny units within the kidney where blood is filtered - result in the release of too much protein from the body into the urine
When the kidneys are damaged, the protein albumin, normally found in the blood, will leak into the urine. Proteins are large, complex molecules that perform a number of important functions in the body.
The two types of childhood nephrotic syndrome are
- primarythe most common type of childhood nephrotic syndrome, which begins in the kidneys and affects only the kidneys - secondarythe syndrome is caused by other diseases
A health care provider may refer a child with nephrotic syndrome to a nephrologista doctor who specializes in treating kidney disease. A child should see a pediatric nephrologist, who has special training to take care of kidney problems in children, if possible. However, in many parts of the country, pediatric nephrologists are in short supply, so the child may need to travel. If traveling is not possible, some nephrologists who treat adults can also treat children. |
On this page: Nephrotic syndrome is a group of symptoms that indicate the kidneys are not working properly. These symptoms include The kidneys are made up of about a million filtering units called nephrons. Each nephron includes a filter, called the glomerulus, and a tubule. The glomerulus filters the blood, and the tubule returns needed substances to the blood and removes wastes and extra water, which become urine. Nephrotic syndrome usually happens when the glomeruli are damaged, allowing too much protein to leak from the blood into the urine. Health care professionals use different terms to refer to nephrotic syndrome in children, depending on Nephrotic syndrome is not very common in children. On average, fewer than 5 in 100,000 children worldwide develop nephrotic syndrome each year.1
Children of all ages can develop nephrotic syndrome. But the condition most often affects children who are 2 to 7 years old, particularly boys.2 Losing too much protein in the urine can lead to many complications, including3
Swelling around the eyes is the most common sign of nephrotic syndrome in children.3 The swelling is usually greater in the morning and, when mild, may be confused with seasonal allergies.
Other common symptoms include2,3
Some children with nephrotic syndrome may also have
Kidney disease that affects a kidney’s filtering system is the most common cause of nephrotic syndrome in children. Other causes can include diseases that affect other parts of the body, infections, some medicines, and genetics.
Four types of kidney disease can cause primary nephrotic syndrome in children and adolescents.2
Other causes of primary nephrotic syndrome are uncommon.
Causes of secondary nephrotic syndrome in children include3
Among newborns and infants younger than 12 months old, the two most common causes of nephrotic syndrome are4
Nephrotic syndrome in children is diagnosed with
Additional tests to identify the cause of nephrotic syndrome may include3
Many children with nephrotic syndrome will not need a kidney biopsy. The test is usually reserved for children who have complex disease, who have low kidney function, or who are 12 years old or older.3
Nephrotic syndrome in children is most often treated with medicines.
Corticosteroids. Corticosteroids, or steroids, are the medicines most often used to treat children with primary nephrotic syndrome. These medicines suppress the immune system, reduce the amount of protein passed into the urine, and decrease swelling.
In most children, treatment with corticosteroids will make nephrotic syndrome improve—also called “remission.” If symptoms return, called a “relapse,” the health care professional may prescribe a shorter course of corticosteroids until the disease goes into remission again. Although children may have multiple relapses, they often recover without long-term kidney damage. In most cases, relapses happen less often as children get older.3
Although corticosteroids effectively treat nephrotic syndrome in many children, using these medicines for long periods of time can cause side effects, such as impaired growth, obesity, high blood pressure, eye problems, and bone loss.3 Other common side effects include anxiety, depression, and aggressive behavior. These problems are more likely to develop with larger doses and longer use.
In some cases, nephrotic syndrome may not improve with corticosteroids. Cases of nephrotic syndrome that don’t respond to corticosteroids are more difficult to treat than those that do. They are also more likely to progress to end-stage kidney disease.3
Other medicines that suppress the immune system. If corticosteroids are not working or are causing harmful side effects, your child’s health care professional may prescribe other medicines that reduce the activity of the immune system. In some cases, your child may take these medicines together with low-dose corticosteroids.
Medicines for managing symptoms and complications. Health care professionals may also prescribe other medicines to help your child manage the symptoms and complications of nephrotic syndrome. Examples include Children with nephrotic syndrome should get the pneumococcal vaccine and yearly flu shots to prevent viral and bacterial infections. They should also get age-appropriate vaccinations. But the health care professional may delay certain “live” vaccines—vaccines that use weakened forms of a virus—while your child is taking certain medicines.
Treatment focuses on the cause of nephrotic syndrome. For example, the health care professional may
Your child’s health care professional may also prescribe the same medicines used to manage the symptoms and complications of primary nephrotic syndrome.
Treatment varies depending on whether the cause is genetic or an infection.
Genetic. Your child’s treatment will depend on the type of genetic mutation that is causing nephrotic syndrome and how bad the symptoms and complications are. Many children will lose kidney function over time and ultimately need a kidney transplant. To keep your child healthy until the transplant, the health care professional may recommend4,5
Infection. When nephrotic syndrome is caused by a congenital infection, such as syphilis or toxoplasmosis, it will usually go away when the infection is treated.4
Researchers have not found a way to prevent nephrotic syndrome in children. Knowing the symptoms can help you get your child treated early and reduce the risk of complications.
Children who have nephrotic syndrome may need to change what they eat and drink, such as In some cases, the child’s health care professional may recommend other dietary changes. Parents or other caregivers should talk with their child’s health care professional before making any changes to the child’s diet.
The NIDDK conducts and supports clinical trials in many diseases and conditions, including kidney diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Children respond to medicines and treatments differently than adults. The way to get the best treatments for children is through research designed specifically for them.
We have already made great strides in improving children's health outcomes through clinical trials—and other types of clinical studies. Vaccines, treatments for children with cancer, and interventions for premature babies are just a few examples of how this targeted research can help. However, we still have many questions to answer and more children waiting to benefit.
The data gathered from trials and studies involving children help doctors and researchers
We understand you have many questions, want to weigh the pros and cons, and need to learn as much as possible. Deciding to enroll in a study can be life changing for you and for your child. Depending on the outcome of the study, your child may find relief from their condition, see no benefit, or help to improve the health of future generations.
Talk with your child and consider what would be expected. What could be the potential benefit or harm? Would you need to travel? Is my child well enough to participate? While parents or guardians must give their permission, or consent, for their children to join a study, the children must also agree to participate, if they are capable (verbal). In the end, no choice is right or wrong. Your decision is about what is best for your child.
The National Institutes of Health (NIH) is committed to ensuring you get all the information you need to feel comfortable and make informed decisions. The safety of children remains the utmost priority for all NIH research studies. For more resources to help decide if clinical trials are right for your child, visit Clinical Trials and You: For Parents and Children.
Researchers study many aspects of nephrotic syndrome in children, such as the kidney diseases that can cause nephrotic syndrome in children and the genetic factors that can cause congenital nephrotic syndrome.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
You can view a filtered list of clinical studies on nephrotic syndrome in children that are federally funded, open, and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the NIH does not review these studies and cannot ensure they are safe. If you find a trial you think may be right for your child, talk with your child’s doctor about how to enroll.
1. Downie ML, Gallibois C, Parekh RS, Noone DG. Nephrotic syndrome in infants and children: pathophysiology and management. Paediatrics and International Child Health. 2017;37(4):248–258. doi: 10.1080/20469047.2017.1374003 2. Wang CS, Greenbaum LA. Nephrotic syndrome. Pediatric Clinics of North America. 2019;66(1):73–85. doi: 10.1016/j.pcl.2018.08.006 3. Noone DG, Iijima K, Parekh R. Idiopathic nephrotic syndrome in children. Lancet. 2018;392(10141):61–74. doi: 10.1016/S0140-6736(18)30536-1 4. Reynolds BC, Oswald RJA. Diagnostic and management challenges in congenital nephrotic syndrome. Pediatric Health, Medicine, and Therapeutics. 2019;10:157–167. doi: 10.2147/PHMT.S193684 5. Hölttä T, Jalanko H. Congenital nephrotic syndrome: is early aggressive treatment needed? Yes. Pediatric Nephrology. 2020;35(10):1985–1990. doi: 10.1007/s00467-020-04578-4
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
| What is (are) Childhood Nephrotic Syndrome ? | The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. Children produce less urine than adults and the amount produced depends on their age. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder.
Kidneys work at the microscopic level. The kidney is not one large filter. Each kidney is made up of about a million filtering units called nephrons. Each nephron filters a small amount of blood. The nephron includes a filter, called the glomerulus, and a tubule. The nephrons work through a two-step process. The glomerulus lets fluid and waste products pass through it; however, it prevents blood cells and large molecules, mostly proteins, from passing. The filtered fluid then passes through the tubule, which sends needed minerals back to the bloodstream and removes wastes. |
On this page: Nephrotic syndrome is a group of symptoms that indicate the kidneys are not working properly. These symptoms include The kidneys are made up of about a million filtering units called nephrons. Each nephron includes a filter, called the glomerulus, and a tubule. The glomerulus filters the blood, and the tubule returns needed substances to the blood and removes wastes and extra water, which become urine. Nephrotic syndrome usually happens when the glomeruli are damaged, allowing too much protein to leak from the blood into the urine. Health care professionals use different terms to refer to nephrotic syndrome in children, depending on Nephrotic syndrome is not very common in children. On average, fewer than 5 in 100,000 children worldwide develop nephrotic syndrome each year.1
Children of all ages can develop nephrotic syndrome. But the condition most often affects children who are 2 to 7 years old, particularly boys.2 Losing too much protein in the urine can lead to many complications, including3
Swelling around the eyes is the most common sign of nephrotic syndrome in children.3 The swelling is usually greater in the morning and, when mild, may be confused with seasonal allergies.
Other common symptoms include2,3
Some children with nephrotic syndrome may also have
Kidney disease that affects a kidney’s filtering system is the most common cause of nephrotic syndrome in children. Other causes can include diseases that affect other parts of the body, infections, some medicines, and genetics.
Four types of kidney disease can cause primary nephrotic syndrome in children and adolescents.2
Other causes of primary nephrotic syndrome are uncommon.
Causes of secondary nephrotic syndrome in children include3
Among newborns and infants younger than 12 months old, the two most common causes of nephrotic syndrome are4
Nephrotic syndrome in children is diagnosed with
Additional tests to identify the cause of nephrotic syndrome may include3
Many children with nephrotic syndrome will not need a kidney biopsy. The test is usually reserved for children who have complex disease, who have low kidney function, or who are 12 years old or older.3
Nephrotic syndrome in children is most often treated with medicines.
Corticosteroids. Corticosteroids, or steroids, are the medicines most often used to treat children with primary nephrotic syndrome. These medicines suppress the immune system, reduce the amount of protein passed into the urine, and decrease swelling.
In most children, treatment with corticosteroids will make nephrotic syndrome improve—also called “remission.” If symptoms return, called a “relapse,” the health care professional may prescribe a shorter course of corticosteroids until the disease goes into remission again. Although children may have multiple relapses, they often recover without long-term kidney damage. In most cases, relapses happen less often as children get older.3
Although corticosteroids effectively treat nephrotic syndrome in many children, using these medicines for long periods of time can cause side effects, such as impaired growth, obesity, high blood pressure, eye problems, and bone loss.3 Other common side effects include anxiety, depression, and aggressive behavior. These problems are more likely to develop with larger doses and longer use.
In some cases, nephrotic syndrome may not improve with corticosteroids. Cases of nephrotic syndrome that don’t respond to corticosteroids are more difficult to treat than those that do. They are also more likely to progress to end-stage kidney disease.3
Other medicines that suppress the immune system. If corticosteroids are not working or are causing harmful side effects, your child’s health care professional may prescribe other medicines that reduce the activity of the immune system. In some cases, your child may take these medicines together with low-dose corticosteroids.
Medicines for managing symptoms and complications. Health care professionals may also prescribe other medicines to help your child manage the symptoms and complications of nephrotic syndrome. Examples include Children with nephrotic syndrome should get the pneumococcal vaccine and yearly flu shots to prevent viral and bacterial infections. They should also get age-appropriate vaccinations. But the health care professional may delay certain “live” vaccines—vaccines that use weakened forms of a virus—while your child is taking certain medicines.
Treatment focuses on the cause of nephrotic syndrome. For example, the health care professional may
Your child’s health care professional may also prescribe the same medicines used to manage the symptoms and complications of primary nephrotic syndrome.
Treatment varies depending on whether the cause is genetic or an infection.
Genetic. Your child’s treatment will depend on the type of genetic mutation that is causing nephrotic syndrome and how bad the symptoms and complications are. Many children will lose kidney function over time and ultimately need a kidney transplant. To keep your child healthy until the transplant, the health care professional may recommend4,5
Infection. When nephrotic syndrome is caused by a congenital infection, such as syphilis or toxoplasmosis, it will usually go away when the infection is treated.4
Researchers have not found a way to prevent nephrotic syndrome in children. Knowing the symptoms can help you get your child treated early and reduce the risk of complications.
Children who have nephrotic syndrome may need to change what they eat and drink, such as In some cases, the child’s health care professional may recommend other dietary changes. Parents or other caregivers should talk with their child’s health care professional before making any changes to the child’s diet.
The NIDDK conducts and supports clinical trials in many diseases and conditions, including kidney diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Children respond to medicines and treatments differently than adults. The way to get the best treatments for children is through research designed specifically for them.
We have already made great strides in improving children's health outcomes through clinical trials—and other types of clinical studies. Vaccines, treatments for children with cancer, and interventions for premature babies are just a few examples of how this targeted research can help. However, we still have many questions to answer and more children waiting to benefit.
The data gathered from trials and studies involving children help doctors and researchers
We understand you have many questions, want to weigh the pros and cons, and need to learn as much as possible. Deciding to enroll in a study can be life changing for you and for your child. Depending on the outcome of the study, your child may find relief from their condition, see no benefit, or help to improve the health of future generations.
Talk with your child and consider what would be expected. What could be the potential benefit or harm? Would you need to travel? Is my child well enough to participate? While parents or guardians must give their permission, or consent, for their children to join a study, the children must also agree to participate, if they are capable (verbal). In the end, no choice is right or wrong. Your decision is about what is best for your child.
The National Institutes of Health (NIH) is committed to ensuring you get all the information you need to feel comfortable and make informed decisions. The safety of children remains the utmost priority for all NIH research studies. For more resources to help decide if clinical trials are right for your child, visit Clinical Trials and You: For Parents and Children.
Researchers study many aspects of nephrotic syndrome in children, such as the kidney diseases that can cause nephrotic syndrome in children and the genetic factors that can cause congenital nephrotic syndrome.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
You can view a filtered list of clinical studies on nephrotic syndrome in children that are federally funded, open, and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the NIH does not review these studies and cannot ensure they are safe. If you find a trial you think may be right for your child, talk with your child’s doctor about how to enroll.
1. Downie ML, Gallibois C, Parekh RS, Noone DG. Nephrotic syndrome in infants and children: pathophysiology and management. Paediatrics and International Child Health. 2017;37(4):248–258. doi: 10.1080/20469047.2017.1374003 2. Wang CS, Greenbaum LA. Nephrotic syndrome. Pediatric Clinics of North America. 2019;66(1):73–85. doi: 10.1016/j.pcl.2018.08.006 3. Noone DG, Iijima K, Parekh R. Idiopathic nephrotic syndrome in children. Lancet. 2018;392(10141):61–74. doi: 10.1016/S0140-6736(18)30536-1 4. Reynolds BC, Oswald RJA. Diagnostic and management challenges in congenital nephrotic syndrome. Pediatric Health, Medicine, and Therapeutics. 2019;10:157–167. doi: 10.2147/PHMT.S193684 5. Hölttä T, Jalanko H. Congenital nephrotic syndrome: is early aggressive treatment needed? Yes. Pediatric Nephrology. 2020;35(10):1985–1990. doi: 10.1007/s00467-020-04578-4
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
| What causes Childhood Nephrotic Syndrome ? | While idiopathic, or unknown, diseases are the most common cause of primary childhood nephrotic syndrome, researchers have linked certain diseases and some specific genetic changes that damage the kidneys with primary childhood nephrotic syndrome.
The cause of secondary childhood nephrotic syndrome is an underlying disease or infection. Called a primary illness, its this underlying disease or infection that causes changes in the kidney function that can result in secondary childhood nephrotic syndrome.
Congenital diseasesdiseases that are present at birthcan also cause childhood nephrotic syndrome.
Primary Childhood Nephrotic Syndrome
The following diseases are different types of idiopathic childhood nephrotic syndrome:
- Minimal change disease involves damage to the glomeruli that can be seen only with an electron microscope. This type of microscope shows tiny details better than any other microscope. Scientists do not know the exact cause of minimal change disease. Minimal change disease is the most common cause of idiopathic childhood nephrotic syndrome.1 - Focal segmental glomerulosclerosis is scarring in scattered regions of the kidney: - Focal means that only some of the glomeruli become scarred. - Segmental means damage affects only part of an individual glomerulus. - Membranoproliferative glomerulonephritis is a group of disorders involving deposits of antibodies that build up in the glomeruli, causing thickening and damage. Antibodies are proteins made by the immune system to protect the body from foreign substances such as bacteria or viruses.
Secondary Childhood Nephrotic Syndrome
Some common diseases that can cause secondary childhood nephrotic syndrome include
- diabetes, a condition that occurs when the body cannot use glucosea type of sugarnormally - Henoch-Schnlein purpura, a disease that causes small blood vessels in the body to become inflamed and leak - hepatitis, inflammation of the liver caused by a virus - human immunodeficiency virus (HIV), a virus that alters the immune system - lupus, an autoimmune disease that occurs when the body attacks its own immune system - malaria, a disease of the blood that is spread by mosquitos - streptococcal infection, an infection that results when the bacteria that causes strep throat or a skin infection is left untreated
Other causes of secondary childhood nephrotic syndrome can include certain medications, such as aspirin, ibuprofen, or other nonsteroidal anti-inflammatory drugs, and exposure to chemicals, such as mercury and lithium.
Congenital Diseases and Childhood Nephrotic Syndrome
Congenital nephrotic syndrome is rare and affects infants in the first 3 months of life.2 This type of nephrotic syndrome, sometimes called infantile nephrotic syndrome, can be caused by
- inherited genetic defects, which are problems passed from parent to child through genes - infections at the time of birth
More information about underlying diseases or infections that cause changes in kidney function is provided in the NIDDK health topic, Glomerular Diseases. |
On this page: Nephrotic syndrome is a group of symptoms that indicate the kidneys are not working properly. These symptoms include The kidneys are made up of about a million filtering units called nephrons. Each nephron includes a filter, called the glomerulus, and a tubule. The glomerulus filters the blood, and the tubule returns needed substances to the blood and removes wastes and extra water, which become urine. Nephrotic syndrome usually happens when the glomeruli are damaged, allowing too much protein to leak from the blood into the urine. Health care professionals use different terms to refer to nephrotic syndrome in children, depending on Nephrotic syndrome is not very common in children. On average, fewer than 5 in 100,000 children worldwide develop nephrotic syndrome each year.1
Children of all ages can develop nephrotic syndrome. But the condition most often affects children who are 2 to 7 years old, particularly boys.2 Losing too much protein in the urine can lead to many complications, including3
Swelling around the eyes is the most common sign of nephrotic syndrome in children.3 The swelling is usually greater in the morning and, when mild, may be confused with seasonal allergies.
Other common symptoms include2,3
Some children with nephrotic syndrome may also have
Kidney disease that affects a kidney’s filtering system is the most common cause of nephrotic syndrome in children. Other causes can include diseases that affect other parts of the body, infections, some medicines, and genetics.
Four types of kidney disease can cause primary nephrotic syndrome in children and adolescents.2
Other causes of primary nephrotic syndrome are uncommon.
Causes of secondary nephrotic syndrome in children include3
Among newborns and infants younger than 12 months old, the two most common causes of nephrotic syndrome are4
Nephrotic syndrome in children is diagnosed with
Additional tests to identify the cause of nephrotic syndrome may include3
Many children with nephrotic syndrome will not need a kidney biopsy. The test is usually reserved for children who have complex disease, who have low kidney function, or who are 12 years old or older.3
Nephrotic syndrome in children is most often treated with medicines.
Corticosteroids. Corticosteroids, or steroids, are the medicines most often used to treat children with primary nephrotic syndrome. These medicines suppress the immune system, reduce the amount of protein passed into the urine, and decrease swelling.
In most children, treatment with corticosteroids will make nephrotic syndrome improve—also called “remission.” If symptoms return, called a “relapse,” the health care professional may prescribe a shorter course of corticosteroids until the disease goes into remission again. Although children may have multiple relapses, they often recover without long-term kidney damage. In most cases, relapses happen less often as children get older.3
Although corticosteroids effectively treat nephrotic syndrome in many children, using these medicines for long periods of time can cause side effects, such as impaired growth, obesity, high blood pressure, eye problems, and bone loss.3 Other common side effects include anxiety, depression, and aggressive behavior. These problems are more likely to develop with larger doses and longer use.
In some cases, nephrotic syndrome may not improve with corticosteroids. Cases of nephrotic syndrome that don’t respond to corticosteroids are more difficult to treat than those that do. They are also more likely to progress to end-stage kidney disease.3
Other medicines that suppress the immune system. If corticosteroids are not working or are causing harmful side effects, your child’s health care professional may prescribe other medicines that reduce the activity of the immune system. In some cases, your child may take these medicines together with low-dose corticosteroids.
Medicines for managing symptoms and complications. Health care professionals may also prescribe other medicines to help your child manage the symptoms and complications of nephrotic syndrome. Examples include Children with nephrotic syndrome should get the pneumococcal vaccine and yearly flu shots to prevent viral and bacterial infections. They should also get age-appropriate vaccinations. But the health care professional may delay certain “live” vaccines—vaccines that use weakened forms of a virus—while your child is taking certain medicines.
Treatment focuses on the cause of nephrotic syndrome. For example, the health care professional may
Your child’s health care professional may also prescribe the same medicines used to manage the symptoms and complications of primary nephrotic syndrome.
Treatment varies depending on whether the cause is genetic or an infection.
Genetic. Your child’s treatment will depend on the type of genetic mutation that is causing nephrotic syndrome and how bad the symptoms and complications are. Many children will lose kidney function over time and ultimately need a kidney transplant. To keep your child healthy until the transplant, the health care professional may recommend4,5
Infection. When nephrotic syndrome is caused by a congenital infection, such as syphilis or toxoplasmosis, it will usually go away when the infection is treated.4
Researchers have not found a way to prevent nephrotic syndrome in children. Knowing the symptoms can help you get your child treated early and reduce the risk of complications.
Children who have nephrotic syndrome may need to change what they eat and drink, such as In some cases, the child’s health care professional may recommend other dietary changes. Parents or other caregivers should talk with their child’s health care professional before making any changes to the child’s diet.
The NIDDK conducts and supports clinical trials in many diseases and conditions, including kidney diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Children respond to medicines and treatments differently than adults. The way to get the best treatments for children is through research designed specifically for them.
We have already made great strides in improving children's health outcomes through clinical trials—and other types of clinical studies. Vaccines, treatments for children with cancer, and interventions for premature babies are just a few examples of how this targeted research can help. However, we still have many questions to answer and more children waiting to benefit.
The data gathered from trials and studies involving children help doctors and researchers
We understand you have many questions, want to weigh the pros and cons, and need to learn as much as possible. Deciding to enroll in a study can be life changing for you and for your child. Depending on the outcome of the study, your child may find relief from their condition, see no benefit, or help to improve the health of future generations.
Talk with your child and consider what would be expected. What could be the potential benefit or harm? Would you need to travel? Is my child well enough to participate? While parents or guardians must give their permission, or consent, for their children to join a study, the children must also agree to participate, if they are capable (verbal). In the end, no choice is right or wrong. Your decision is about what is best for your child.
The National Institutes of Health (NIH) is committed to ensuring you get all the information you need to feel comfortable and make informed decisions. The safety of children remains the utmost priority for all NIH research studies. For more resources to help decide if clinical trials are right for your child, visit Clinical Trials and You: For Parents and Children.
Researchers study many aspects of nephrotic syndrome in children, such as the kidney diseases that can cause nephrotic syndrome in children and the genetic factors that can cause congenital nephrotic syndrome.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
You can view a filtered list of clinical studies on nephrotic syndrome in children that are federally funded, open, and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the NIH does not review these studies and cannot ensure they are safe. If you find a trial you think may be right for your child, talk with your child’s doctor about how to enroll.
1. Downie ML, Gallibois C, Parekh RS, Noone DG. Nephrotic syndrome in infants and children: pathophysiology and management. Paediatrics and International Child Health. 2017;37(4):248–258. doi: 10.1080/20469047.2017.1374003 2. Wang CS, Greenbaum LA. Nephrotic syndrome. Pediatric Clinics of North America. 2019;66(1):73–85. doi: 10.1016/j.pcl.2018.08.006 3. Noone DG, Iijima K, Parekh R. Idiopathic nephrotic syndrome in children. Lancet. 2018;392(10141):61–74. doi: 10.1016/S0140-6736(18)30536-1 4. Reynolds BC, Oswald RJA. Diagnostic and management challenges in congenital nephrotic syndrome. Pediatric Health, Medicine, and Therapeutics. 2019;10:157–167. doi: 10.2147/PHMT.S193684 5. Hölttä T, Jalanko H. Congenital nephrotic syndrome: is early aggressive treatment needed? Yes. Pediatric Nephrology. 2020;35(10):1985–1990. doi: 10.1007/s00467-020-04578-4
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
| What are the symptoms of Childhood Nephrotic Syndrome ? | The signs and symptoms of childhood nephrotic syndrome may include
- edemaswelling, most often in the legs, feet, or ankles and less often in the hands or face - albuminuriawhen a childs urine has high levels of albumin - hypoalbuminemiawhen a childs blood has low levels of albumin - hyperlipidemiawhen a childs blood cholesterol and fat levels are higher than normal
In addition, some children with nephrotic syndrome may have
- blood in their urine - symptoms of infection, such as fever, lethargy, irritability, or abdominal pain - loss of appetite - diarrhea - high blood pressure |
On this page: Nephrotic syndrome is a group of symptoms that indicate the kidneys are not working properly. These symptoms include The kidneys are made up of about a million filtering units called nephrons. Each nephron includes a filter, called the glomerulus, and a tubule. The glomerulus filters the blood, and the tubule returns needed substances to the blood and removes wastes and extra water, which become urine. Nephrotic syndrome usually happens when the glomeruli are damaged, allowing too much protein to leak from the blood into the urine. Health care professionals use different terms to refer to nephrotic syndrome in children, depending on Nephrotic syndrome is not very common in children. On average, fewer than 5 in 100,000 children worldwide develop nephrotic syndrome each year.1
Children of all ages can develop nephrotic syndrome. But the condition most often affects children who are 2 to 7 years old, particularly boys.2 Losing too much protein in the urine can lead to many complications, including3
Swelling around the eyes is the most common sign of nephrotic syndrome in children.3 The swelling is usually greater in the morning and, when mild, may be confused with seasonal allergies.
Other common symptoms include2,3
Some children with nephrotic syndrome may also have
Kidney disease that affects a kidney’s filtering system is the most common cause of nephrotic syndrome in children. Other causes can include diseases that affect other parts of the body, infections, some medicines, and genetics.
Four types of kidney disease can cause primary nephrotic syndrome in children and adolescents.2
Other causes of primary nephrotic syndrome are uncommon.
Causes of secondary nephrotic syndrome in children include3
Among newborns and infants younger than 12 months old, the two most common causes of nephrotic syndrome are4
Nephrotic syndrome in children is diagnosed with
Additional tests to identify the cause of nephrotic syndrome may include3
Many children with nephrotic syndrome will not need a kidney biopsy. The test is usually reserved for children who have complex disease, who have low kidney function, or who are 12 years old or older.3
Nephrotic syndrome in children is most often treated with medicines.
Corticosteroids. Corticosteroids, or steroids, are the medicines most often used to treat children with primary nephrotic syndrome. These medicines suppress the immune system, reduce the amount of protein passed into the urine, and decrease swelling.
In most children, treatment with corticosteroids will make nephrotic syndrome improve—also called “remission.” If symptoms return, called a “relapse,” the health care professional may prescribe a shorter course of corticosteroids until the disease goes into remission again. Although children may have multiple relapses, they often recover without long-term kidney damage. In most cases, relapses happen less often as children get older.3
Although corticosteroids effectively treat nephrotic syndrome in many children, using these medicines for long periods of time can cause side effects, such as impaired growth, obesity, high blood pressure, eye problems, and bone loss.3 Other common side effects include anxiety, depression, and aggressive behavior. These problems are more likely to develop with larger doses and longer use.
In some cases, nephrotic syndrome may not improve with corticosteroids. Cases of nephrotic syndrome that don’t respond to corticosteroids are more difficult to treat than those that do. They are also more likely to progress to end-stage kidney disease.3
Other medicines that suppress the immune system. If corticosteroids are not working or are causing harmful side effects, your child’s health care professional may prescribe other medicines that reduce the activity of the immune system. In some cases, your child may take these medicines together with low-dose corticosteroids.
Medicines for managing symptoms and complications. Health care professionals may also prescribe other medicines to help your child manage the symptoms and complications of nephrotic syndrome. Examples include Children with nephrotic syndrome should get the pneumococcal vaccine and yearly flu shots to prevent viral and bacterial infections. They should also get age-appropriate vaccinations. But the health care professional may delay certain “live” vaccines—vaccines that use weakened forms of a virus—while your child is taking certain medicines.
Treatment focuses on the cause of nephrotic syndrome. For example, the health care professional may
Your child’s health care professional may also prescribe the same medicines used to manage the symptoms and complications of primary nephrotic syndrome.
Treatment varies depending on whether the cause is genetic or an infection.
Genetic. Your child’s treatment will depend on the type of genetic mutation that is causing nephrotic syndrome and how bad the symptoms and complications are. Many children will lose kidney function over time and ultimately need a kidney transplant. To keep your child healthy until the transplant, the health care professional may recommend4,5
Infection. When nephrotic syndrome is caused by a congenital infection, such as syphilis or toxoplasmosis, it will usually go away when the infection is treated.4
Researchers have not found a way to prevent nephrotic syndrome in children. Knowing the symptoms can help you get your child treated early and reduce the risk of complications.
Children who have nephrotic syndrome may need to change what they eat and drink, such as In some cases, the child’s health care professional may recommend other dietary changes. Parents or other caregivers should talk with their child’s health care professional before making any changes to the child’s diet.
The NIDDK conducts and supports clinical trials in many diseases and conditions, including kidney diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Children respond to medicines and treatments differently than adults. The way to get the best treatments for children is through research designed specifically for them.
We have already made great strides in improving children's health outcomes through clinical trials—and other types of clinical studies. Vaccines, treatments for children with cancer, and interventions for premature babies are just a few examples of how this targeted research can help. However, we still have many questions to answer and more children waiting to benefit.
The data gathered from trials and studies involving children help doctors and researchers
We understand you have many questions, want to weigh the pros and cons, and need to learn as much as possible. Deciding to enroll in a study can be life changing for you and for your child. Depending on the outcome of the study, your child may find relief from their condition, see no benefit, or help to improve the health of future generations.
Talk with your child and consider what would be expected. What could be the potential benefit or harm? Would you need to travel? Is my child well enough to participate? While parents or guardians must give their permission, or consent, for their children to join a study, the children must also agree to participate, if they are capable (verbal). In the end, no choice is right or wrong. Your decision is about what is best for your child.
The National Institutes of Health (NIH) is committed to ensuring you get all the information you need to feel comfortable and make informed decisions. The safety of children remains the utmost priority for all NIH research studies. For more resources to help decide if clinical trials are right for your child, visit Clinical Trials and You: For Parents and Children.
Researchers study many aspects of nephrotic syndrome in children, such as the kidney diseases that can cause nephrotic syndrome in children and the genetic factors that can cause congenital nephrotic syndrome.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
You can view a filtered list of clinical studies on nephrotic syndrome in children that are federally funded, open, and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the NIH does not review these studies and cannot ensure they are safe. If you find a trial you think may be right for your child, talk with your child’s doctor about how to enroll.
1. Downie ML, Gallibois C, Parekh RS, Noone DG. Nephrotic syndrome in infants and children: pathophysiology and management. Paediatrics and International Child Health. 2017;37(4):248–258. doi: 10.1080/20469047.2017.1374003 2. Wang CS, Greenbaum LA. Nephrotic syndrome. Pediatric Clinics of North America. 2019;66(1):73–85. doi: 10.1016/j.pcl.2018.08.006 3. Noone DG, Iijima K, Parekh R. Idiopathic nephrotic syndrome in children. Lancet. 2018;392(10141):61–74. doi: 10.1016/S0140-6736(18)30536-1 4. Reynolds BC, Oswald RJA. Diagnostic and management challenges in congenital nephrotic syndrome. Pediatric Health, Medicine, and Therapeutics. 2019;10:157–167. doi: 10.2147/PHMT.S193684 5. Hölttä T, Jalanko H. Congenital nephrotic syndrome: is early aggressive treatment needed? Yes. Pediatric Nephrology. 2020;35(10):1985–1990. doi: 10.1007/s00467-020-04578-4
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
| What are the complications of Childhood Nephrotic Syndrome ? | The complications of childhood nephrotic syndrome may include
- infection. When the kidneys are damaged, a child is more likely to develop infections because the body loses proteins that normally protect against infection. Health care providers will prescribe medications to treat infections. Children with childhood nephrotic syndrome should receive the pneumococcal vaccine and yearly flu shots to prevent those infections. Children should also receive age-appropriate vaccinations, although a health care provider may delay certain live vaccines while a child is taking certain medications. - blood clots. Blood clots can block the flow of blood and oxygen through a blood vessel anywhere in the body. A child is more likely to develop clots when he or she loses proteins through the urine. The health care provider will treat blood clots with blood-thinning medications. - high blood cholesterol. When albumin leaks into the urine, the albumin levels in the blood drop. The liver makes more albumin to make up for the low levels in the blood. At the same time, the liver makes more cholesterol. Sometimes children may need treatment with medications to lower blood cholesterol levels. |
On this page: Nephrotic syndrome is a group of symptoms that indicate the kidneys are not working properly. These symptoms include The kidneys are made up of about a million filtering units called nephrons. Each nephron includes a filter, called the glomerulus, and a tubule. The glomerulus filters the blood, and the tubule returns needed substances to the blood and removes wastes and extra water, which become urine. Nephrotic syndrome usually happens when the glomeruli are damaged, allowing too much protein to leak from the blood into the urine. Health care professionals use different terms to refer to nephrotic syndrome in children, depending on Nephrotic syndrome is not very common in children. On average, fewer than 5 in 100,000 children worldwide develop nephrotic syndrome each year.1
Children of all ages can develop nephrotic syndrome. But the condition most often affects children who are 2 to 7 years old, particularly boys.2 Losing too much protein in the urine can lead to many complications, including3
Swelling around the eyes is the most common sign of nephrotic syndrome in children.3 The swelling is usually greater in the morning and, when mild, may be confused with seasonal allergies.
Other common symptoms include2,3
Some children with nephrotic syndrome may also have
Kidney disease that affects a kidney’s filtering system is the most common cause of nephrotic syndrome in children. Other causes can include diseases that affect other parts of the body, infections, some medicines, and genetics.
Four types of kidney disease can cause primary nephrotic syndrome in children and adolescents.2
Other causes of primary nephrotic syndrome are uncommon.
Causes of secondary nephrotic syndrome in children include3
Among newborns and infants younger than 12 months old, the two most common causes of nephrotic syndrome are4
Nephrotic syndrome in children is diagnosed with
Additional tests to identify the cause of nephrotic syndrome may include3
Many children with nephrotic syndrome will not need a kidney biopsy. The test is usually reserved for children who have complex disease, who have low kidney function, or who are 12 years old or older.3
Nephrotic syndrome in children is most often treated with medicines.
Corticosteroids. Corticosteroids, or steroids, are the medicines most often used to treat children with primary nephrotic syndrome. These medicines suppress the immune system, reduce the amount of protein passed into the urine, and decrease swelling.
In most children, treatment with corticosteroids will make nephrotic syndrome improve—also called “remission.” If symptoms return, called a “relapse,” the health care professional may prescribe a shorter course of corticosteroids until the disease goes into remission again. Although children may have multiple relapses, they often recover without long-term kidney damage. In most cases, relapses happen less often as children get older.3
Although corticosteroids effectively treat nephrotic syndrome in many children, using these medicines for long periods of time can cause side effects, such as impaired growth, obesity, high blood pressure, eye problems, and bone loss.3 Other common side effects include anxiety, depression, and aggressive behavior. These problems are more likely to develop with larger doses and longer use.
In some cases, nephrotic syndrome may not improve with corticosteroids. Cases of nephrotic syndrome that don’t respond to corticosteroids are more difficult to treat than those that do. They are also more likely to progress to end-stage kidney disease.3
Other medicines that suppress the immune system. If corticosteroids are not working or are causing harmful side effects, your child’s health care professional may prescribe other medicines that reduce the activity of the immune system. In some cases, your child may take these medicines together with low-dose corticosteroids.
Medicines for managing symptoms and complications. Health care professionals may also prescribe other medicines to help your child manage the symptoms and complications of nephrotic syndrome. Examples include Children with nephrotic syndrome should get the pneumococcal vaccine and yearly flu shots to prevent viral and bacterial infections. They should also get age-appropriate vaccinations. But the health care professional may delay certain “live” vaccines—vaccines that use weakened forms of a virus—while your child is taking certain medicines.
Treatment focuses on the cause of nephrotic syndrome. For example, the health care professional may
Your child’s health care professional may also prescribe the same medicines used to manage the symptoms and complications of primary nephrotic syndrome.
Treatment varies depending on whether the cause is genetic or an infection.
Genetic. Your child’s treatment will depend on the type of genetic mutation that is causing nephrotic syndrome and how bad the symptoms and complications are. Many children will lose kidney function over time and ultimately need a kidney transplant. To keep your child healthy until the transplant, the health care professional may recommend4,5
Infection. When nephrotic syndrome is caused by a congenital infection, such as syphilis or toxoplasmosis, it will usually go away when the infection is treated.4
Researchers have not found a way to prevent nephrotic syndrome in children. Knowing the symptoms can help you get your child treated early and reduce the risk of complications.
Children who have nephrotic syndrome may need to change what they eat and drink, such as In some cases, the child’s health care professional may recommend other dietary changes. Parents or other caregivers should talk with their child’s health care professional before making any changes to the child’s diet.
The NIDDK conducts and supports clinical trials in many diseases and conditions, including kidney diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Children respond to medicines and treatments differently than adults. The way to get the best treatments for children is through research designed specifically for them.
We have already made great strides in improving children's health outcomes through clinical trials—and other types of clinical studies. Vaccines, treatments for children with cancer, and interventions for premature babies are just a few examples of how this targeted research can help. However, we still have many questions to answer and more children waiting to benefit.
The data gathered from trials and studies involving children help doctors and researchers
We understand you have many questions, want to weigh the pros and cons, and need to learn as much as possible. Deciding to enroll in a study can be life changing for you and for your child. Depending on the outcome of the study, your child may find relief from their condition, see no benefit, or help to improve the health of future generations.
Talk with your child and consider what would be expected. What could be the potential benefit or harm? Would you need to travel? Is my child well enough to participate? While parents or guardians must give their permission, or consent, for their children to join a study, the children must also agree to participate, if they are capable (verbal). In the end, no choice is right or wrong. Your decision is about what is best for your child.
The National Institutes of Health (NIH) is committed to ensuring you get all the information you need to feel comfortable and make informed decisions. The safety of children remains the utmost priority for all NIH research studies. For more resources to help decide if clinical trials are right for your child, visit Clinical Trials and You: For Parents and Children.
Researchers study many aspects of nephrotic syndrome in children, such as the kidney diseases that can cause nephrotic syndrome in children and the genetic factors that can cause congenital nephrotic syndrome.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
You can view a filtered list of clinical studies on nephrotic syndrome in children that are federally funded, open, and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the NIH does not review these studies and cannot ensure they are safe. If you find a trial you think may be right for your child, talk with your child’s doctor about how to enroll.
1. Downie ML, Gallibois C, Parekh RS, Noone DG. Nephrotic syndrome in infants and children: pathophysiology and management. Paediatrics and International Child Health. 2017;37(4):248–258. doi: 10.1080/20469047.2017.1374003 2. Wang CS, Greenbaum LA. Nephrotic syndrome. Pediatric Clinics of North America. 2019;66(1):73–85. doi: 10.1016/j.pcl.2018.08.006 3. Noone DG, Iijima K, Parekh R. Idiopathic nephrotic syndrome in children. Lancet. 2018;392(10141):61–74. doi: 10.1016/S0140-6736(18)30536-1 4. Reynolds BC, Oswald RJA. Diagnostic and management challenges in congenital nephrotic syndrome. Pediatric Health, Medicine, and Therapeutics. 2019;10:157–167. doi: 10.2147/PHMT.S193684 5. Hölttä T, Jalanko H. Congenital nephrotic syndrome: is early aggressive treatment needed? Yes. Pediatric Nephrology. 2020;35(10):1985–1990. doi: 10.1007/s00467-020-04578-4
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
| How to diagnose Childhood Nephrotic Syndrome ? | A health care provider diagnoses childhood nephrotic syndrome with
- a medical and family history - a physical exam - urine tests - a blood test - ultrasound of the kidney - kidney biopsy
Medical and Family History
Taking a medical and family history is one of the first things a health care provider may do to help diagnose childhood nephrotic syndrome.
Physical Exam
A physical exam may help diagnose childhood nephrotic syndrome. During a physical exam, a health care provider most often
- examines a childs body - taps on specific areas of the childs body
Urine Tests
A health care provider may order the following urine tests to help determine if a child has kidney damage from childhood nephrotic syndrome.
Dipstick test for albumin. A dipstick test performed on a urine sample can detect the presence of albumin in the urine, which could mean kidney damage. The child or a caretaker collects a urine sample in a special container. For the test, a nurse or technician places a strip of chemically treated paper, called a dipstick, into the childs urine sample. Patches on the dipstick change color when albumin is present in urine.
Urine albumin-to-creatinine ratio. A health care provider uses this measurement to estimate the amount of albumin passed into the urine over a 24-hour period. The child provides a urine sample during an appointment with the health care provider. Creatinine is a waste product filtered in the kidneys and passed in the urine. A high urine albumin-to-creatinine ratio indicates that the kidneys are leaking large amounts of albumin into the urine.
Blood Test
A blood test involves drawing blood at a health care providers office or a commercial facility and sending the sample to a lab for analysis. The lab tests the sample to estimate how much blood the kidneys filter each minute, called the estimated glomerular filtration rate, or eGFR. The test results help the health care provider determine the amount of kidney damage. Health care providers may also order other blood tests to help determine the underlying disease that may be causing childhood nephrotic syndrome.
Ultrasound of the Kidney
Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A specially trained technician performs the procedure in a health care providers office, an outpatient center, or a hospital. A radiologista doctor who specializes in medical imaginginterprets the images to see if the kidneys look normal; a child does not need anesthesia.
Kidney Biopsy
Biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. A health care provider performs the biopsy in an outpatient center or a hospital. The health care provider will give the child light sedation and local anesthetic; however, in some cases, the child will require general anesthesia. A pathologista doctor who specializes in diagnosing diseasesexamines the tissue in a lab. The test can help diagnose childhood nephrotic syndrome.
When the health care provider suspects a child has minimal change disease, he or she often starts treatment with medications without performing a biopsy. If the medication is effective, the child does not need a biopsy. In most cases, a health care provider does not perform a biopsy on children younger than age 12 unless he or she thinks that another disease is the cause. |
On this page: Nephrotic syndrome is a group of symptoms that indicate the kidneys are not working properly. These symptoms include The kidneys are made up of about a million filtering units called nephrons. Each nephron includes a filter, called the glomerulus, and a tubule. The glomerulus filters the blood, and the tubule returns needed substances to the blood and removes wastes and extra water, which become urine. Nephrotic syndrome usually happens when the glomeruli are damaged, allowing too much protein to leak from the blood into the urine. Health care professionals use different terms to refer to nephrotic syndrome in children, depending on Nephrotic syndrome is not very common in children. On average, fewer than 5 in 100,000 children worldwide develop nephrotic syndrome each year.1
Children of all ages can develop nephrotic syndrome. But the condition most often affects children who are 2 to 7 years old, particularly boys.2 Losing too much protein in the urine can lead to many complications, including3
Swelling around the eyes is the most common sign of nephrotic syndrome in children.3 The swelling is usually greater in the morning and, when mild, may be confused with seasonal allergies.
Other common symptoms include2,3
Some children with nephrotic syndrome may also have
Kidney disease that affects a kidney’s filtering system is the most common cause of nephrotic syndrome in children. Other causes can include diseases that affect other parts of the body, infections, some medicines, and genetics.
Four types of kidney disease can cause primary nephrotic syndrome in children and adolescents.2
Other causes of primary nephrotic syndrome are uncommon.
Causes of secondary nephrotic syndrome in children include3
Among newborns and infants younger than 12 months old, the two most common causes of nephrotic syndrome are4
Nephrotic syndrome in children is diagnosed with
Additional tests to identify the cause of nephrotic syndrome may include3
Many children with nephrotic syndrome will not need a kidney biopsy. The test is usually reserved for children who have complex disease, who have low kidney function, or who are 12 years old or older.3
Nephrotic syndrome in children is most often treated with medicines.
Corticosteroids. Corticosteroids, or steroids, are the medicines most often used to treat children with primary nephrotic syndrome. These medicines suppress the immune system, reduce the amount of protein passed into the urine, and decrease swelling.
In most children, treatment with corticosteroids will make nephrotic syndrome improve—also called “remission.” If symptoms return, called a “relapse,” the health care professional may prescribe a shorter course of corticosteroids until the disease goes into remission again. Although children may have multiple relapses, they often recover without long-term kidney damage. In most cases, relapses happen less often as children get older.3
Although corticosteroids effectively treat nephrotic syndrome in many children, using these medicines for long periods of time can cause side effects, such as impaired growth, obesity, high blood pressure, eye problems, and bone loss.3 Other common side effects include anxiety, depression, and aggressive behavior. These problems are more likely to develop with larger doses and longer use.
In some cases, nephrotic syndrome may not improve with corticosteroids. Cases of nephrotic syndrome that don’t respond to corticosteroids are more difficult to treat than those that do. They are also more likely to progress to end-stage kidney disease.3
Other medicines that suppress the immune system. If corticosteroids are not working or are causing harmful side effects, your child’s health care professional may prescribe other medicines that reduce the activity of the immune system. In some cases, your child may take these medicines together with low-dose corticosteroids.
Medicines for managing symptoms and complications. Health care professionals may also prescribe other medicines to help your child manage the symptoms and complications of nephrotic syndrome. Examples include Children with nephrotic syndrome should get the pneumococcal vaccine and yearly flu shots to prevent viral and bacterial infections. They should also get age-appropriate vaccinations. But the health care professional may delay certain “live” vaccines—vaccines that use weakened forms of a virus—while your child is taking certain medicines.
Treatment focuses on the cause of nephrotic syndrome. For example, the health care professional may
Your child’s health care professional may also prescribe the same medicines used to manage the symptoms and complications of primary nephrotic syndrome.
Treatment varies depending on whether the cause is genetic or an infection.
Genetic. Your child’s treatment will depend on the type of genetic mutation that is causing nephrotic syndrome and how bad the symptoms and complications are. Many children will lose kidney function over time and ultimately need a kidney transplant. To keep your child healthy until the transplant, the health care professional may recommend4,5
Infection. When nephrotic syndrome is caused by a congenital infection, such as syphilis or toxoplasmosis, it will usually go away when the infection is treated.4
Researchers have not found a way to prevent nephrotic syndrome in children. Knowing the symptoms can help you get your child treated early and reduce the risk of complications.
Children who have nephrotic syndrome may need to change what they eat and drink, such as In some cases, the child’s health care professional may recommend other dietary changes. Parents or other caregivers should talk with their child’s health care professional before making any changes to the child’s diet.
The NIDDK conducts and supports clinical trials in many diseases and conditions, including kidney diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Children respond to medicines and treatments differently than adults. The way to get the best treatments for children is through research designed specifically for them.
We have already made great strides in improving children's health outcomes through clinical trials—and other types of clinical studies. Vaccines, treatments for children with cancer, and interventions for premature babies are just a few examples of how this targeted research can help. However, we still have many questions to answer and more children waiting to benefit.
The data gathered from trials and studies involving children help doctors and researchers
We understand you have many questions, want to weigh the pros and cons, and need to learn as much as possible. Deciding to enroll in a study can be life changing for you and for your child. Depending on the outcome of the study, your child may find relief from their condition, see no benefit, or help to improve the health of future generations.
Talk with your child and consider what would be expected. What could be the potential benefit or harm? Would you need to travel? Is my child well enough to participate? While parents or guardians must give their permission, or consent, for their children to join a study, the children must also agree to participate, if they are capable (verbal). In the end, no choice is right or wrong. Your decision is about what is best for your child.
The National Institutes of Health (NIH) is committed to ensuring you get all the information you need to feel comfortable and make informed decisions. The safety of children remains the utmost priority for all NIH research studies. For more resources to help decide if clinical trials are right for your child, visit Clinical Trials and You: For Parents and Children.
Researchers study many aspects of nephrotic syndrome in children, such as the kidney diseases that can cause nephrotic syndrome in children and the genetic factors that can cause congenital nephrotic syndrome.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
You can view a filtered list of clinical studies on nephrotic syndrome in children that are federally funded, open, and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the NIH does not review these studies and cannot ensure they are safe. If you find a trial you think may be right for your child, talk with your child’s doctor about how to enroll.
1. Downie ML, Gallibois C, Parekh RS, Noone DG. Nephrotic syndrome in infants and children: pathophysiology and management. Paediatrics and International Child Health. 2017;37(4):248–258. doi: 10.1080/20469047.2017.1374003 2. Wang CS, Greenbaum LA. Nephrotic syndrome. Pediatric Clinics of North America. 2019;66(1):73–85. doi: 10.1016/j.pcl.2018.08.006 3. Noone DG, Iijima K, Parekh R. Idiopathic nephrotic syndrome in children. Lancet. 2018;392(10141):61–74. doi: 10.1016/S0140-6736(18)30536-1 4. Reynolds BC, Oswald RJA. Diagnostic and management challenges in congenital nephrotic syndrome. Pediatric Health, Medicine, and Therapeutics. 2019;10:157–167. doi: 10.2147/PHMT.S193684 5. Hölttä T, Jalanko H. Congenital nephrotic syndrome: is early aggressive treatment needed? Yes. Pediatric Nephrology. 2020;35(10):1985–1990. doi: 10.1007/s00467-020-04578-4
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
| What are the treatments for Childhood Nephrotic Syndrome ? | Health care providers will decide how to treat childhood nephrotic syndrome based on the type:
- primary childhood nephrotic syndrome: medications - secondary childhood nephrotic syndrome: treat the underlying illness or disease - congenital nephrotic syndrome: medications, surgery to remove one or both kidneys, and transplantation
Primary Childhood Nephrotic Syndrome
Health care providers treat idiopathic childhood nephrotic syndrome with several types of medications that control the immune system, remove extra fluid, and lower blood pressure.
- Control the immune system. Corticosteroids are a group of medications that reduce the activity of the immune system, decrease the amount of albumin lost in the urine, and decrease swelling. Health care providers commonly use prednisone or a related corticosteroid to treat idiopathic childhood nephrotic syndrome. About 90 percent of children achieve remission with daily corticosteroids for 6 weeks and then a slightly smaller dose every other day for 6 weeks.2 Remission is a period when the child is symptom-free. Many children relapse after initial therapy, and health care providers treat them with a shorter course of corticosteroids until the disease goes into remission again. Children may have multiple relapses; however, they most often recover without long-term kidney damage. When a child has frequent relapses or does not respond to treatment, a health care provider may prescribe other medications that reduce the activity of the immune system. These medications prevent the body from making antibodies that can damage kidney tissues. They include - cyclophosphamide - mycophenolate (CellCept, Myfortic) - cyclosporine - tacrolimus (Hecoria, Prograf) A health care provider may use these other immune system medications with corticosteroids or in place of corticosteroids. - Remove extra fluid. A health care provider may prescribe a diuretic, a medication that helps the kidneys remove extra fluid from the blood. Removing the extra fluid can often help to lower blood pressure. - Lower blood pressure. Some children with childhood nephrotic syndrome develop high blood pressure and may need to take additional medications to lower their blood pressure. Two types of blood pressure-lowering medications, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, have the additional benefit of slowing the progression of kidney disease. Many children with nephrotic syndrome require two or more medications to control their blood pressure.
Secondary Childhood Nephrotic Syndrome
Health care providers treat secondary childhood nephrotic syndrome by treating the underlying cause of the primary illness. For example, a health care provider may treat children by
- prescribing antibiotics for an infection - adjusting medications to treat lupus, HIV, or diabetes - changing or stopping medications that are known to cause secondary childhood nephrotic syndrome
While treating the underlying cause, the health care provider will also treat the child to improve or restore kidney function with the same medications used to treat primary childhood nephrotic syndrome.
Caretakers should make sure that children take all prescribed medications and follow the treatment plan recommended by their health care provider.
More information about specific treatments for secondary childhood nephrotic syndrome is provided in the NIDDK health topic, Glomerular Diseases.
Congenital Nephrotic Syndrome
Researchers have found that medications are not effective in treating congenital nephrotic syndrome, and that most children will need a kidney transplant by the time they are 2 or 3 years old. A kidney transplant is surgery to place a healthy kidney from someone who has just died or a living donor, most often a family member, into a persons body to take over the job of the failing kidney. To keep the child healthy until the transplant, the health care provider may recommend the following:
- albumin injections to make up for the albumin lost in urine - diuretics to help remove extra fluid that causes swelling - antibiotics to treat the first signs of infection - growth hormones to promote growth and help bones mature - removal of one or both kidneys to decrease the loss of albumin in the urine - dialysis to artificially filter wastes from the blood if the kidneys fail
More information is provided in the NIDDK health topic, Treatment Methods for Kidney Failure in Children. |
On this page: Nephrotic syndrome is a group of symptoms that indicate the kidneys are not working properly. These symptoms include The kidneys are made up of about a million filtering units called nephrons. Each nephron includes a filter, called the glomerulus, and a tubule. The glomerulus filters the blood, and the tubule returns needed substances to the blood and removes wastes and extra water, which become urine. Nephrotic syndrome usually happens when the glomeruli are damaged, allowing too much protein to leak from the blood into the urine. Health care professionals use different terms to refer to nephrotic syndrome in children, depending on Nephrotic syndrome is not very common in children. On average, fewer than 5 in 100,000 children worldwide develop nephrotic syndrome each year.1
Children of all ages can develop nephrotic syndrome. But the condition most often affects children who are 2 to 7 years old, particularly boys.2 Losing too much protein in the urine can lead to many complications, including3
Swelling around the eyes is the most common sign of nephrotic syndrome in children.3 The swelling is usually greater in the morning and, when mild, may be confused with seasonal allergies.
Other common symptoms include2,3
Some children with nephrotic syndrome may also have
Kidney disease that affects a kidney’s filtering system is the most common cause of nephrotic syndrome in children. Other causes can include diseases that affect other parts of the body, infections, some medicines, and genetics.
Four types of kidney disease can cause primary nephrotic syndrome in children and adolescents.2
Other causes of primary nephrotic syndrome are uncommon.
Causes of secondary nephrotic syndrome in children include3
Among newborns and infants younger than 12 months old, the two most common causes of nephrotic syndrome are4
Nephrotic syndrome in children is diagnosed with
Additional tests to identify the cause of nephrotic syndrome may include3
Many children with nephrotic syndrome will not need a kidney biopsy. The test is usually reserved for children who have complex disease, who have low kidney function, or who are 12 years old or older.3
Nephrotic syndrome in children is most often treated with medicines.
Corticosteroids. Corticosteroids, or steroids, are the medicines most often used to treat children with primary nephrotic syndrome. These medicines suppress the immune system, reduce the amount of protein passed into the urine, and decrease swelling.
In most children, treatment with corticosteroids will make nephrotic syndrome improve—also called “remission.” If symptoms return, called a “relapse,” the health care professional may prescribe a shorter course of corticosteroids until the disease goes into remission again. Although children may have multiple relapses, they often recover without long-term kidney damage. In most cases, relapses happen less often as children get older.3
Although corticosteroids effectively treat nephrotic syndrome in many children, using these medicines for long periods of time can cause side effects, such as impaired growth, obesity, high blood pressure, eye problems, and bone loss.3 Other common side effects include anxiety, depression, and aggressive behavior. These problems are more likely to develop with larger doses and longer use.
In some cases, nephrotic syndrome may not improve with corticosteroids. Cases of nephrotic syndrome that don’t respond to corticosteroids are more difficult to treat than those that do. They are also more likely to progress to end-stage kidney disease.3
Other medicines that suppress the immune system. If corticosteroids are not working or are causing harmful side effects, your child’s health care professional may prescribe other medicines that reduce the activity of the immune system. In some cases, your child may take these medicines together with low-dose corticosteroids.
Medicines for managing symptoms and complications. Health care professionals may also prescribe other medicines to help your child manage the symptoms and complications of nephrotic syndrome. Examples include Children with nephrotic syndrome should get the pneumococcal vaccine and yearly flu shots to prevent viral and bacterial infections. They should also get age-appropriate vaccinations. But the health care professional may delay certain “live” vaccines—vaccines that use weakened forms of a virus—while your child is taking certain medicines.
Treatment focuses on the cause of nephrotic syndrome. For example, the health care professional may
Your child’s health care professional may also prescribe the same medicines used to manage the symptoms and complications of primary nephrotic syndrome.
Treatment varies depending on whether the cause is genetic or an infection.
Genetic. Your child’s treatment will depend on the type of genetic mutation that is causing nephrotic syndrome and how bad the symptoms and complications are. Many children will lose kidney function over time and ultimately need a kidney transplant. To keep your child healthy until the transplant, the health care professional may recommend4,5
Infection. When nephrotic syndrome is caused by a congenital infection, such as syphilis or toxoplasmosis, it will usually go away when the infection is treated.4
Researchers have not found a way to prevent nephrotic syndrome in children. Knowing the symptoms can help you get your child treated early and reduce the risk of complications.
Children who have nephrotic syndrome may need to change what they eat and drink, such as In some cases, the child’s health care professional may recommend other dietary changes. Parents or other caregivers should talk with their child’s health care professional before making any changes to the child’s diet.
The NIDDK conducts and supports clinical trials in many diseases and conditions, including kidney diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Children respond to medicines and treatments differently than adults. The way to get the best treatments for children is through research designed specifically for them.
We have already made great strides in improving children's health outcomes through clinical trials—and other types of clinical studies. Vaccines, treatments for children with cancer, and interventions for premature babies are just a few examples of how this targeted research can help. However, we still have many questions to answer and more children waiting to benefit.
The data gathered from trials and studies involving children help doctors and researchers
We understand you have many questions, want to weigh the pros and cons, and need to learn as much as possible. Deciding to enroll in a study can be life changing for you and for your child. Depending on the outcome of the study, your child may find relief from their condition, see no benefit, or help to improve the health of future generations.
Talk with your child and consider what would be expected. What could be the potential benefit or harm? Would you need to travel? Is my child well enough to participate? While parents or guardians must give their permission, or consent, for their children to join a study, the children must also agree to participate, if they are capable (verbal). In the end, no choice is right or wrong. Your decision is about what is best for your child.
The National Institutes of Health (NIH) is committed to ensuring you get all the information you need to feel comfortable and make informed decisions. The safety of children remains the utmost priority for all NIH research studies. For more resources to help decide if clinical trials are right for your child, visit Clinical Trials and You: For Parents and Children.
Researchers study many aspects of nephrotic syndrome in children, such as the kidney diseases that can cause nephrotic syndrome in children and the genetic factors that can cause congenital nephrotic syndrome.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
You can view a filtered list of clinical studies on nephrotic syndrome in children that are federally funded, open, and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the NIH does not review these studies and cannot ensure they are safe. If you find a trial you think may be right for your child, talk with your child’s doctor about how to enroll.
1. Downie ML, Gallibois C, Parekh RS, Noone DG. Nephrotic syndrome in infants and children: pathophysiology and management. Paediatrics and International Child Health. 2017;37(4):248–258. doi: 10.1080/20469047.2017.1374003 2. Wang CS, Greenbaum LA. Nephrotic syndrome. Pediatric Clinics of North America. 2019;66(1):73–85. doi: 10.1016/j.pcl.2018.08.006 3. Noone DG, Iijima K, Parekh R. Idiopathic nephrotic syndrome in children. Lancet. 2018;392(10141):61–74. doi: 10.1016/S0140-6736(18)30536-1 4. Reynolds BC, Oswald RJA. Diagnostic and management challenges in congenital nephrotic syndrome. Pediatric Health, Medicine, and Therapeutics. 2019;10:157–167. doi: 10.2147/PHMT.S193684 5. Hölttä T, Jalanko H. Congenital nephrotic syndrome: is early aggressive treatment needed? Yes. Pediatric Nephrology. 2020;35(10):1985–1990. doi: 10.1007/s00467-020-04578-4
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
| How to prevent Childhood Nephrotic Syndrome ? | Researchers have not found a way to prevent childhood nephrotic syndrome when the cause is idiopathic or congenital. |
On this page: Nephrotic syndrome is a group of symptoms that indicate the kidneys are not working properly. These symptoms include The kidneys are made up of about a million filtering units called nephrons. Each nephron includes a filter, called the glomerulus, and a tubule. The glomerulus filters the blood, and the tubule returns needed substances to the blood and removes wastes and extra water, which become urine. Nephrotic syndrome usually happens when the glomeruli are damaged, allowing too much protein to leak from the blood into the urine. Health care professionals use different terms to refer to nephrotic syndrome in children, depending on Nephrotic syndrome is not very common in children. On average, fewer than 5 in 100,000 children worldwide develop nephrotic syndrome each year.1
Children of all ages can develop nephrotic syndrome. But the condition most often affects children who are 2 to 7 years old, particularly boys.2 Losing too much protein in the urine can lead to many complications, including3
Swelling around the eyes is the most common sign of nephrotic syndrome in children.3 The swelling is usually greater in the morning and, when mild, may be confused with seasonal allergies.
Other common symptoms include2,3
Some children with nephrotic syndrome may also have
Kidney disease that affects a kidney’s filtering system is the most common cause of nephrotic syndrome in children. Other causes can include diseases that affect other parts of the body, infections, some medicines, and genetics.
Four types of kidney disease can cause primary nephrotic syndrome in children and adolescents.2
Other causes of primary nephrotic syndrome are uncommon.
Causes of secondary nephrotic syndrome in children include3
Among newborns and infants younger than 12 months old, the two most common causes of nephrotic syndrome are4
Nephrotic syndrome in children is diagnosed with
Additional tests to identify the cause of nephrotic syndrome may include3
Many children with nephrotic syndrome will not need a kidney biopsy. The test is usually reserved for children who have complex disease, who have low kidney function, or who are 12 years old or older.3
Nephrotic syndrome in children is most often treated with medicines.
Corticosteroids. Corticosteroids, or steroids, are the medicines most often used to treat children with primary nephrotic syndrome. These medicines suppress the immune system, reduce the amount of protein passed into the urine, and decrease swelling.
In most children, treatment with corticosteroids will make nephrotic syndrome improve—also called “remission.” If symptoms return, called a “relapse,” the health care professional may prescribe a shorter course of corticosteroids until the disease goes into remission again. Although children may have multiple relapses, they often recover without long-term kidney damage. In most cases, relapses happen less often as children get older.3
Although corticosteroids effectively treat nephrotic syndrome in many children, using these medicines for long periods of time can cause side effects, such as impaired growth, obesity, high blood pressure, eye problems, and bone loss.3 Other common side effects include anxiety, depression, and aggressive behavior. These problems are more likely to develop with larger doses and longer use.
In some cases, nephrotic syndrome may not improve with corticosteroids. Cases of nephrotic syndrome that don’t respond to corticosteroids are more difficult to treat than those that do. They are also more likely to progress to end-stage kidney disease.3
Other medicines that suppress the immune system. If corticosteroids are not working or are causing harmful side effects, your child’s health care professional may prescribe other medicines that reduce the activity of the immune system. In some cases, your child may take these medicines together with low-dose corticosteroids.
Medicines for managing symptoms and complications. Health care professionals may also prescribe other medicines to help your child manage the symptoms and complications of nephrotic syndrome. Examples include Children with nephrotic syndrome should get the pneumococcal vaccine and yearly flu shots to prevent viral and bacterial infections. They should also get age-appropriate vaccinations. But the health care professional may delay certain “live” vaccines—vaccines that use weakened forms of a virus—while your child is taking certain medicines.
Treatment focuses on the cause of nephrotic syndrome. For example, the health care professional may
Your child’s health care professional may also prescribe the same medicines used to manage the symptoms and complications of primary nephrotic syndrome.
Treatment varies depending on whether the cause is genetic or an infection.
Genetic. Your child’s treatment will depend on the type of genetic mutation that is causing nephrotic syndrome and how bad the symptoms and complications are. Many children will lose kidney function over time and ultimately need a kidney transplant. To keep your child healthy until the transplant, the health care professional may recommend4,5
Infection. When nephrotic syndrome is caused by a congenital infection, such as syphilis or toxoplasmosis, it will usually go away when the infection is treated.4
Researchers have not found a way to prevent nephrotic syndrome in children. Knowing the symptoms can help you get your child treated early and reduce the risk of complications.
Children who have nephrotic syndrome may need to change what they eat and drink, such as In some cases, the child’s health care professional may recommend other dietary changes. Parents or other caregivers should talk with their child’s health care professional before making any changes to the child’s diet.
The NIDDK conducts and supports clinical trials in many diseases and conditions, including kidney diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Children respond to medicines and treatments differently than adults. The way to get the best treatments for children is through research designed specifically for them.
We have already made great strides in improving children's health outcomes through clinical trials—and other types of clinical studies. Vaccines, treatments for children with cancer, and interventions for premature babies are just a few examples of how this targeted research can help. However, we still have many questions to answer and more children waiting to benefit.
The data gathered from trials and studies involving children help doctors and researchers
We understand you have many questions, want to weigh the pros and cons, and need to learn as much as possible. Deciding to enroll in a study can be life changing for you and for your child. Depending on the outcome of the study, your child may find relief from their condition, see no benefit, or help to improve the health of future generations.
Talk with your child and consider what would be expected. What could be the potential benefit or harm? Would you need to travel? Is my child well enough to participate? While parents or guardians must give their permission, or consent, for their children to join a study, the children must also agree to participate, if they are capable (verbal). In the end, no choice is right or wrong. Your decision is about what is best for your child.
The National Institutes of Health (NIH) is committed to ensuring you get all the information you need to feel comfortable and make informed decisions. The safety of children remains the utmost priority for all NIH research studies. For more resources to help decide if clinical trials are right for your child, visit Clinical Trials and You: For Parents and Children.
Researchers study many aspects of nephrotic syndrome in children, such as the kidney diseases that can cause nephrotic syndrome in children and the genetic factors that can cause congenital nephrotic syndrome.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
You can view a filtered list of clinical studies on nephrotic syndrome in children that are federally funded, open, and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the NIH does not review these studies and cannot ensure they are safe. If you find a trial you think may be right for your child, talk with your child’s doctor about how to enroll.
1. Downie ML, Gallibois C, Parekh RS, Noone DG. Nephrotic syndrome in infants and children: pathophysiology and management. Paediatrics and International Child Health. 2017;37(4):248–258. doi: 10.1080/20469047.2017.1374003 2. Wang CS, Greenbaum LA. Nephrotic syndrome. Pediatric Clinics of North America. 2019;66(1):73–85. doi: 10.1016/j.pcl.2018.08.006 3. Noone DG, Iijima K, Parekh R. Idiopathic nephrotic syndrome in children. Lancet. 2018;392(10141):61–74. doi: 10.1016/S0140-6736(18)30536-1 4. Reynolds BC, Oswald RJA. Diagnostic and management challenges in congenital nephrotic syndrome. Pediatric Health, Medicine, and Therapeutics. 2019;10:157–167. doi: 10.2147/PHMT.S193684 5. Hölttä T, Jalanko H. Congenital nephrotic syndrome: is early aggressive treatment needed? Yes. Pediatric Nephrology. 2020;35(10):1985–1990. doi: 10.1007/s00467-020-04578-4
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
| What to do for Childhood Nephrotic Syndrome ? | Children who have nephrotic syndrome may need to make changes to their diet, such as
- limiting the amount of sodium, often from salt, they take in each day - reducing the amount of liquids they drink each day - eating a diet low in saturated fat and cholesterol to help control elevated cholesterol levels
Parents or caretakers should talk with the childs health care provider before making any changes to the childs diet.
More information is provided in the NIDDK health topic, Nutrition for Chronic Kidney Disease in Children. |
On this page: Nephrotic syndrome is a group of symptoms that indicate the kidneys are not working properly. These symptoms include The kidneys are made up of about a million filtering units called nephrons. Each nephron includes a filter, called the glomerulus, and a tubule. The glomerulus filters the blood, and the tubule returns needed substances to the blood and removes wastes and extra water, which become urine. Nephrotic syndrome usually happens when the glomeruli are damaged, allowing too much protein to leak from the blood into the urine. Health care professionals use different terms to refer to nephrotic syndrome in children, depending on Nephrotic syndrome is not very common in children. On average, fewer than 5 in 100,000 children worldwide develop nephrotic syndrome each year.1
Children of all ages can develop nephrotic syndrome. But the condition most often affects children who are 2 to 7 years old, particularly boys.2 Losing too much protein in the urine can lead to many complications, including3
Swelling around the eyes is the most common sign of nephrotic syndrome in children.3 The swelling is usually greater in the morning and, when mild, may be confused with seasonal allergies.
Other common symptoms include2,3
Some children with nephrotic syndrome may also have
Kidney disease that affects a kidney’s filtering system is the most common cause of nephrotic syndrome in children. Other causes can include diseases that affect other parts of the body, infections, some medicines, and genetics.
Four types of kidney disease can cause primary nephrotic syndrome in children and adolescents.2
Other causes of primary nephrotic syndrome are uncommon.
Causes of secondary nephrotic syndrome in children include3
Among newborns and infants younger than 12 months old, the two most common causes of nephrotic syndrome are4
Nephrotic syndrome in children is diagnosed with
Additional tests to identify the cause of nephrotic syndrome may include3
Many children with nephrotic syndrome will not need a kidney biopsy. The test is usually reserved for children who have complex disease, who have low kidney function, or who are 12 years old or older.3
Nephrotic syndrome in children is most often treated with medicines.
Corticosteroids. Corticosteroids, or steroids, are the medicines most often used to treat children with primary nephrotic syndrome. These medicines suppress the immune system, reduce the amount of protein passed into the urine, and decrease swelling.
In most children, treatment with corticosteroids will make nephrotic syndrome improve—also called “remission.” If symptoms return, called a “relapse,” the health care professional may prescribe a shorter course of corticosteroids until the disease goes into remission again. Although children may have multiple relapses, they often recover without long-term kidney damage. In most cases, relapses happen less often as children get older.3
Although corticosteroids effectively treat nephrotic syndrome in many children, using these medicines for long periods of time can cause side effects, such as impaired growth, obesity, high blood pressure, eye problems, and bone loss.3 Other common side effects include anxiety, depression, and aggressive behavior. These problems are more likely to develop with larger doses and longer use.
In some cases, nephrotic syndrome may not improve with corticosteroids. Cases of nephrotic syndrome that don’t respond to corticosteroids are more difficult to treat than those that do. They are also more likely to progress to end-stage kidney disease.3
Other medicines that suppress the immune system. If corticosteroids are not working or are causing harmful side effects, your child’s health care professional may prescribe other medicines that reduce the activity of the immune system. In some cases, your child may take these medicines together with low-dose corticosteroids.
Medicines for managing symptoms and complications. Health care professionals may also prescribe other medicines to help your child manage the symptoms and complications of nephrotic syndrome. Examples include Children with nephrotic syndrome should get the pneumococcal vaccine and yearly flu shots to prevent viral and bacterial infections. They should also get age-appropriate vaccinations. But the health care professional may delay certain “live” vaccines—vaccines that use weakened forms of a virus—while your child is taking certain medicines.
Treatment focuses on the cause of nephrotic syndrome. For example, the health care professional may
Your child’s health care professional may also prescribe the same medicines used to manage the symptoms and complications of primary nephrotic syndrome.
Treatment varies depending on whether the cause is genetic or an infection.
Genetic. Your child’s treatment will depend on the type of genetic mutation that is causing nephrotic syndrome and how bad the symptoms and complications are. Many children will lose kidney function over time and ultimately need a kidney transplant. To keep your child healthy until the transplant, the health care professional may recommend4,5
Infection. When nephrotic syndrome is caused by a congenital infection, such as syphilis or toxoplasmosis, it will usually go away when the infection is treated.4
Researchers have not found a way to prevent nephrotic syndrome in children. Knowing the symptoms can help you get your child treated early and reduce the risk of complications.
Children who have nephrotic syndrome may need to change what they eat and drink, such as In some cases, the child’s health care professional may recommend other dietary changes. Parents or other caregivers should talk with their child’s health care professional before making any changes to the child’s diet.
The NIDDK conducts and supports clinical trials in many diseases and conditions, including kidney diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Children respond to medicines and treatments differently than adults. The way to get the best treatments for children is through research designed specifically for them.
We have already made great strides in improving children's health outcomes through clinical trials—and other types of clinical studies. Vaccines, treatments for children with cancer, and interventions for premature babies are just a few examples of how this targeted research can help. However, we still have many questions to answer and more children waiting to benefit.
The data gathered from trials and studies involving children help doctors and researchers
We understand you have many questions, want to weigh the pros and cons, and need to learn as much as possible. Deciding to enroll in a study can be life changing for you and for your child. Depending on the outcome of the study, your child may find relief from their condition, see no benefit, or help to improve the health of future generations.
Talk with your child and consider what would be expected. What could be the potential benefit or harm? Would you need to travel? Is my child well enough to participate? While parents or guardians must give their permission, or consent, for their children to join a study, the children must also agree to participate, if they are capable (verbal). In the end, no choice is right or wrong. Your decision is about what is best for your child.
The National Institutes of Health (NIH) is committed to ensuring you get all the information you need to feel comfortable and make informed decisions. The safety of children remains the utmost priority for all NIH research studies. For more resources to help decide if clinical trials are right for your child, visit Clinical Trials and You: For Parents and Children.
Researchers study many aspects of nephrotic syndrome in children, such as the kidney diseases that can cause nephrotic syndrome in children and the genetic factors that can cause congenital nephrotic syndrome.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
You can view a filtered list of clinical studies on nephrotic syndrome in children that are federally funded, open, and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the NIH does not review these studies and cannot ensure they are safe. If you find a trial you think may be right for your child, talk with your child’s doctor about how to enroll.
1. Downie ML, Gallibois C, Parekh RS, Noone DG. Nephrotic syndrome in infants and children: pathophysiology and management. Paediatrics and International Child Health. 2017;37(4):248–258. doi: 10.1080/20469047.2017.1374003 2. Wang CS, Greenbaum LA. Nephrotic syndrome. Pediatric Clinics of North America. 2019;66(1):73–85. doi: 10.1016/j.pcl.2018.08.006 3. Noone DG, Iijima K, Parekh R. Idiopathic nephrotic syndrome in children. Lancet. 2018;392(10141):61–74. doi: 10.1016/S0140-6736(18)30536-1 4. Reynolds BC, Oswald RJA. Diagnostic and management challenges in congenital nephrotic syndrome. Pediatric Health, Medicine, and Therapeutics. 2019;10:157–167. doi: 10.2147/PHMT.S193684 5. Hölttä T, Jalanko H. Congenital nephrotic syndrome: is early aggressive treatment needed? Yes. Pediatric Nephrology. 2020;35(10):1985–1990. doi: 10.1007/s00467-020-04578-4
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
The NIDDK would like to thank:
Debbie Gipson, M.D., University of Michigan Medical School
| What to do for Childhood Nephrotic Syndrome ? | - Childhood nephrotic syndrome is not a disease in itself; rather, it is a group of symptoms that - indicate kidney damageparticularly damage to the glomeruli, the tiny units within the kidney where blood is filtered - result in the release of too much protein from the body into the urine - The two types of childhood nephrotic syndrome are - primarythe most common type of childhood nephrotic syndrome, which begins in the kidneys and affects only the kidneys - secondarythe syndrome is caused by other diseases - The signs and symptoms of childhood nephrotic syndrome may include - edemaswelling, most often in the legs, feet, or ankles and less often in the hands or face - albuminuriawhen a childs urine has high levels of albumin - hypoalbuminemiawhen a childs blood has low levels of albumin - hyperlipidemiawhen a childs blood cholesterol and fat levels are higher than normal - A health care provider may order urine tests to help determine if a child has kidney damage from childhood nephrotic syndrome. - Health care providers will decide how to treat childhood nephrotic syndrome based on the type: - primary childhood nephrotic syndrome: medications - secondary childhood nephrotic syndrome: treat the underlying illness or disease - congenital nephrotic syndrome: medications, surgery to remove one or both kidneys, or transplantation |
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly.
Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please
contact us.
| What is (are) Human Growth Hormone and Creutzfeldt-Jakob Disease Resource List ? | MAGIC (Major Aspects of Growth in Children) Foundation is a national, nonprofit organization that provides support and education about growth disorders in children and growth hormone deficiency in adults. Staff will help connect people who have similar interests or concerns.
The Human Growth Foundation (HGF) is a nonprofit organization concerned with childrens growth disorders and adult growth hormone deficiency. The HGF offers a brochure about adult growth hormone deficiency. The foundation also sponsors adult and pediatric Internet discussion forums to support the exchange of information about growth hormone deficiency and growth hormone replacement therapy. To subscribe, follow the instructions at www.hgfound.org.
The Creutzfeldt-Jakob Disease (CJD) Foundation, Inc. was created in 1993 by two families who lost relatives to CJD and the neurologist who treated the patients. This nonprofit corporation seeks to promote awareness of CJD through research and education and to reach out to people who have lost loved ones to this illness. |
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly.
Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please
contact us.
| What is (are) Human Growth Hormone and Creutzfeldt-Jakob Disease Resource List ? | Health Alert: Adrenal Crisis Causes Death in Some People Who Were Treated with Human Growth Hormone
National Hormone and Pituitary Program (NHPP): Information for People Treated with Pituitary Human Growth Hormone (Summary)
National Hormone and Pituitary Program (NHPP): Information for People Treated with Pituitary Human Growth Hormone (Comprehensive Report)
Creutzfeldt-Jakob Disease. Fact sheet of the National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH)
NIH and Italian Scientists Develop Nasal Test for Human Prion Disease
What is a prion?from Scientific American: Ask the Experts |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What is (are) Causes of Diabetes ? | Diabetes is a complex group of diseases with a variety of causes. People with diabetes have high blood glucose, also called high blood sugar or hyperglycemia.
Diabetes is a disorder of metabolismthe way the body uses digested food for energy. The digestive tract breaks down carbohydratessugars and starches found in many foodsinto glucose, a form of sugar that enters the bloodstream. With the help of the hormone insulin, cells throughout the body absorb glucose and use it for energy. Diabetes develops when the body doesnt make enough insulin or is not able to use insulin effectively, or both.
Insulin is made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells called islets. Beta cells within the islets make insulin and release it into the blood.
If beta cells dont produce enough insulin, or the body doesnt respond to the insulin that is present, glucose builds up in the blood instead of being absorbed by cells in the body, leading to prediabetes or diabetes. Prediabetes is a condition in which blood glucose levels or A1C levelswhich reflect average blood glucose levelsare higher than normal but not high enough to be diagnosed as diabetes. In diabetes, the bodys cells are starved of energy despite high blood glucose levels.
Over time, high blood glucose damages nerves and blood vessels, leading to complications such as heart disease, stroke, kidney disease, blindness, dental disease, and amputations. Other complications of diabetes may include increased susceptibility to other diseases, loss of mobility with aging, depression, and pregnancy problems. No one is certain what starts the processes that cause diabetes, but scientists believe genes and environmental factors interact to cause diabetes in most cases.
The two main types of diabetes are type 1 diabetes and type 2 diabetes. A third type, gestational diabetes, develops only during pregnancy. Other types of diabetes are caused by defects in specific genes, diseases of the pancreas, certain drugs or chemicals, infections, and other conditions. Some people show signs of both type 1 and type 2 diabetes. |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What causes Causes of Diabetes ? | Type 1 diabetes is caused by a lack of insulin due to the destruction of insulin-producing beta cells in the pancreas. In type 1 diabetesan autoimmune diseasethe bodys immune system attacks and destroys the beta cells. Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. But in autoimmune diseases, the immune system attacks the bodys own cells. In type 1 diabetes, beta cell destruction may take place over several years, but symptoms of the disease usually develop over a short period of time.
Type 1 diabetes typically occurs in children and young adults, though it can appear at any age. In the past, type 1 diabetes was called juvenile diabetes or insulin-dependent diabetes mellitus.
Latent autoimmune diabetes in adults (LADA) may be a slowly developing kind of type 1 diabetes. Diagnosis usually occurs after age 30. In LADA, as in type 1 diabetes, the bodys immune system destroys the beta cells. At the time of diagnosis, people with LADA may still produce their own insulin, but eventually most will need insulin shots or an insulin pump to control blood glucose levels.
Genetic Susceptibility
Heredity plays an important part in determining who is likely to develop type 1 diabetes. Genes are passed down from biological parent to child. Genes carry instructions for making proteins that are needed for the bodys cells to function. Many genes, as well as interactions among genes, are thought to influence susceptibility to and protection from type 1 diabetes. The key genes may vary in different population groups. Variations in genes that affect more than 1 percent of a population group are called gene variants.
Certain gene variants that carry instructions for making proteins called human leukocyte antigens (HLAs) on white blood cells are linked to the risk of developing type 1 diabetes. The proteins produced by HLA genes help determine whether the immune system recognizes a cell as part of the body or as foreign material. Some combinations of HLA gene variants predict that a person will be at higher risk for type 1 diabetes, while other combinations are protective or have no effect on risk.
While HLA genes are the major risk genes for type 1 diabetes, many additional risk genes or gene regions have been found. Not only can these genes help identify people at risk for type 1 diabetes, but they also provide important clues to help scientists better understand how the disease develops and identify potential targets for therapy and prevention.
Genetic testing can show what types of HLA genes a person carries and can reveal other genes linked to diabetes. However, most genetic testing is done in a research setting and is not yet available to individuals. Scientists are studying how the results of genetic testing can be used to improve type 1 diabetes prevention or treatment.
Autoimmune Destruction of Beta Cells
In type 1 diabetes, white blood cells called T cells attack and destroy beta cells. The process begins well before diabetes symptoms appear and continues after diagnosis. Often, type 1 diabetes is not diagnosed until most beta cells have already been destroyed. At this point, a person needs daily insulin treatment to survive. Finding ways to modify or stop this autoimmune process and preserve beta cell function is a major focus of current scientific research.
Recent research suggests insulin itself may be a key trigger of the immune attack on beta cells. The immune systems of people who are susceptible to developing type 1 diabetes respond to insulin as if it were a foreign substance, or antigen. To combat antigens, the body makes proteins called antibodies. Antibodies to insulin and other proteins produced by beta cells are found in people with type 1 diabetes. Researchers test for these antibodies to help identify people at increased risk of developing the disease. Testing the types and levels of antibodies in the blood can help determine whether a person has type 1 diabetes, LADA, or another type of diabetes.
Environmental Factors
Environmental factors, such as foods, viruses, and toxins, may play a role in the development of type 1 diabetes, but the exact nature of their role has not been determined. Some theories suggest that environmental factors trigger the autoimmune destruction of beta cells in people with a genetic susceptibility to diabetes. Other theories suggest that environmental factors play an ongoing role in diabetes, even after diagnosis.
Viruses and infections. A virus cannot cause diabetes on its own, but people are sometimes diagnosed with type 1 diabetes during or after a viral infection, suggesting a link between the two. Also, the onset of type 1 diabetes occurs more frequently during the winter when viral infections are more common. Viruses possibly associated with type 1 diabetes include coxsackievirus B, cytomegalovirus, adenovirus, rubella, and mumps. Scientists have described several ways these viruses may damage or destroy beta cells or possibly trigger an autoimmune response in susceptible people. For example, anti-islet antibodies have been found in patients with congenital rubella syndrome, and cytomegalovirus has been associated with significant beta cell damage and acute pancreatitisinflammation of the pancreas. Scientists are trying to identify a virus that can cause type 1 diabetes so that a vaccine might be developed to prevent the disease.
Infant feeding practices. Some studies have suggested that dietary factors may raise or lower the risk of developing type 1 diabetes. For example, breastfed infants and infants receiving vitamin D supplements may have a reduced risk of developing type 1 diabetes, while early exposure to cows milk and cereal proteins may increase risk. More research is needed to clarify how infant nutrition affects the risk for type 1 diabetes.
Read more in the Centers for Disease Control and Preventions (CDCs) publication National Diabetes Statistics Report, 2014 at www.cdc.gov for information about research studies related to type 1 diabetes. |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What causes Causes of Diabetes ? | Type 2 diabetesthe most common form of diabetesis caused by a combination of factors, including insulin resistance, a condition in which the bodys muscle, fat, and liver cells do not use insulin effectively. Type 2 diabetes develops when the body can no longer produce enough insulin to compensate for the impaired ability to use insulin. Symptoms of type 2 diabetes may develop gradually and can be subtle; some people with type 2 diabetes remain undiagnosed for years.
Type 2 diabetes develops most often in middle-aged and older people who are also overweight or obese. The disease, once rare in youth, is becoming more common in overweight and obese children and adolescents. Scientists think genetic susceptibility and environmental factors are the most likely triggers of type 2 diabetes.
Genetic Susceptibility
Genes play a significant part in susceptibility to type 2 diabetes. Having certain genes or combinations of genes may increase or decrease a persons risk for developing the disease. The role of genes is suggested by the high rate of type 2 diabetes in families and identical twins and wide variations in diabetes prevalence by ethnicity. Type 2 diabetes occurs more frequently in African Americans, Alaska Natives, American Indians, Hispanics/Latinos, and some Asian Americans, Native Hawaiians, and Pacific Islander Americans than it does in non-Hispanic whites.
Recent studies have combined genetic data from large numbers of people, accelerating the pace of gene discovery. Though scientists have now identified many gene variants that increase susceptibility to type 2 diabetes, the majority have yet to be discovered. The known genes appear to affect insulin production rather than insulin resistance. Researchers are working to identify additional gene variants and to learn how they interact with one another and with environmental factors to cause diabetes.
Studies have shown that variants of the TCF7L2 gene increase susceptibility to type 2 diabetes. For people who inherit two copies of the variants, the risk of developing type 2 diabetes is about 80 percent higher than for those who do not carry the gene variant.1 However, even in those with the variant, diet and physical activity leading to weight loss help delay diabetes, according to the Diabetes Prevention Program (DPP), a major clinical trial involving people at high risk.
Genes can also increase the risk of diabetes by increasing a persons tendency to become overweight or obese. One theory, known as the thrifty gene hypothesis, suggests certain genes increase the efficiency of metabolism to extract energy from food and store the energy for later use. This survival trait was advantageous for populations whose food supplies were scarce or unpredictable and could help keep people alive during famine. In modern times, however, when high-calorie foods are plentiful, such a trait can promote obesity and type 2 diabetes.
Obesity and Physical Inactivity
Physical inactivity and obesity are strongly associated with the development of type 2 diabetes. People who are genetically susceptible to type 2 diabetes are more vulnerable when these risk factors are present.
An imbalance between caloric intake and physical activity can lead to obesity, which causes insulin resistance and is common in people with type 2 diabetes. Central obesity, in which a person has excess abdominal fat, is a major risk factor not only for insulin resistance and type 2 diabetes but also for heart and blood vessel disease, also called cardiovascular disease (CVD). This excess belly fat produces hormones and other substances that can cause harmful, chronic effects in the body such as damage to blood vessels.
The DPP and other studies show that millions of people can lower their risk for type 2 diabetes by making lifestyle changes and losing weight. The DPP proved that people with prediabetesat high risk of developing type 2 diabetescould sharply lower their risk by losing weight through regular physical activity and a diet low in fat and calories. In 2009, a follow-up study of DPP participantsthe Diabetes Prevention Program Outcomes Study (DPPOS)showed that the benefits of weight loss lasted for at least 10 years after the original study began.2
Read more about the DPP, funded under National Institutes of Health (NIH) clinical trial number NCT00004992, and the DPPOS, funded under NIH clinical trial number NCT00038727 in Diabetes Prevention Program.
Insulin Resistance
Insulin resistance is a common condition in people who are overweight or obese, have excess abdominal fat, and are not physically active. Muscle, fat, and liver cells stop responding properly to insulin, forcing the pancreas to compensate by producing extra insulin. As long as beta cells are able to produce enough insulin, blood glucose levels stay in the normal range. But when insulin production falters because of beta cell dysfunction, glucose levels rise, leading to prediabetes or diabetes.
Abnormal Glucose Production by the Liver
In some people with diabetes, an abnormal increase in glucose production by the liver also contributes to high blood glucose levels. Normally, the pancreas releases the hormone glucagon when blood glucose and insulin levels are low. Glucagon stimulates the liver to produce glucose and release it into the bloodstream. But when blood glucose and insulin levels are high after a meal, glucagon levels drop, and the liver stores excess glucose for later, when it is needed. For reasons not completely understood, in many people with diabetes, glucagon levels stay higher than needed. High glucagon levels cause the liver to produce unneeded glucose, which contributes to high blood glucose levels. Metformin, the most commonly used drug to treat type 2 diabetes, reduces glucose production by the liver.
The Roles of Insulin and Glucagon in Normal Blood Glucose Regulation
A healthy persons body keeps blood glucose levels in a normal range through several complex mechanisms. Insulin and glucagon, two hormones made in the pancreas, help regulate blood glucose levels:
- Insulin, made by beta cells, lowers elevated blood glucose levels. - Glucagon, made by alpha cells, raises low blood glucose levels.
- Insulin helps muscle, fat, and liver cells absorb glucose from the bloodstream, lowering blood glucose levels. - Insulin stimulates the liver and muscle tissue to store excess glucose. The stored form of glucose is called glycogen. - Insulin also lowers blood glucose levels by reducing glucose production in the liver.
- Glucagon signals the liver and muscle tissue to break down glycogen into glucose, which enters the bloodstream and raises blood glucose levels. - If the body needs more glucose, glucagon stimulates the liver to make glucose from amino acids.
Metabolic Syndrome
Metabolic syndrome, also called insulin resistance syndrome, refers to a group of conditions common in people with insulin resistance, including
- higher than normal blood glucose levels - increased waist size due to excess abdominal fat - high blood pressure - abnormal levels of cholesterol and triglycerides in the blood
Cell Signaling and Regulation
Cells communicate through a complex network of molecular signaling pathways. For example, on cell surfaces, insulin receptor molecules capture, or bind, insulin molecules circulating in the bloodstream. This interaction between insulin and its receptor prompts the biochemical signals that enable the cells to absorb glucose from the blood and use it for energy.
Problems in cell signaling systems can set off a chain reaction that leads to diabetes or other diseases. Many studies have focused on how insulin signals cells to communicate and regulate action. Researchers have identified proteins and pathways that transmit the insulin signal and have mapped interactions between insulin and body tissues, including the way insulin helps the liver control blood glucose levels. Researchers have also found that key signals also come from fat cells, which produce substances that cause inflammation and insulin resistance.
This work holds the key to combating insulin resistance and diabetes. As scientists learn more about cell signaling systems involved in glucose regulation, they will have more opportunities to develop effective treatments.
Beta Cell Dysfunction
Scientists think beta cell dysfunction is a key contributor to type 2 diabetes. Beta cell impairment can cause inadequate or abnormal patterns of insulin release. Also, beta cells may be damaged by high blood glucose itself, a condition called glucose toxicity.
Scientists have not determined the causes of beta cell dysfunction in most cases. Single gene defects lead to specific forms of diabetes called maturity-onset diabetes of the young (MODY). The genes involved regulate insulin production in the beta cells. Although these forms of diabetes are rare, they provide clues as to how beta cell function may be affected by key regulatory factors. Other gene variants are involved in determining the number and function of beta cells. But these variants account for only a small percentage of type 2 diabetes cases. Malnutrition early in life is also being investigated as a cause of beta cell dysfunction. The metabolic environment of the developing fetus may also create a predisposition for diabetes later in life.
Risk Factors for Type 2 Diabetes
People who develop type 2 diabetes are more likely to have the following characteristics:
- age 45 or older - overweight or obese - physically inactive - parent or sibling with diabetes - family background that is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American - history of giving birth to a baby weighing more than 9 pounds - history of gestational diabetes - high blood pressure140/90 or aboveor being treated for high blood pressure - high-density lipoprotein (HDL), or good, cholesterol below 35 milligrams per deciliter (mg/dL), or a triglyceride level above 250 mg/dL - polycystic ovary syndrome, also called PCOS - prediabetesan A1C level of 5.7 to 6.4 percent; a fasting plasma glucose test result of 100125 mg/dL, called impaired fasting glucose; or a 2-hour oral glucose tolerance test result of 140199, called impaired glucose tolerance - acanthosis nigricans, a condition associated with insulin resistance, characterized by a dark, velvety rash around the neck or armpits - history of CVD
The American Diabetes Association (ADA) recommends that testing to detect prediabetes and type 2 diabetes be considered in adults who are overweight or obese and have one or more additional risk factors for diabetes. In adults without these risk factors, testing should begin at age 45. |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What causes Causes of Diabetes ? | Insulin Resistance and Beta Cell Dysfunction
Hormones produced by the placenta and other pregnancy-related factors contribute to insulin resistance, which occurs in all women during late pregnancy. Insulin resistance increases the amount of insulin needed to control blood glucose levels. If the pancreas cant produce enough insulin due to beta cell dysfunction, gestational diabetes occurs.
As with type 2 diabetes, excess weight is linked to gestational diabetes. Overweight or obese women are at particularly high risk for gestational diabetes because they start pregnancy with a higher need for insulin due to insulin resistance. Excessive weight gain during pregnancy may also increase risk.
Family History
Having a family history of diabetes is also a risk factor for gestational diabetes, suggesting that genes play a role in its development. Genetics may also explain why the disorder occurs more frequently in African Americans, American Indians, and Hispanics/Latinos. Many gene variants or combinations of variants may increase a womans risk for developing gestational diabetes. Studies have found several gene variants associated with gestational diabetes, but these variants account for only a small fraction of women with gestational diabetes.
Future Risk of Type 2 Diabetes
Because a womans hormones usually return to normal levels soon after giving birth, gestational diabetes disappears in most women after delivery. However, women who have gestational diabetes are more likely to develop gestational diabetes with future pregnancies and develop type 2 diabetes.3 Women with gestational diabetes should be tested for persistent diabetes 6 to 12 weeks after delivery and at least every 3 years thereafter.
Also, exposure to high glucose levels during gestation increases a childs risk for becoming overweight or obese and for developing type 2 diabetes later on. The result may be a cycle of diabetes affecting multiple generations in a family. For both mother and child, maintaining a healthy body weight and being physically active may help prevent type 2 diabetes. |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What causes Causes of Diabetes ? | Other types of diabetes have a variety of possible causes.
Genetic Mutations Affecting Beta Cells, Insulin, and Insulin Action
Some relatively uncommon forms of diabetes known as monogenic diabetes are caused by mutations, or changes, in a single gene. These mutations are usually inherited, but sometimes the gene mutation occurs spontaneously. Most of these gene mutations cause diabetes by reducing beta cells ability to produce insulin.
The most common types of monogenic diabetes are neonatal diabetes mellitus (NDM) and MODY. NDM occurs in the first 6 months of life. MODY is usually found during adolescence or early adulthood but sometimes is not diagnosed until later in life. More information about NDM and MODY is provided in the NIDDK health topic, Monogenic Forms of Diabetes.
Other rare genetic mutations can cause diabetes by damaging the quality of insulin the body produces or by causing abnormalities in insulin receptors.
Other Genetic Diseases
Diabetes occurs in people with Down syndrome, Klinefelter syndrome, and Turner syndrome at higher rates than the general population. Scientists are investigating whether genes that may predispose people to genetic syndromes also predispose them to diabetes.
The genetic disorders cystic fibrosis and hemochromatosis are linked to diabetes. Cystic fibrosis produces abnormally thick mucus, which blocks the pancreas. The risk of diabetes increases with age in people with cystic fibrosis. Hemochromatosis causes the body to store too much iron. If the disorder is not treated, iron can build up in and damage the pancreas and other organs.
Damage to or Removal of the Pancreas
Pancreatitis, cancer, and trauma can all harm the pancreatic beta cells or impair insulin production, thus causing diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells.
Endocrine Diseases
Endocrine diseases affect organs that produce hormones. Cushings syndrome and acromegaly are examples of hormonal disorders that can cause prediabetes and diabetes by inducing insulin resistance. Cushings syndrome is marked by excessive production of cortisolsometimes called the stress hormone. Acromegaly occurs when the body produces too much growth hormone. Glucagonoma, a rare tumor of the pancreas, can also cause diabetes. The tumor causes the body to produce too much glucagon. Hyperthyroidism, a disorder that occurs when the thyroid gland produces too much thyroid hormone, can also cause elevated blood glucose levels.
Autoimmune Disorders
Rare disorders characterized by antibodies that disrupt insulin action can lead to diabetes. This kind of diabetes is often associated with other autoimmune disorders such as lupus erythematosus. Another rare autoimmune disorder called stiff-man syndrome is associated with antibodies that attack the beta cells, similar to type 1 diabetes.
Medications and Chemical Toxins
Some medications, such as nicotinic acid and certain types of diuretics, anti-seizure drugs, psychiatric drugs, and drugs to treat human immunodeficiency virus (HIV), can impair beta cells or disrupt insulin action. Pentamidine, a drug prescribed to treat a type of pneumonia, can increase the risk of pancreatitis, beta cell damage, and diabetes. Also, glucocorticoidssteroid hormones that are chemically similar to naturally produced cortisolmay impair insulin action. Glucocorticoids are used to treat inflammatory illnesses such as rheumatoid arthritis, asthma, lupus, and ulcerative colitis.
Many chemical toxins can damage or destroy beta cells in animals, but only a few have been linked to diabetes in humans. For example, dioxina contaminant of the herbicide Agent Orange, used during the Vietnam Warmay be linked to the development of type 2 diabetes. In 2000, based on a report from the Institute of Medicine, the U.S. Department of Veterans Affairs (VA) added diabetes to the list of conditions for which Vietnam veterans are eligible for disability compensation. Also, a chemical in a rat poison no longer in use has been shown to cause diabetes if ingested. Some studies suggest a high intake of nitrogen-containing chemicals such as nitrates and nitrites might increase the risk of diabetes. Arsenic has also been studied for possible links to diabetes.
Lipodystrophy
Lipodystrophy is a condition in which fat tissue is lost or redistributed in the body. The condition is associated with insulin resistance and type 2 diabetes. |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What causes Causes of Diabetes ? | Other types of diabetes have a variety of possible causes.
Genetic Mutations Affecting Beta Cells, Insulin, and Insulin Action
Some relatively uncommon forms of diabetes known as monogenic diabetes are caused by mutations, or changes, in a single gene. These mutations are usually inherited, but sometimes the gene mutation occurs spontaneously. Most of these gene mutations cause diabetes by reducing beta cells ability to produce insulin.
The most common types of monogenic diabetes are neonatal diabetes mellitus (NDM) and MODY. NDM occurs in the first 6 months of life. MODY is usually found during adolescence or early adulthood but sometimes is not diagnosed until later in life. More information about NDM and MODY is provided in the NIDDK health topic, Monogenic Forms of Diabetes.
Other rare genetic mutations can cause diabetes by damaging the quality of insulin the body produces or by causing abnormalities in insulin receptors.
Other Genetic Diseases
Diabetes occurs in people with Down syndrome, Klinefelter syndrome, and Turner syndrome at higher rates than the general population. Scientists are investigating whether genes that may predispose people to genetic syndromes also predispose them to diabetes.
The genetic disorders cystic fibrosis and hemochromatosis are linked to diabetes. Cystic fibrosis produces abnormally thick mucus, which blocks the pancreas. The risk of diabetes increases with age in people with cystic fibrosis. Hemochromatosis causes the body to store too much iron. If the disorder is not treated, iron can build up in and damage the pancreas and other organs.
Damage to or Removal of the Pancreas
Pancreatitis, cancer, and trauma can all harm the pancreatic beta cells or impair insulin production, thus causing diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells.
Endocrine Diseases
Endocrine diseases affect organs that produce hormones. Cushings syndrome and acromegaly are examples of hormonal disorders that can cause prediabetes and diabetes by inducing insulin resistance. Cushings syndrome is marked by excessive production of cortisolsometimes called the stress hormone. Acromegaly occurs when the body produces too much growth hormone. Glucagonoma, a rare tumor of the pancreas, can also cause diabetes. The tumor causes the body to produce too much glucagon. Hyperthyroidism, a disorder that occurs when the thyroid gland produces too much thyroid hormone, can also cause elevated blood glucose levels.
Autoimmune Disorders
Rare disorders characterized by antibodies that disrupt insulin action can lead to diabetes. This kind of diabetes is often associated with other autoimmune disorders such as lupus erythematosus. Another rare autoimmune disorder called stiff-man syndrome is associated with antibodies that attack the beta cells, similar to type 1 diabetes.
Medications and Chemical Toxins
Some medications, such as nicotinic acid and certain types of diuretics, anti-seizure drugs, psychiatric drugs, and drugs to treat human immunodeficiency virus (HIV), can impair beta cells or disrupt insulin action. Pentamidine, a drug prescribed to treat a type of pneumonia, can increase the risk of pancreatitis, beta cell damage, and diabetes. Also, glucocorticoidssteroid hormones that are chemically similar to naturally produced cortisolmay impair insulin action. Glucocorticoids are used to treat inflammatory illnesses such as rheumatoid arthritis, asthma, lupus, and ulcerative colitis.
Many chemical toxins can damage or destroy beta cells in animals, but only a few have been linked to diabetes in humans. For example, dioxina contaminant of the herbicide Agent Orange, used during the Vietnam Warmay be linked to the development of type 2 diabetes. In 2000, based on a report from the Institute of Medicine, the U.S. Department of Veterans Affairs (VA) added diabetes to the list of conditions for which Vietnam veterans are eligible for disability compensation. Also, a chemical in a rat poison no longer in use has been shown to cause diabetes if ingested. Some studies suggest a high intake of nitrogen-containing chemicals such as nitrates and nitrites might increase the risk of diabetes. Arsenic has also been studied for possible links to diabetes.
Lipodystrophy
Lipodystrophy is a condition in which fat tissue is lost or redistributed in the body. The condition is associated with insulin resistance and type 2 diabetes. |
In this section:
Symptoms of diabetes include Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.
Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:
Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.
Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.
Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.
Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.
Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.
Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells. Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.
If you take any of these medicines and are concerned about their side effects, talk with your doctor.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
| What to do for Causes of Diabetes ? | - Diabetes is a complex group of diseases with a variety of causes. Scientists believe genes and environmental factors interact to cause diabetes in most cases. - People with diabetes have high blood glucose, also called high blood sugar or hyperglycemia. Diabetes develops when the body doesnt make enough insulin or is not able to use insulin effectively, or both. - Insulin is a hormone made by beta cells in the pancreas. Insulin helps cells throughout the body absorb and use glucose for energy. If the body does not produce enough insulin or cannot use insulin effectively, glucose builds up in the blood instead of being absorbed by cells in the body, and the body is starved of energy. - Prediabetes is a condition in which blood glucose levels or A1C levels are higher than normal but not high enough to be diagnosed as diabetes. People with prediabetes can substantially reduce their risk of developing diabetes by losing weight and increasing physical activity. - The two main types of diabetes are type 1 diabetes and type 2 diabetes. Gestational diabetes is a third form of diabetes that develops only during pregnancy. - Type 1 diabetes is caused by a lack of insulin due to the destruction of insulin-producing beta cells. In type 1 diabetesan autoimmune diseasethe bodys immune system attacks and destroys the beta cells. - Type 2 diabetesthe most common form of diabetesis caused by a combination of factors, including insulin resistance, a condition in which the bodys muscle, fat, and liver cells do not use insulin effectively. Type 2 diabetes develops when the body can no longer produce enough insulin to compensate for the impaired ability to use insulin. - Scientists believe gestational diabetes is caused by the hormonal changes and metabolic demands of pregnancy together with genetic and environmental factors. Risk factors for gestational diabetes include being overweight and having a family history of diabetes. - Monogenic forms of diabetes are relatively uncommon and are caused by mutations in single genes that limit insulin production, quality, or action in the body. - Other types of diabetes are caused by diseases and injuries that damage the pancreas; certain chemical toxins and medications; infections; and other conditions. |
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| What causes Nerve Disease and Bladder Control ? | Nerves that work poorly can lead to three different kinds of bladder control problems.
Overactive bladder. Damaged nerves may send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. The symptoms of overactive bladder include
- urinary frequencydefined as urination eight or more times a day or two or more times at night - urinary urgencythe sudden, strong need to urinate immediately - urge incontinenceleakage of urine that follows a sudden, strong urge to urinate
Poor control of sphincter muscles. Sphincter muscles surround the urethra and keep it closed to hold urine in the bladder. If the nerves to the sphincter muscles are damaged, the muscles may become loose and allow leakage or stay tight when you are trying to release urine.
Urine retention. For some people, nerve damage means their bladder muscles do not get the message that it is time to release urine or are too weak to completely empty the bladder. If the bladder becomes too full, urine may back up and the increasing pressure may damage the kidneys. Or urine that stays too long may lead to an infection in the kidneys or bladder. Urine retention may also lead to overflow incontinence. |
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| What causes Nerve Disease and Bladder Control ? | Many events or conditions can damage nerves and nerve pathways. Some of the most common causes are
- vaginal childbirth - infections of the brain or spinal cord - diabetes - stroke - accidents that injure the brain or spinal cord - multiple sclerosis - heavy metal poisoning
In addition, some children are born with nerve problems that can keep the bladder from releasing urine, leading to urinary infections or kidney damage. |
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| What are the treatments for Nerve Disease and Bladder Control ? | The treatment for a bladder control problem depends on the cause of the nerve damage and the type of voiding dysfunction that results.
In the case of overactive bladder, your doctor may suggest a number of strategies, including bladder training, electrical stimulation, drug therapy, and, in severe cases where all other treatments have failed, surgery.
Bladder training. Your doctor may ask you to keep a bladder diary-a record of your fluid intake, trips to the bathroom, and episodes of urine leakage. This record may indicate a pattern and suggest ways to avoid accidents by making a point of using the bathroom at certain times of the day-a practice called timed voiding. As you gain control, you can extend the time between trips to the bathroom. Bladder training also includes Kegel exercises to strengthen the muscles that hold in urine.
Electrical stimulation. Mild electrical pulses can be used to stimulate the nerves that control the bladder and sphincter muscles. Depending on which nerves the doctor plans to treat, these pulses can be given through the vagina or anus, or by using patches on the skin. Another method is a minor surgical procedure to place the electric wire near the tailbone. This procedure involves two steps. First, the wire is placed under the skin and connected to a temporary stimulator, which you carry with you for several days. If your condition improves during this trial period, then the wire is placed next to the tailbone and attached to a permanent stimulator under your skin. The Food and Drug Administration (FDA) has approved this device, marketed as the InterStim system, to treat urge incontinence, urgency-frequency syndrome, and urinary retention in patients for whom other treatments have not worked.
Drug therapy. Different drugs can affect the nerves and muscles of the urinary tract in different ways.
- Drugs that relax bladder muscles and prevent bladder spasms include oxybutynin chloride (Ditropan), tolterodine (Detrol), hyoscyamine (Levsin), and propantheline bromide (Pro-Banthine), which belong to the class of drugs called anticholinergics. Their most common side effect is dry mouth, although large doses may cause blurred vision, constipation, a faster heartbeat, and flushing. A new patch delivery system for oxybutynin (Oxytrol) may decrease side effects. Ditropan XL and Detrol LA are timed-release formulations that deliver a low level of the drug continuously in the body. These drugs have the advantage of once-a-day administration. In 2004, the FDA approved trospium chloride (Sanctura), darifenacin (Enablex), and solifenacin succinate (VESIcare) for the treatment of overactive bladder. - Drugs for depression that also relax bladder muscles include imipramine hydrochloride (Tofranil), a tricyclic antidepressant. Side effects may include fatigue, dry mouth, dizziness, blurred vision, nausea, and insomnia.
Additional drugs are being evaluated for the treatment of overactive bladder and may soon receive FDA approval.
Surgery. In extreme cases, when incontinence is severe and other treatments have failed, surgery may be considered. The bladder may be made larger through an operation known as augmentation cystoplasty, in which a part of the diseased bladder is replaced with a section taken from the patient's bowel. This operation may improve the ability to store urine but may make the bladder more difficult to empty, making regular catheterization necessary. Additional risks of surgery include the bladder breaking open and leaking urine into the body, bladder stones, mucus in the bladder, and infection. |
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| What are the treatments for Nerve Disease and Bladder Control ? | The job of the sphincter muscles is to hold urine in the bladder by squeezing the urethra shut. If the urethral sphincter fails to stay closed, urine may leak out of the bladder. When nerve signals are coordinated properly, the sphincter muscles relax to allow urine to pass through the urethra as the bladder contracts to push out urine. If the signals are not coordinated, the bladder and the sphincter may contract at the same time, so urine cannot pass easily.
Drug therapy for an uncoordinated bladder and urethra. Scientists have not yet found a drug that works selectively on the urethral sphincter muscles, but drugs used to reduce muscle spasms or tremors are sometimes used to help the sphincter relax. Baclofen (Lioresal) is prescribed for muscle spasms or cramping in patients with multiple sclerosis and spinal injuries. Diazepam (Valium) can be taken as a muscle relaxant or to reduce anxiety. Drugs called alpha-adrenergic blockers can also be used to relax the sphincter. Examples of these drugs are alfuzosin (UroXatral), tamsulosin (Flomax), terazosin (Hytrin), and doxazosin (Cardura). The main side effects are low blood pressure, dizziness, fainting, and nasal congestion. All of these drugs have been used to relax the urethral sphincter in people whose sphincter does not relax well on its own.
Botox injection. Botulinum toxin type A (Botox) is best known as a cosmetic treatment for facial wrinkles. Doctors have also found that botulinum toxin is useful in blocking spasms like eye ticks or relaxing muscles in patients with multiple sclerosis. Urologists have found that injecting botulinum toxin into the tissue surrounding the sphincter can help it to relax. Although the FDA has approved botulinum toxin only for facial cosmetic purposes, researchers are studying the safety and effectiveness of botulinum toxin injection into the sphincter for possible FDA approval in the future. |
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| What are the treatments for Nerve Disease and Bladder Control ? | Urine retention may occur either because the bladder wall muscles cannot contract or because the sphincter muscles cannot relax.
Catheter. A catheter is a thin tube that can be inserted through the urethra into the bladder to allow urine to flow into a collection bag. If you are able to place the catheter yourself, you can learn to carry out the procedure at regular intervals, a practice called clean intermittent catheterization. Some patients cannot place their own catheters because nerve damage affects their hand coordination as well as their voiding function. These patients need to have a caregiver place the catheter for them at regular intervals. If regular catheter placement is not feasible, the patients may need to have an indwelling catheter that can be changed less often. Indwelling catheters have several risks, including infection, bladder stones, and bladder tumors. However, if the bladder cannot be emptied any other way, then the catheter is the only way to stop the buildup of urine in the bladder that can damage the kidneys.
Urethral stent. Stents are small tube-like devices inserted into the urethra and allowed to expand, like a spring, widening the opening for urine to flow out. Stents can help prevent urine backup when the bladder wall and sphincter contract at the same time because of improper nerve signals. However, stents can cause problems if they move or lead to infection.
Surgery. Men may consider a surgery that removes the external sphincter-a sphincterotomy-or a piece of it-a sphincter resection-to prevent urinary retention. The surgeon will pass a thin instrument through the urethra to deliver electrical or laser energy that burns away sphincter tissue. Possible complications include bleeding that requires a transfusion and, rarely, problems with erections. This procedure causes loss of urine control and requires the patient to collect urine by wearing an external catheter that fits over the penis like a condom. No external collection device is available for women.
Urinary diversion. If other treatments fail and urine regularly backs up and damages the kidneys, the doctor may recommend a urinary diversion, a procedure that may require an outside collection bag attached to a stoma, a surgically created opening where urine passes out of the body. Another form of urinary diversion replaces the bladder with a continent urinary reservoir, an internal pouch made from sections of the bowel or other tissue. This method allows the person to store urine inside the body until a catheter is used to empty it through a stoma. |
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| What is (are) What I need to know about Hepatitis B ? | Hepatitis* B is a virus, or infection, that causes liver disease and inflammation of the liver. Viruses can cause sickness. For example, the flu is caused by a virus. People can pass viruses to each other.
Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can cause organs to not work properly. |
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| What is (are) What I need to know about Hepatitis B ? | The liver is an organ that does many important things. You cannot live without a liver.
*See the Pronunciation Guide for tips on how to say the words in bold type.
The liver
- removes harmful chemicals from your blood - fights infection - helps digest food - stores nutrients and vitamins - stores energy |
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| Who is at risk for What I need to know about Hepatitis B? ? | Anyone can get hepatitis B, but those more likely to are people who
- were born to a mother with hepatitis B - are in contact with blood, needles, or body fluids at work - live with someone who currently has an active hepatitis B infection - have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease - are on kidney dialysisthe process of filtering wastes and extra water from the body by means other than the kidneys - are taking medicines that suppress the immune system, such as steroids or chemotherapy medicines - have lived in or travel often to parts of the world where hepatitis B is common - are from Asian and Pacific Island nations - are infected with HIV or hepatitis C - have injected illegal drugs - work or live in a prison - had a blood transfusion or organ transplant before the mid-1980s
Also, men who have sex with men are more likely to get hepatitis B. |
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| What are the symptoms of What I need to know about Hepatitis B ? | Most people do not have any symptoms of hepatitis B. Adults and children ages 5 and older may have one or more of the following symptoms:
- feeling tired - muscle soreness - upset stomach - stomach pain - fever - loss of appetite - diarrhea - dark-yellow urine - light-colored stools - yellowish eyes and skin, called jaundice
When symptoms occur, they can begin 2 to 5 months after coming into contact with the virus. See a doctor right away if you or a child in your care has symptoms of hepatitis B. |
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| What is (are) What I need to know about Hepatitis B ? | Acute hepatitis B is a short-term infection with the hepatitis B virus. Symptoms usually last several weeks but they can last up to 6 months. The infection sometimes clears up because your body is able to fight off the infection and get rid of the virus. Most healthy adults and children older than 5 who have hepatitis B get better without treatment. |
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| What is (are) What I need to know about Hepatitis B ? | Chronic hepatitis B is a long-lasting infection with the hepatitis B virus. Chronic hepatitis B occurs when the body cant get rid of the hepatitis B virus. Children, especially infants, are more likely to get chronic hepatitis B, which usually has no symptoms until signs of liver damage appear.
Without treatment, chronic hepatitis B can cause liver cancer or severe liver damage that leads to liver failure. Liver failure occurs when the liver stops working properly. |
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| How to diagnose What I need to know about Hepatitis B ? | A blood test will show if you have hepatitis B. Blood tests are done at a doctors office or outpatient facility. A blood sample is taken using a needle inserted into a vein in your arm or hand. The blood sample is sent to a lab to test for hepatitis B.
If you are at higher risk of getting hepatitis B, get tested. If you are pregnant, you should also get tested. Many people with hepatitis B do not know they are infected. Early diagnosis and treatment can help prevent liver damage.
Your doctor may suggest getting a liver biopsy if chronic hepatitis B is suspected. A liver biopsy is a test to take a small piece of your liver to look for liver damage. The doctor may ask you to stop taking certain medicines before the test. You may be asked to fast for 8 hours before the test.
During the test, you lie on a table with your right hand resting above your head. Medicine is applied to numb the area where the biopsy needle will be inserted. If needed, sedatives and pain medicine are also given. The doctor uses a needle to take a small piece of liver tissue. After the test, you must lie on your right side for up to 2 hours. You will stay 2 to 4 hours after the test before being sent home.
A liver biopsy is performed at a hospital or outpatient center by a doctor. The liver tissue is sent to a special lab where a doctor looks at the tissue with a microscope and sends a report to your doctor. |
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| What are the treatments for What I need to know about Hepatitis B ? | Hepatitis B is not usually treated unless it becomes chronic. Chronic hepatitis B is treated with medicines that slow or stop the virus from damaging the liver.
Medicines for Chronic Hepatitis B
Your doctor will choose medicines or a combination of medicines that are likely to work for you. The doctor will closely watch your symptoms and schedule regular blood tests to make sure treatment is working.
Medicines given by shots include
- interferon - peginterferon
Medicines taken by mouth include
- adefovir - entecavir - lamivudine - telbivudine - tenofovir
The length of treatment varies. Talk with your doctor before taking other prescription medicines and over-the-counter medicines.
Liver Transplant
A liver transplant may be necessary if chronic hepatitis B causes severe liver damage that leads to liver failure. Symptoms of severe liver damage include the symptoms of hepatitis B and
- generalized itching - a longer than usual amount of time for bleeding to stop - easy bruising - swollen stomach or ankles - spiderlike blood vessels, called spider angiomas, that develop on the skin
Liver transplant is surgery to remove a diseased or injured liver and replace it with a healthy one from another person, called a donor. If your doctors tell you that you need a transplant, you should talk with them about the long-term demands of living with a liver transplant.
A team of surgeonsdoctors who specialize in surgeryperforms a liver transplant in a hospital. You will learn how to take care of yourself after you go home and about the medicines youll need to take to protect your new liver. Medicines taken after liver transplant surgery can prevent hepatitis B from coming back.
Testing for Liver Cancer
Having hepatitis B increases your risk for getting liver cancer, so your doctor may suggest an ultrasound test of the liver every 6 to 12 months. Finding cancer early makes it more treatable. Ultrasound is a machine that uses sound waves to create a picture of your liver. Ultrasound is performed at a hospital or radiology center by a specially trained technician. The image, called a sonogram, can show the livers size and the presence of cancerous tumors. |
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| What to do for What I need to know about Hepatitis B ? | If you have chronic hepatitis B, you should do things to take care of yourself, including eating a healthy diet. Avoid drinking alcohol, which can harm the liver. Talk with your doctor before taking vitamins and other supplements. |
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| What to do for What I need to know about Hepatitis B ? | - Hepatitis B is a virus, or infection, that causes liver disease and inflammation of the liver. - Anyone can get hepatitis B, but some people are more likely to than others. - You could get hepatitis B through contact with an infected persons blood, semen, or other body fluid. - Most people do not have any symptoms of hepatitis B. Adults and children ages 5 and older may have symptoms. - See a doctor right away if you or a child in your care has symptoms of hepatitis B. - Acute hepatitis B is a short-term infection with the hepatitis B virus. - Chronic hepatitis B is a long-lasting infection with the hepatitis B virus. Chronic hepatitis B occurs when the body cant get rid of the hepatitis B virus. - Children, especially infants, are more likely to get chronic hepatitis B. - A blood test will show if you have hepatitis B. - If you are at higher risk of getting hepatitis B, get tested. If you are pregnant, you should also get tested. - Many people with hepatitis B do not know they are infected. Early diagnosis and treatment can help prevent liver damage. - Hepatitis B is usually not treated unless it becomes chronic. Chronic hepatitis B is treated with medicines that slow or stop the virus from damaging the liver. - You can avoid getting hepatitis B by receiving the hepatitis B vaccine. - Tell your doctor and your dentist if you have hepatitis B. - If you are pregnant and have hepatitis B, tell the doctor and staff who deliver your baby. - See your doctor right away if you think you have been in contact with the hepatitis B virus. |
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| What is (are) Urine Blockage in Newborns ? | The urinary tract is the bodys drainage system for removing wastes and extra fluid. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. Children produce less urine than adults. The amount produced depends on their age. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination. When the bladder empties, urine flows out of the body through a tube called the urethra at the bottom of the bladder.
The kidneys and urinary system keep fluids and natural chemicals in the body balanced. While a baby is developing in the mothers womb, called prenatal development, the placentaa temporary organ joining mother and babycontrols much of that balance. The babys kidneys begin to produce urine at about 10 to 12 weeks after conception. However, the mothers placenta continues to do most of the work until the last few weeks of the pregnancy. Wastes and extra water are removed from the babys body through the umbilical cord. The babys urine is released into the amniotic sac and becomes part of the amniotic fluid. This fluid plays a role in the babys lung development. |
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| What causes Urine Blockage in Newborns ? | Many types of defects in the urinary tract can cause urine blockage:
- Vesicoureteral reflux (VUR). Most children with VUR are born with a ureter that did not grow long enough during development in the womb. The valve formed by the ureter pressing against the bladder wall does not close properly, so urine backs uprefluxesfrom the bladder to the ureter and eventually to the kidney. Severe reflux may prevent a kidney from developing normally and may increase the risk for damage from infections after birth. VUR usually affects only one ureter and kidney, though it can affect both ureters and kidneys. - Ureteropelvic junction (UPJ) obstruction. If urine is blocked where the ureter joins the kidney, only the kidney swells. The ureter remains a normal size. UPJ obstruction usually occurs in only one kidney.
- Bladder outlet obstruction (BOO). BOO describes any blockage in the urethra or at the opening of the bladder.Posterior urethral valves (PUV), the most common form of BOO seen in newborns and during prenatal ultrasound exams, is a birth defect in boys in which an abnormal fold of tissue in the urethra keeps urine from flowing freely out of the bladder. This defect may cause swelling in the entire urinary tract, including the urethra, bladder, ureters, and kidneys. - Ureterocele. If the end of the ureter does not develop normally, it can bulge, creating a ureterocele. The ureterocele may obstruct part of the ureter or the bladder.
Some babies are born with genetic conditions that affect several different systems in the body, including the urinary tract:
- Prune belly syndrome (PBS). PBS is a group of birth defects involving poor development of the abdominal muscles, enlargement of the ureters and bladder, and both testicles remaining inside the body instead of descending into the scrotum. The skin over the abdomen is wrinkled, giving the appearance of a prune. PBS usually occurs in boys, and most children with PBS have hydronephrosisswelling in the kidneyand VUR. - Esophageal atresia (EA). EA is a birth defect in which the esophagusthe muscular tube that carries food and liquids from the mouth to the stomachlacks the opening for food to pass into the stomach. Babies born with EA may also have problems with their spinal columns, digestive systems, hearts, and urinary tracts. - Congenital heart defects. Heart defects range from mild to life threatening. Children born with heart defects also have a higher rate of problems in the urinary tract than children in the general population, suggesting that some types of heart and urinary defects may have a common genetic cause.
Urine blockage can also be caused by spina bifida and other birth defects that affect the spinal cord. These defects may interrupt nerve signals between the bladder, spinal cord, and brain, which are needed for urination, and lead to urinary retentionthe inability to empty the bladder completelyin newborns. Urine that remains in the bladder can reflux into the ureters and kidneys, causing swelling. |
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| What are the symptoms of Urine Blockage in Newborns ? | Before leaving the hospital, a baby with urine blockage may urinate only small amounts or may not urinate at all. As part of the routine newborn exam, the health care provider may feel an enlarged kidney or find a closed urethra, which may indicate urine blockage. Sometimes urine blockage is not apparent until a child develops symptoms of a urinary tract infection (UTI), including
- fever - irritability - not eating - nausea - diarrhea - vomiting - cloudy, dark, bloody, or foul-smelling urine - urinating often
If these symptoms persist, the child should see a health care provider. A child 2 months of age or younger with a fever should see a health care provider immediately. The health care provider will ask for a urine sample to test for bacteria. |
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| What are the complications of Urine Blockage in Newborns ? | When a defect in the urinary tract blocks the flow of urine, the urine backs up and causes the ureters to swell, called hydroureter, and hydronephrosis.
Hydronephrosis is the most common problem found during prenatal ultrasound of a baby in the womb. The swelling may be easy to see or barely detectable. The results of hydronephrosis may be mild or severe, yet the long-term outcome for the childs health cannot always be predicted by the severity of swelling. Urine blockage may damage the developing kidneys and reduce their ability to filter. In the most severe cases of urine blockage, where little or no urine leaves the babys bladder, the amount of amniotic fluid is reduced to the point that the babys lung development is threatened.
After birth, urine blockage may raise a childs risk of developing a UTI. Recurring UTIs can lead to more permanent kidney damage. |
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| How to diagnose Urine Blockage in Newborns ? | Defects of the urinary tract may be diagnosed before or after the baby is born.
Diagnosis before Birth
Tests during pregnancy can help determine if the baby is developing normally in the womb.
- Ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A prenatal ultrasound can show internal organs within the baby. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by - a radiologista doctor who specializes in medical imaging, or - an obstetriciana doctor who delivers babies
The images can show enlarged kidneys, ureters, or bladders in babies.
- Amniocentesis. Amniocentesis is a procedure in which amniotic fluid is removed from the mothers womb for testing. The procedure can be performed in the health care providers office, and local anesthetic may be used. The health care provider inserts a thin needle through the abdomen into the uterus to obtain a small amount of amniotic fluid. Cells from the fluid are grown in a lab and then analyzed. The health care provider usually uses ultrasound to find the exact location of the baby. The test can show whether the baby has certain birth defects and how well the babys lungs are developing. - Chorionic villus sampling (CVS). CVS is the removal of a small piece of tissue from the placenta for testing. The procedure can be performed in the health care providers office; anesthesia is not needed. The health care provider uses ultrasound to guide a thin tube or needle through the vagina or abdomen into the placenta. Cells are removed from the placenta and then analyzed. The test can show whether the baby has certain genetic defects.
Most healthy women do not need all of these tests. Ultrasound exams during pregnancy are routine. Amniocentesis and CVS are recommended only when a risk of genetic problems exists because of family history or a problem is detected during an ultrasound. Amniocentesis and CVS carry a slight risk of harming the baby and mother or ending the pregnancy in miscarriage, so the risks should be carefully considered.
Diagnosis after Birth
Different imaging techniques can be used in infants and children to determine the cause of urine blockage.
- Ultrasound. Ultrasound can be used to view the childs urinary tract. For infants, the image is clearer than could be achieved while the baby was in the womb. - Voiding cystourethrogram (VCUG). VCUG is an x-ray image of the bladder and urethra taken while the bladder is full and during urination, also called voiding. The procedure is performed in an outpatient center or hospital by an x-ray technician supervised by a radiologist, who then interprets the images. While anesthesia is not needed, sedation may be used for some children. The bladder and urethra are filled with a special dye, called contrast medium, to make the structures clearly visible on the x-ray images. The x-ray machine captures images of the contrast medium while the bladder is full and when the child urinates. The test can show reflux or blockage of the bladder due to an obstruction, such as PUV. - Radionuclide scan. A radionuclide scan is an imaging technique that detects small amounts of radiation after a person is injected with radioactive chemicals. The dose of the radioactive chemicals is small; therefore, the risk of causing damage to cells is low. Radionuclide scans are performed in an outpatient center or hospital by a specially trained technician, and the images are interpreted by a radiologist. Anesthesia is not needed. Special cameras and computers are used to create images of the radioactive chemicals as they pass through the kidneys. Radioactive chemicals injected into the blood can provide information about kidney function. |
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| What are the treatments for Urine Blockage in Newborns ? | Treatment for urine blockage depends on the cause and severity of the blockage. Hydronephrosis discovered before the baby is born rarely requires immediate action, especially if it is only on one side. The condition often goes away without any treatment before or after birth. The health care provider should keep track of the condition with frequent ultrasounds.
Surgery
If the urine blockage threatens the life of the unborn baby, a fetal surgeon may recommend surgery to insert a shunt or correct the problem causing the blockage. A shunt is a small tube that can be inserted into the babys bladder to release urine into the amniotic sac. The procedure is similar to amniocentesis, in that a needle is inserted through the mothers abdomen. Ultrasound guides placement of the shunt, which is attached to the end of the needle. Alternatively, an endoscopea small, flexible tube with a lightcan be used to place a shunt or to repair the problem causing the blockage. Fetal surgery carries many risks, so it is performed only in special circumstances, such as when the amniotic fluid is absent and the babys lungs are not developing or when the kidneys are severely damaged.
If the urinary defect does not correct itself after the child is born, and the child continues to have urine blockage, surgery may be needed to remove the obstruction and restore urine flow. The decision to operate depends on the degree of blockage. After surgery, a small tube, called a stent, may be placed in the ureter or urethra to keep it open temporarily while healing occurs.
Antibiotics
Antibiotics are bacteria-fighting medications. A child with possible urine blockage or VUR may be given antibiotics to prevent UTIs from developing until the urinary defect corrects itself or is corrected with surgery.
Intermittent Catheterization
Intermittent catheterization may be used for a child with urinary retention due to a nerve disease. The parent or guardian, and later the child, is taught to drain the bladder by inserting a thin tube, called a catheter, through the urethra to the bladder. Emptying the bladder in this way helps to decrease kidney damage, urine leakage, and UTIs. |
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| What to do for Urine Blockage in Newborns ? | Researchers have not found that a mothers eating, diet, and nutrition play a role in causing or preventing urine blockage in newborns. |
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| What to do for Urine Blockage in Newborns ? | - Many types of defects in the urinary tract can cause urine blockage: - vesicoureteral reflux (VUR) - ureteropelvic junction (UPJ) obstruction - bladder outlet obstruction (BOO), such as posterior urethral valves (PUV) - ureterocele - Some babies are born with genetic conditions that affect several different systems in the body, including the urinary tract: - prune belly syndrome (PBS) - esophageal atresia (EA) - congenital heart defects - Urine blockage can also be caused by spina bifida and other birth defects that affect the spinal cord. - Before leaving the hospital, a baby with urine blockage may urinate only small amounts or may not urinate at all. As part of the routine newborn exam, the health care provider may feel an enlarged kidney or find a closed urethra, which may indicate urine blockage. Sometimes urine blockage is not apparent until a child develops symptoms of a urinary tract infection (UTI). - When a defect in the urinary tract blocks the flow of urine, the urine backs up and causes the ureters to swell, called hydroureter, and hydronephrosis. - Defects of the urinary tract may be discovered before or after the baby is born. - Prenatal tests include ultrasound, amniocentesis, and chorionic villus sampling (CVS). - Different imaging techniques, including ultrasound, voiding cystourethrogram (VCUG), and radionuclide scan, can be used in infants and children to determine the cause of urine blockage. - Treatment for urine blockage depends on the cause and severity of the blockage. Hydronephrosis discovered before the baby is born rarely requires immediate action, especially if it is only on one side. Treatments for more serious conditions include - surgery - antibiotics - intermittent catheterization |
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| What is (are) High Blood Pressure and Kidney Disease ? | Blood pressure is the force of blood pushing against blood vessel walls as the heart pumps out blood, and high blood pressure, also called hypertension, is an increase in the amount of force that blood places on blood vessels as it moves through the body. Factors that can increase this force include higher blood volume due to extra fluid in the blood and blood vessels that are narrow, stiff, or clogged.
Blood pressure test results are written with two numbers separated by a slash. For example, a health care provider will write a blood pressure result as 120/80. A health care provider will say this blood pressure result as 120 over 80. The top number is called the systolic pressure and represents the pressure as the heart beats and pushes blood through the blood vessels. The bottom number is called the diastolic pressure and represents the pressure as blood vessels relax between heartbeats.
Most people without chronic health conditions have a normal blood pressure if it stays below 120/80. Prehypertension is a systolic pressure of 120 to 139 or a diastolic pressure of 80 to 89. High blood pressure is a systolic pressure of 140 or above or a diastolic pressure of 90 or above.1
People should talk with their health care provider about their individual blood pressure goals and how often they should have their blood pressure checked. |
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| What is (are) High Blood Pressure and Kidney Disease ? | The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder. In men the urethra is long, while in women it is short.
Kidneys work at the microscopic level. The kidney is not one large filter. Each kidney is made up of about a million filtering units called nephrons. Each nephron filters a small amount of blood. The nephron includes a filter, called the glomerulus, and a tubule. The nephrons work through a two-step process. The glomerulus lets fluid and waste products pass through it; however, it prevents blood cells and large molecules, mostly proteins, from passing. The filtered fluid then passes through the tubule, which sends needed minerals back to the bloodstream and removes wastes. The final product becomes urine. |
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| What are the symptoms of High Blood Pressure and Kidney Disease ? | Most people with high blood pressure do not have symptoms. In rare cases, high blood pressure can cause headaches.
Kidney disease also does not have symptoms in the early stages. A person may have swelling called edema, which happens when the kidneys cannot get rid of extra fluid and salt. Edema can occur in the legs, feet, or ankles and less often in the hands or face. Once kidney function decreases further, symptoms can include
- appetite loss - nausea - vomiting - drowsiness or feeling tired - trouble concentrating - sleep problems - increased or decreased urination - generalized itching or numbness - dry skin - headaches - weight loss - darkened skin - muscle cramps - shortness of breath - chest pain |
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| How to diagnose High Blood Pressure and Kidney Disease ? | A health care provider diagnoses high blood pressure when multiple blood pressure testsoften repeated over several visits to a health care providers officeshow that a systolic blood pressure is consistently above 140 or a diastolic blood pressure is consistently above 90. Health care providers measure blood pressure with a blood pressure cuff. People can also buy blood pressure cuffs at discount chain stores and drugstores to monitor their blood pressure at home.
Kidney disease is diagnosed with urine and blood tests.
Urine Tests
Dipstick test for albumin. A dipstick test performed on a urine sample can detect the presence of albumin in the urine. Albumin is a protein in the blood that can pass into the urine when the kidneys are damaged. A patient collects the urine sample in a special container in a health care providers office or a commercial facility. The office or facility tests the sample onsite or sends it to a lab for analysis. For the test, a nurse or technician places a strip of chemically treated paper, called a dipstick, into the urine. Patches on the dipstick change color when blood or protein is present in urine.
Urine albumin-to-creatinine ratio. A health care provider uses the albumin and creatinine measurement to determine the ratio between the albumin and creatinine in the urine. Creatinine is a waste product in the blood that is filtered in the kidneys and excreted in the urine. A urine albumin-to-creatinine ratio above 30 mg/g may be a sign of kidney disease.
Blood Test
A blood test involves having blood drawn at a health care providers office or a commercial facility and sending the sample to a lab for analysis. A health care provider may order a blood test to estimate how much blood the kidneys filter each minute, called the estimated glomerular filtration rate (eGFR). The results of the test indicate the following:
- eGFR of 60 or above is in the normal range - eGFR below 60 may indicate kidney damage - eGFR of 15 or below may indicate kidney failure
Get Screened for Kidney Disease Kidney disease, when found early, can be treated to prevent more serious disease and other complications. The National Kidney Foundation recommends people with high blood pressure receive the following regular screenings: - blood pressure tests - urine albumin - eGFR Health care providers will help determine how often people with high blood pressure should be screened. |
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| How to prevent High Blood Pressure and Kidney Disease ? | The best way to slow or prevent kidney disease from high blood pressure is to take steps to lower blood pressure. These steps include a combination of medication and lifestyle changes, such as
- healthy eating - physical activity - maintaining a healthy weight - quitting smoking - managing stress
No matter what the cause of the kidney disease, high blood pressure can increase damage to the kidneys. People with kidney disease should keep their blood pressure below 140/90.4
Medication
Medications that lower blood pressure can also significantly slow the progression of kidney disease. Two types of blood pressure-lowering medications, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have been shown effective in slowing the progression of kidney disease. Many people require two or more medications to control their blood pressure. In addition to an ACE inhibitor or an ARB, a health care provider may prescribe a diuretica medication that helps the kidneys remove fluid from the blood. A person may also need beta blockers, calcium channel blockers, and other blood pressure medications. |
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| What to do for High Blood Pressure and Kidney Disease ? | Following a healthy eating plan can help lower blood pressure. A health care provider may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan. DASH focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and lower in sodium, which often comes from salt. The DASH eating plan
- is low in fat and cholesterol - features fat-free or low-fat milk and dairy products, fish, poultry, and nuts - suggests less red meat, sweets, added sugars, and sugar-containing beverages - is rich in nutrients, protein, and fiber
Read more about DASH at www.nhlbi.nih.gov/health/resources/heart/hbp-dash-index.htm.
A dietitian may also recommend this type of diet for people who have already developed kidney disease. A diet low in sodium and liquid intake can help reduce edema and lower blood pressure. Reducing saturated fat and cholesterol can help control high levels of lipids, or fats, in the blood.
Health care providers may recommend that people with kidney disease eat moderate or reduced amounts of protein, though the benefits of reducing protein in a persons diet is still being researched. Proteins break down into waste products that the kidneys filter from the blood. Eating more protein than the body needs may burden the kidneys and cause kidney function to decline faster. However, protein intake that is too low may lead to malnutrition, a condition that occurs when the body does not get enough nutrients. People with kidney disease who are on a restricted protein diet should be monitored with blood tests that can show low nutrient levels.
In addition, consuming too much alcohol raises blood pressure, so people should limit alcoholic drinkstwo per day for men and one per day for women.
A health care provider can help people change their diet to meet their individual needs.
Physical Activity
Regular physical activity can lower blood pressure and reduce the chances of other health problems. A health care provider can provide information about how much and what kinds of activity are safe. Most people should try to get at least 30 to 60 minutes of activity most or all days of the week. A person can do all physical activity at once or break up activities into shorter periods of at least 10 minutes each. Moderate activities include brisk walking, dancing, bowling, riding a bike, working in a garden, and cleaning the house.
Body Weight
People who are overweight or obese should aim to reduce their weight by 7 to 10 percent during the first year of treatment for high blood pressure. This amount of weight loss can lower the chance of health problems related to high blood pressure. Overweight is defined as a body mass index (BMI)a measurement of weight in relation to heightof 25 to 29. A BMI of 30 or higher is considered obese. A BMI lower than 25 is the goal for keeping blood pressure under control.5
Smoking
People who smoke should quit. Smoking can damage blood vessels, raise the chance of high blood pressure, and worsen health problems related to high blood pressure. People with high blood pressure should talk with their health care provider about programs and products they can use to quit smoking.
Stress
Learning how to manage stress, relax, and cope with problems can improve emotional and physical health. Some activities that may help reduce stress include
- exercising - practicing yoga or tai chi - listening to music - focusing on something calm or peaceful - meditating |
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| What to do for High Blood Pressure and Kidney Disease ? | - Blood pressure is the force of blood pushing against blood vessel walls as the heart pumps out blood, and high blood pressure, also called hypertension, is an increase in the amount of force that blood places on blood vessels as it moves through the body. - High blood pressure can damage blood vessels in the kidneys, reducing their ability to work properly. When the force of blood flow is high, blood vessels stretch so blood flows more easily. Eventually, this stretching scars and weakens blood vessels throughout the body, including those in the kidneys. - High blood pressure is the second leading cause of kidney failure in the United States after diabetes. - A health care provider diagnoses high blood pressure when multiple blood pressure testsoften repeated over several visits to a health care providers officeshow that a systolic blood pressure is consistently above 140 or a diastolic blood pressure is consistently above 90. - Kidney disease is diagnosed with urine and blood tests. - The best way to slow or prevent kidney damage from high blood pressure is to take steps to lower blood pressure. These steps include a combination of medication and lifestyle changes, such as - healthy eating - physical activity - maintaining a healthy weight - quitting smoking - managing stress - No matter what the cause of the kidney disease, high blood pressure can increase damage to the kidneys. People with kidney disease should keep their blood pressure below 140/90. |
Hemochromatosis is a disorder in which extra iron builds up in the body to harmful levels. Without treatment, hemochromatosis can cause iron overload, a buildup of iron that can damage many parts of the body, including your liver, heart, pancreas, endocrine glands, and joints. With the buildup of harmful levels of iron, hemochromatosis can cause symptoms including feeling tired or weak, pain in the joints, loss of interest in sex or erectile dysfunction, pain in the abdomen over the liver, and darkening of skin color. Gene mutations cause the most common type of hemochromatosis. Doctors diagnose hemochromatosis based on blood tests to check levels of iron and certain proteins in the blood and to check for gene mutations that commonly cause hemochromatosis. In some cases, doctors may also use a liver biopsy to confirm iron overload is present. Treatment of hemochromatosis can improve symptoms and prevent complications. In most cases, doctors treat hemochromatosis with phlebotomy, or drawing about a pint of blood at a time, on a regular schedule. This is the most direct and safe way to lower body stores of iron. If you have hemochromatosis, you should eat a healthy, well-balanced diet. Your doctor may recommend avoiding raw shellfish, avoiding iron and vitamin C supplements, and limiting alcohol. If you have cirrhosis, you should completely stop drinking alcohol. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. Liver Disease Health Topics See more about liver diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Adrian M. Di Bisceglie, M.D., Saint Louis University School of Medicine
The NIDDK would like to thank:
Adrian M. Di Bisceglie, M.D., Saint Louis University School of Medicine
| What is (are) Hemochromatosis ? | Hemochromatosis is the most common form of iron overload disease. Too much iron in the body causes hemochromatosis. Iron is important because it is part of hemoglobin, a molecule in the blood that transports oxygen from the lungs to all body tissues. However, too much iron in the body leads to iron overloada buildup of extra iron that, without treatment, can damage organs such as the liver, heart, and pancreas; endocrine glands; and joints.
The three types of hemochromatosis are primary hemochromatosis, also called hereditary hemochromatosis; secondary hemochromatosis; and neonatal hemochromatosis. |
Hemochromatosis is a disorder in which extra iron builds up in the body to harmful levels. Without treatment, hemochromatosis can cause iron overload, a buildup of iron that can damage many parts of the body, including your liver, heart, pancreas, endocrine glands, and joints. With the buildup of harmful levels of iron, hemochromatosis can cause symptoms including feeling tired or weak, pain in the joints, loss of interest in sex or erectile dysfunction, pain in the abdomen over the liver, and darkening of skin color. Gene mutations cause the most common type of hemochromatosis. Doctors diagnose hemochromatosis based on blood tests to check levels of iron and certain proteins in the blood and to check for gene mutations that commonly cause hemochromatosis. In some cases, doctors may also use a liver biopsy to confirm iron overload is present. Treatment of hemochromatosis can improve symptoms and prevent complications. In most cases, doctors treat hemochromatosis with phlebotomy, or drawing about a pint of blood at a time, on a regular schedule. This is the most direct and safe way to lower body stores of iron. If you have hemochromatosis, you should eat a healthy, well-balanced diet. Your doctor may recommend avoiding raw shellfish, avoiding iron and vitamin C supplements, and limiting alcohol. If you have cirrhosis, you should completely stop drinking alcohol. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. Liver Disease Health Topics See more about liver diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Adrian M. Di Bisceglie, M.D., Saint Louis University School of Medicine
The NIDDK would like to thank:
Adrian M. Di Bisceglie, M.D., Saint Louis University School of Medicine
| What causes Hemochromatosis ? | Primary Hemochromatosis
Inherited genetic defects cause primary hemochromatosis, and mutations in the HFE gene are associated with up to 90 percent of cases.1 The HFE gene helps regulate the amount of iron absorbed from food. The two known mutations of HFE are C282Y and H63D. C282Y defects are the most common cause of primary hemochromatosis.
People inherit two copies of the HFE geneone copy from each parent. Most people who inherit two copies of the HFE gene with the C282Y defect will have higher-than-average iron absorption. However, not all of these people will develop health problems associated with hemochromatosis. One recent study found that 31 percent of people with two copies of the C282Y defect developed health problems by their early fifties.2 Men who develop health problems from HFE defects typically develop them after age 40.1 Women who develop health problems from HFE defects typically develop them after menopause.1
People who inherit two H63D defects or one C282Y and one H63D defect may have higher-than-average iron absorption.3 However, they are unlikely to develop iron overload and organ damage.
Rare defects in other genes may also cause primary hemochromatosis. Mutations in the hemojuvelin or hepcidin genes cause juvenile hemochromatosis, a type of primary hemochromatosis. People with juvenile hemochromatosis typically develop severe iron overload and liver and heart damage between ages 15 and 30.
Secondary Hemochromatosis
Hemochromatosis that is not inherited is called secondary hemochromatosis. The most common cause of secondary hemochromatosis is frequent blood transfusions in people with severe anemia. Anemia is a condition in which red blood cells are fewer or smaller than normal, which means they carry less oxygen to the bodys cells. Types of anemia that may require frequent blood transfusions include
- congenital, or inherited, anemias such as sickle cell disease, thalassemia, and Fanconis syndrome - severe acquired anemias, which are not inherited, such as aplastic anemia and autoimmune hemolytic anemia
Liver diseasessuch as alcoholic liver disease, nonalcoholic steatohepatitis, and chronic hepatitis C infectionmay cause mild iron overload. However, this iron overload causes much less liver damage than the underlying liver disease causes.
Neonatal Hemochromatosis
Neonatal hemochromatosis is a rare disease characterized by liver failure and death in fetuses and newborns. Researchers are studying the causes of neonatal hemochromatosis and believe more than one factor may lead to the disease.
Experts previously considered neonatal hemochromatosis a type of primary hemochromatosis. However, recent studies suggest genetic defects that increase iron absorption do not cause this disease. Instead, the mothers immune system may produce antibodiesproteins made by the immune system to protect the body from foreign substances such as bacteria or virusesthat damage the liver of the fetus. Women who have had one child with neonatal hemochromatosis are at risk for having more children with the disease.4 Treating these women during pregnancy with intravenous (IV) immunoglobulina solution of antibodies from healthy peoplecan prevent fetal liver damage.4
Researchers supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recently found that a combination of exchange transfusionremoving blood and replacing it with donor bloodand IV immunoglobulin is an effective treatment for babies born with neonatal hemochromatosis.5 |
Hemochromatosis is a disorder in which extra iron builds up in the body to harmful levels. Without treatment, hemochromatosis can cause iron overload, a buildup of iron that can damage many parts of the body, including your liver, heart, pancreas, endocrine glands, and joints. With the buildup of harmful levels of iron, hemochromatosis can cause symptoms including feeling tired or weak, pain in the joints, loss of interest in sex or erectile dysfunction, pain in the abdomen over the liver, and darkening of skin color. Gene mutations cause the most common type of hemochromatosis. Doctors diagnose hemochromatosis based on blood tests to check levels of iron and certain proteins in the blood and to check for gene mutations that commonly cause hemochromatosis. In some cases, doctors may also use a liver biopsy to confirm iron overload is present. Treatment of hemochromatosis can improve symptoms and prevent complications. In most cases, doctors treat hemochromatosis with phlebotomy, or drawing about a pint of blood at a time, on a regular schedule. This is the most direct and safe way to lower body stores of iron. If you have hemochromatosis, you should eat a healthy, well-balanced diet. Your doctor may recommend avoiding raw shellfish, avoiding iron and vitamin C supplements, and limiting alcohol. If you have cirrhosis, you should completely stop drinking alcohol. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. Liver Disease Health Topics See more about liver diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Adrian M. Di Bisceglie, M.D., Saint Louis University School of Medicine
The NIDDK would like to thank:
Adrian M. Di Bisceglie, M.D., Saint Louis University School of Medicine
| What are the symptoms of Hemochromatosis ? | A person with hemochromatosis may notice one or more of the following symptoms:
- joint pain - fatigue, or feeling tired - unexplained weight loss - abnormal bronze or gray skin color - abdominal pain - loss of sex drive
Not everyone with hemochromatosis will develop these symptoms. |
Hemochromatosis is a disorder in which extra iron builds up in the body to harmful levels. Without treatment, hemochromatosis can cause iron overload, a buildup of iron that can damage many parts of the body, including your liver, heart, pancreas, endocrine glands, and joints. With the buildup of harmful levels of iron, hemochromatosis can cause symptoms including feeling tired or weak, pain in the joints, loss of interest in sex or erectile dysfunction, pain in the abdomen over the liver, and darkening of skin color. Gene mutations cause the most common type of hemochromatosis. Doctors diagnose hemochromatosis based on blood tests to check levels of iron and certain proteins in the blood and to check for gene mutations that commonly cause hemochromatosis. In some cases, doctors may also use a liver biopsy to confirm iron overload is present. Treatment of hemochromatosis can improve symptoms and prevent complications. In most cases, doctors treat hemochromatosis with phlebotomy, or drawing about a pint of blood at a time, on a regular schedule. This is the most direct and safe way to lower body stores of iron. If you have hemochromatosis, you should eat a healthy, well-balanced diet. Your doctor may recommend avoiding raw shellfish, avoiding iron and vitamin C supplements, and limiting alcohol. If you have cirrhosis, you should completely stop drinking alcohol. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. Liver Disease Health Topics See more about liver diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Adrian M. Di Bisceglie, M.D., Saint Louis University School of Medicine
The NIDDK would like to thank:
Adrian M. Di Bisceglie, M.D., Saint Louis University School of Medicine
| What are the complications of Hemochromatosis ? | Without treatment, iron may build up in the organs and cause complications, including
- cirrhosis, or scarring of liver tissue - diabetes - irregular heart rhythms or weakening of the heart muscle - arthritis - erectile dysfunction
The complication most often associated with hemochromatosis is liver damage. Iron buildup in the liver causes cirrhosis, which increases the chance of developing liver cancer.
For some people, complications may be the first sign of hemochromatosis. However, not everyone with hemochromatosis will develop complications. |
Hemochromatosis is a disorder in which extra iron builds up in the body to harmful levels. Without treatment, hemochromatosis can cause iron overload, a buildup of iron that can damage many parts of the body, including your liver, heart, pancreas, endocrine glands, and joints. With the buildup of harmful levels of iron, hemochromatosis can cause symptoms including feeling tired or weak, pain in the joints, loss of interest in sex or erectile dysfunction, pain in the abdomen over the liver, and darkening of skin color. Gene mutations cause the most common type of hemochromatosis. Doctors diagnose hemochromatosis based on blood tests to check levels of iron and certain proteins in the blood and to check for gene mutations that commonly cause hemochromatosis. In some cases, doctors may also use a liver biopsy to confirm iron overload is present. Treatment of hemochromatosis can improve symptoms and prevent complications. In most cases, doctors treat hemochromatosis with phlebotomy, or drawing about a pint of blood at a time, on a regular schedule. This is the most direct and safe way to lower body stores of iron. If you have hemochromatosis, you should eat a healthy, well-balanced diet. Your doctor may recommend avoiding raw shellfish, avoiding iron and vitamin C supplements, and limiting alcohol. If you have cirrhosis, you should completely stop drinking alcohol. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. Liver Disease Health Topics See more about liver diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Adrian M. Di Bisceglie, M.D., Saint Louis University School of Medicine
The NIDDK would like to thank:
Adrian M. Di Bisceglie, M.D., Saint Louis University School of Medicine
| How to diagnose Hemochromatosis ? | Health care providers use medical and family history, a physical exam, and routine blood tests to diagnose hemochromatosis or other conditions that could cause the same symptoms or complications.
- Medical and family history. Taking a medical and family history is one of the first things a health care provider may do to help diagnose hemochromatosis. The health care provider will look for clues that may indicate hemochromatosis, such as a family history of arthritis or unexplained liver disease. - Physical exam. After taking a medical history, a health care provider will perform a physical exam, which may help diagnose hemochromatosis. During a physical exam, a health care provider usually - examines a patients body - uses a stethoscope to listen to bodily sounds - taps on specific areas of the patients body - Blood tests. A blood test involves drawing blood at a health care providers office or a commercial facility and sending the sample to a lab for analysis. Blood tests can determine whether the amount of iron stored in the body is higher than normal:1 - The transferrin saturation test shows how much iron is bound to the protein that carries iron in the blood. Transferrin saturation values above or equal to 45 percent are considered abnormal. - The serum ferritin test detects the amount of ferritina protein that stores ironin the blood. Levels above 300 g/L in men and 200 g/L in women are considered abnormal. Levels above 1,000 g/L in men or women indicate a high chance of iron overload and organ damage. If either test shows higher-than-average levels of iron in the body, health care providers can order a special blood test that can detect two copies of the C282Y mutation to confirm the diagnosis. If the mutation is not present, health care providers will look for other causes. - Liver biopsy. Health care providers may perform a liver biopsy, a procedure that involves taking a piece of liver tissue for examination with a microscope for signs of damage or disease. The health care provider may ask the patient to temporarily stop taking certain medications before the liver biopsy. The health care provider may ask the patient to fast for 8 hours before the procedure. During the procedure, the patient lies on a table, right hand resting above the head. The health care provider applies a local anesthetic to the area where he or she will insert the biopsy needle. If needed, a health care provider will also give sedatives and pain medication. The health care provider uses a needle to take a small piece of liver tissue. He or she may use ultrasound, computerized tomography scans, or other imaging techniques to guide the needle. After the biopsy, the patient must lie on the right side for up to 2 hours and is monitored an additional 2 to 4 hours before being sent home. A health care provider performs a liver biopsy at a hospital or an outpatient center. The health care provider sends the liver sample to a pathology lab where the pathologista doctor who specializes in diagnosing diseaselooks at the tissue with a microscope and sends a report to the patients health care provider. The biopsy shows how much iron has accumulated in the liver and whether the patient has liver damage.
Hemochromatosis is rare, and health care providers may not think to test for this disease. Thus, the disease is often not diagnosed or treated. The initial symptoms can be diverse, vague, and similar to the symptoms of many other diseases. Health care providers may focus on the symptoms and complications caused by hemochromatosis rather than on the underlying iron overload. However, if a health care provider diagnoses and treats the iron overload caused by hemochromatosis before organ damage has occurred, a person can live a normal, healthy life.
Who should be tested for hemochromatosis? Experts recommend testing for hemochromatosis in people who have symptoms, complications, or a family history of the disease. Some researchers have suggested widespread screening for the C282Y mutation in the general population. However, screening is not cost-effective. Although the C282Y mutation occurs quite frequently, the disease caused by the mutation is rare, and many people with two copies of the mutation never develop iron overload or organ damage. Researchers and public health officials suggest the following: - Siblings of people who have hemochromatosis should have their blood tested to see if they have the C282Y mutation. - Parents, children, and other close relatives of people who have hemochromatosis should consider being tested. - Health care providers should consider testing people who have severe and continuing fatigue, unexplained cirrhosis, joint pain or arthritis, heart problems, erectile dysfunction, or diabetes because these health issues may result from hemochromatosis. |
Hemochromatosis is a disorder in which extra iron builds up in the body to harmful levels. Without treatment, hemochromatosis can cause iron overload, a buildup of iron that can damage many parts of the body, including your liver, heart, pancreas, endocrine glands, and joints. With the buildup of harmful levels of iron, hemochromatosis can cause symptoms including feeling tired or weak, pain in the joints, loss of interest in sex or erectile dysfunction, pain in the abdomen over the liver, and darkening of skin color. Gene mutations cause the most common type of hemochromatosis. Doctors diagnose hemochromatosis based on blood tests to check levels of iron and certain proteins in the blood and to check for gene mutations that commonly cause hemochromatosis. In some cases, doctors may also use a liver biopsy to confirm iron overload is present. Treatment of hemochromatosis can improve symptoms and prevent complications. In most cases, doctors treat hemochromatosis with phlebotomy, or drawing about a pint of blood at a time, on a regular schedule. This is the most direct and safe way to lower body stores of iron. If you have hemochromatosis, you should eat a healthy, well-balanced diet. Your doctor may recommend avoiding raw shellfish, avoiding iron and vitamin C supplements, and limiting alcohol. If you have cirrhosis, you should completely stop drinking alcohol. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. Liver Disease Health Topics See more about liver diseases research at NIDDK.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Adrian M. Di Bisceglie, M.D., Saint Louis University School of Medicine
The NIDDK would like to thank:
Adrian M. Di Bisceglie, M.D., Saint Louis University School of Medicine
| What are the treatments for Hemochromatosis ? | Health care providers treat hemochromatosis by drawing blood. This process is called phlebotomy. Phlebotomy rids the body of extra iron. This treatment is simple, inexpensive, and safe.
Based on the severity of the iron overload, a patient will have phlebotomy to remove a pint of blood once or twice a week for several months to a year, and occasionally longer. Health care providers will test serum ferritin levels periodically to monitor iron levels. The goal is to bring serum ferritin levels to the low end of the average range and keep them there. Depending on the lab, the level is 25 to 50 g/L.
After phlebotomy reduces serum ferritin levels to the desired level, patients may need maintenance phlebotomy treatment every few months. Some patients may need phlebotomies more often. Serum ferritin tests every 6 months or once a year will help determine how often a patient should have blood drawn. Many blood donation centers provide free phlebotomy treatment for people with hemochromatosis.
Treating hemochromatosis before organs are damaged can prevent complications such as cirrhosis, heart problems, arthritis, and diabetes. Treatment cannot cure these conditions in patients who already have them at diagnosis. However, treatment will help most of these conditions improve. The treatments effectiveness depends on the degree of organ damage. For example, treating hemochromatosis can stop the progression of liver damage in its early stages and lead to a normal life expectancy. However, if a patient develops cirrhosis, his or her chance of developing liver cancer increases, even with phlebotomy treatment. Arthritis usually does not improve even after phlebotomy removes extra iron. |
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