Archive | May 2020


“Gigantism is a serious condition that is nearly always caused by an adenoma, a tumor of the pituitary gland. Gigantism occurs in patients who had excessive growth hormone in childhood. The pituitary tumor cells secrete too much growth hormone (GH), leading to many changes in the body.  Gigantism usually presents in childhood or young adulthood. If a pituitary tumor that secretes growth hormone develops after the bone growth plates fuse, the result is acromegaly.”

UCLA Health Ed.

Gigantism, also knows as Acroemegaly.


Gigantism is described as accelerated growth during childhood from the production of excess growth hormone. By definition, gigantism must occur during childhood before the growth plates in the long bones of the body (for example, the femur or humerus) have closed. In adults, the condition is called acromegaly.

Gigantism is most often caused by a benign tumor on the pituitary gland called a pituitary adenoma. However, it can also be caused by the following disorders:

  • Neurofibromatosis
  • McCune-Albright syndrome (MAS)
  • Carney complex
  • Multiple endocrine neoplasia type 1

Sign and Symptoms of Gigantism:

  • Abnormally tall stature
  • Abnormal growth of the face, hands and feet
  • Thickened facial features
  • Irregular menstrual cycle
  • Excessive perspiration with slight activity
  • Delayed puberty
  • Double vision
  • Deafness
  • Headache

How Gigantism is Diagnosed:

Magnetic resonance imaging (MRI) is used to determine the size and location of your child’s tumor if it is suspected that the disease is caused by a pituitary adenoma.

Furthermore, several blood tests can provide a diagnosis. High levels of prolactin or increased amounts of insulin growth factor-1 (IGF-1) can suggest acromegaly, as can high levels of growth hormone in the blood after oral administration of a large dose of glucose. Low levels of cortisol, thyroid hormone, testosterone (in boys), and estradiol (in girls) can also suggest involvement of the pituitary gland.

Treatment for Gigantism:


Surgery is the best form of treatment and cures 80 percent of the cases of gigantism. Your child’s surgeon will gain access to your child’s pituitary gland using the transsphenoidal approach—so named because the route crosses, or transects, the sphenoid bone. This bone is located behind your child’s nose, mostly within their skull.

Using precise surgical instruments, the surgeon will make an incision through your child’s nasal cavity to create an opening in the sphenoid bone. Once the surgeon gains access to your child’s sphenoid sinus (the air-filled area behind the sphenoid bone), further incisions will be made until a hole is created in the sella turcica—the bone that cradles and protects the pituitary gland.

After your child’s pituitary gland is in the operative field, removal of the tumor can proceed. Your child’s surgeon will use high magnification to readily distinguish normal pituitary tissue from the tumor.

Once the tumor has been removed, your child’s surgeon will clean the tumor cavity and seal it.

At Barrow Neurological Institute at Dignity Health St. Joseph’s Hospital and Medical Center, our surgeons specialize in two types of surgery for adenomas:

  • Microsurgery uses a powerful operating microscope to help your child’s surgeon distinguish between tiny structures in and around the pituitary gland.
  • Endoscopic surgery uses small tubes and a tiny camera to help your child’s surgeon remove the tumor in small pieces.

Most patients are able to return home the day after their surgery for removal of a pituitary adenoma, and nasal packing is seldom required.

Pharmacological Treatment and Hormone Therapy

Treatment with a prescription medication is possible if surgery does not cure your child’s gigantism or if surgery is not recommended. Medicines are also sometimes prescribed before surgery to improve the likelihood of a good outcome.

  • Octreotide or lanreotide are synthetic forms of the hormone somatostatin and stop the release of growth hormone. They are often effective for the long-term control of gigantism, but they can only be administered by injection every two to four weeks. If your child’s tumor is particularly large, these drugs may be administered before surgery. Due to the side effects of these drugs and their expense, surgery to achieve a long-term cure is preferable.
  • Bromocriptine and cabergoline are from a class of drugs called dopamine agonists. They can lower IGF-1 and growth hormone levels in about half of the people treated with them (although your symptoms could improve even if your IGF-1 and growth hormone levels do not decrease). Although not as effective as the synthetic hormones octreotide and lanreotide, they are less expensive and more convenient to administer, because no injection is required. They can be combined with octreotide in children with no adverse effects on long-term health.
  • Pegvisomant is a recently developed drug that blocks the action of growth hormone in your body, thereby lowering IGF-1 levels. It must be administered by subcutaneous (beneath the skin) injection daily. It is another option if your child does not respond to surgery or other medications, or if your child cannot tolerate these treatments for other reasons.

Gamma Knife

Gamma Knife radiosurgery is a highly advanced form of radiotherapy that is used to achieve similar results to the traditional surgical techniques described above. However, with Gamma Knife it can take several years for growth hormone and levels to return to normal, rather than days or weeks as with traditional surgery. It is typically a treatment of last resort in patients with gigantism.

The ‘knife’ in this surgery is actually made up of many small beams of radiation focused on a single point. Each individual beam too weak enough to damage healthy tissue, but at the point where the beams converge they deliver a dose of radiation that is lethal to the tumor.

Gamma Knife is an outpatient procedure, does not involve any incisions, and requires only brief sedation under general anesthetic.

However, there are additional considerations for pediatric Gamma Knife surgery. These are best discussed with your child’s neurosurgeon.



34.2 million people, or 10.5% of the U.S. population, have diabetes. An estimated 26.8 million people – or 10.2% of the population – had diagnosed diabetes. Approximately 7.3 million people have diabetes but have not yet been diagnosed (2018).

Diabetes Research Institute Foundation


“Gigantism is a serious condition that is nearly always caused by an adenoma, a tumor of the pituitary gland. Gigantism occurs in patients who had excessive growth hormone in childhood. The pituitary tumor cells secrete too much growth hormone (GH), leading to many changes in the body.  Gigantism usually presents in childhood or young adulthood. If a pituitary tumor that secretes growth hormone develops after the bone growth plates fuse, the result is acromegaly.”

UCLA Health Ed.


“Insulin is a hormone made by the pancreas that allows your body to use sugar (glucose) from carbohydrates in the food that you eat for energy or to store glucose for future use. Insulin helps keeps your blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia).”

EndocrineWeb (

Simply Understanding Insulin and how people can get Diabetes!

Insulin is a hormone made by the pancreas that allows your body to use sugar (glucose) from carbohydrates in the food that you eat for energy or to store glucose for future use. Insulin helps keeps your blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia).  How it works; when the glucose gets in your body after digestion starting from eating or even if your not eating by mouth but through IV with Dextrose in it (a form of sugar) or just on a feeding tube via a nasogastric tube or gastric tube (PEG) with Dextrose or some form of sugar in it will put glucose in your blood.  When you eat or drink, much of your food is broken down into a simple sugar called “glucose.”   All 3 routes of getting nutrition can cause your glucose count in the bloodstream to go up, if some form of sugar is in the nutrition supply you get in your body for the cells in our bloodstream.  Now glucose is food to our cells but the food has to get into the cells.  For glucose to pass into our cells it needs a hormone to allow the glucose to pass in the cell to be the food for the cell.  This is where Insulin comes into play!  Insulin is released by the pancrease and put in our bloodstream to do one of its MAIN functions to allow glucose in the cell.  For without insulin what happens is the glucose just will pile up outside of the blood cells and in time cause what we call Diabetes.  Without glucose going into our cells through insulin allowing it to pass in the cells we would not have energy that helps us in doing our activities of daily living.

So in review, the amount of glucose in your bloodstream is tightly regulated by the hormone insulin. Insulin is always being released in small amounts by the pancreas but especially after eating and when digestion takes place releasing the broken down sugar to “glucose” being released into our blood. When the amount of glucose in your blood rises to a certain level, the pancreas will release more insulin to push more glucose into the cells.

Diabetes mellitus (sometimes called “sugar diabetes“) is a condition that occurs when the body can’t use glucose (a type of sugar) normally. Glucose is the main source of energy for the body’s cells. The levels of glucose in the blood are controlled by a hormone called insulin, which is made by the pancreas that it releases into the blood- stream when glucose level goes up allowing for it to be utilized by our body in allowing the glucose to transfer over the cell membranes into the cells as the main source of energy-a major form of nutrition for out cells to do its functions especially transfer oxygen throughout the body to keep our tissues healthy and alive.  Without oxygen we would have tissue and cell starvation.  Think in a diabetic when blood flow gets thick due to high glucose levels in the bloodstream making it difficult for the blood to move throughout our body to oxygenate our tissues the first place the body compensates to allow oxygenated blood by our cells to get to our vital organs like heart, lungs, brain and not areas far away from the body like feet.  That is why you commonly hear of amputations of lower legs with uncontrolled or badly controlled diabetics (arms amputated is very, very rare due to diabetes, more its due to trauma.

People with diabetes either don’t make insulin or their body’s cells are resistant to insulin, leading to high levels of sugar circulating in the blood, called simply high blood sugar. By definition, diabetes is having a blood glucose level of 126 milligrams per deciliter (mg/dL) or more after an overnight fast (not eating anything).

So ending line without Insulin no glucose, a energy nutrition for our cells. we would not get glucose inside the cells. This as a ending result would cause cellular starvation of energy resulting into death in time (much sooner than other people without this problem) unless they take their insulin!

Another function of insulin is after our body uses all the glucose it needs at that time it needs to be stored somewhere.  Insulin helps control blood glucose levels by signaling the liver and muscle and fat cells to take in glucose from the blood.  To get the glucose level in therapeutic range for the body in time.

The 2 major groups of Diabetes occurs if someone has a problem with this role function of insulin resulting in one of the following:

Type 1 Diabetes occurs because the insulin-producing cells of the pancreas (called beta cells) are destroyed by the immune system. People with type 1 diabetes produce no insulin and must use insulin injections to control their blood sugar.  This is most commonly seen in people under age 20 but may occur at any age.

Type 2 Diabetes is the most common form of diabetes, affecting almost 18 million Americans. While most of these cases can be prevented, it remains for adults the leading cause of diabetes-related complications such as blindness, non-traumatic amputations, and chronic kidney failure requiring dialysis. Type 2 diabetes usually occurs in people over age 40 who are overweight, but can occur in people who are not overweight as well.Sometimes referred to as “adult-onset diabetes,” type 2 diabetes has started to appear more often in children because of the rise in obesity in young people.

Sometimes referred to as “adult-onset diabetes,” type 2 diabetes has started to appear more often in children because of the rise in obesity in young people.

Some people can manage their type 2 diabetes by controlling their weight, watching their diet, and exercising regularly. Others may also need to take a pill that helps their body use insulin better, or take insulin injections.

Often, doctors are able to detect the likelihood of type 2 diabetes before the condition actually occurs. Commonly referred to as pre-diabetes, this condition occurs when a person’s blood sugar levels are higher than normal, but not high enough for a diagnosis of type 2 diabetes.

Know this diabetes can be hereditary as well.

Maybe you might want to get your glucose checked by your M.D. and make sure your insulin is functioning well for the side effects of uncontrolled diabetes are detrimental and could shorten your life!



“An enzyme is a biological catalyst and is almost always a protein. It speeds up the rate of a specific chemical reaction in the cell. The enzyme is not destroyed during the reaction and is used over and over. A cell contains thousands of different types of enzyme molecules, each specific to a particular chemical reaction.”
National Human Genome Research Institute

What allows vital operations to keep the body alive and working  – ENZYMEs.


                                                                                                                                      Enzymes are vital for processes to take place in our body without them they couldn’t take place.  What are enzymes exactly?   We have an many enzymes  in our body from our saliva to our pancrease.  Enzymes are specialized proteins that are produced by living cells to catalyze reactions in the body=breakdown.   Protein in the form of an enzyme acts as a catalyst.  A catalyst in action brakes down something, any chemical substance affected with the speed of reaction without being permanently altered by the reaction.  For a chemical or biochemical reaction to occur, a certain amount of energy is required=the activation energy.  Energy can be transformed from one state to another.  The role of an enzyme is to decrease the amount of energy needed to start the reaction.  Exactly how enzymes lower activation energies is not completely and fully understood but it is known that an enzyme attaches itself to one of the reacting molecules, this is called a substrate complex.  Thousands of enzymes exist but each kind can attach ONLY to one kind of substrate.  The enzyme molecule must fit exactly with the substrate molecule (just like how pieces in a jigsaw puzzle have to fit in their specific space of the picture).  Well, if the substrate and enzyme don’t perfectly match or fit properly no reaction takes place.  When they do fit perfectly the substrate molecule can react with other molecules in a synthesis reaction and when completed the enzyme is free to move on elsewhere to connect with another substrate molecule.  This whole process takes place quickly.  Clearly, enzymes are essential to the body’s overall homeostasis. (In order to lead a healthy life, we need to bring a balance in the way we lead our lifestyle.  Homeostasis is nothing but a mechanism which helps the human body maintain a balance between the internal and external environment).  Enzymes quickly perform catalyze chemical reactions and they also govern the reactions that occur.   Enzymes are named by adding the suffix “ase” to the name of their substrates.  For example there is:

The breaking down of starches = the enzyme that does this function is amylase.             (Know this about amylase, it is present in human saliva where it begins the chemical process of digestion; that starts in our mouth. Foods that contain much starch but little sugar, such as rice and potato, taste slightly sweet as they are chewed because amylase turns some of their starch into sugar in the mouth. The pancreas also makes amylase (alpha amylase) to hydrolyse dietary starch into disaccharides and trisaccharides which are converted by other enzymes to glucose to supply the body with energy.  There is even b and y amylases. Ending product on enzymes breaking down starches or carbohydrates gives us one thing only sugar.)                                                                                                                                                       The breaking down of sugars, like sucrose = the enzyme is sucrase.  The ending product of the enzyme is it breaks down complex sugars to more simple sugars in the body.                                                                                                                                                                             The breaking down of fats (lipids) = the enzyme is lipase.  Lipase perform essential roles in the digestion, transport and processing of dietary lipids in most if not all living organisms (example (triglycerides, fats, oils).Most lipases act at a specific position on glycerol backbone of lipid substrate (A1,A2 or A3 in the small intestines).  For example, human pancreatic lipase (HPL) is the main enzyme that breaks down dietary fats in the digestive system, converts triglyceride substrates found in ingested oils to monoglycerides and two fatty acids.  Know that glycerol is a simple sugar compound.  Enzymes deal with breaking down our foods because they take a major role in what we call the process digestion in the human body but notice what the ending result is of mostly every ingredient out of 3 of our food groups, which is SUGAR.  It’s because of the food already having some sugar in it but more importantly also the chemical reaction with the enzyme to allow the food to break down into smaller compounds to be utilized in the body=simpler sugar compounds which also plays a part in the entire digestion process.


So know sugar in the body is our fuel for energy but with our digestion process, in how it works is like this:  when the body gets a meal within 1 hour digestion starts in the stomach and complete in 6 to 8 hours depending on how large the meal is, especially if 3 large meals a day.  The foods if contain starches, fat, lipids they all break down to simple sugars that transfer to the bloodstream and whatever energy the body needs at that point the tissues with cells utilize it but when enough sugar is used and we have excess in the blood we than have the body store the extra sugar that first converts the glucose (active sugar) to glycogen (inactive sugar) in our liver.  The liver is only so big and when it reaches its optimal level of storage than the sugar gets stored in our fat tissue = WEIGHT GAIN.  This is the problem with people in America not understanding this process.  Plus as most people get older from 30 than to 40 years old and every 10 years after that till heaven we put cellulite on the body for 2 major reasons not eating as healthy due to the bikini and speedo fit not being the priority in life but getting the feet up after a hard day’s work is.  The other reason is we aren’t as active as when we were 20 or 30 years old and the metabolism naturally slows down unless you’re a Jack la Lanne.


How do we deal with this to prevent obesity?  Do what I did go on a 4-6 small meal/health snack diet.  Eat a meal every 3 hours with keeping fat, calories/sugar, carbohydrates in proper proportions to prevent excess sugar in the meals to not allow fat storage=weight gain.  Of course some exercise or activity daily or every other day helps tone the muscle and not let it flab due to cellulite.  Live healthier habits of living not just a month, 3 months or 6 months but make it your daily routine with treating yourself to foods you don’t eat daily to maintain a good weight and increase your health status to allow you to live a happier, longer and more exciting life.

Let’s not forget with enzymes they also break proteins down in our body:                                                                                                                                                                               The breaking down of proteins=Trypsin Proteins are large biological molecules consisting of one or more chains of amino acids.  Proteins perform a vast array of functions within living organisms, including catalyzing metabolic reactions, replicating DNA, responding to stimuli, and transporting molecules from one location to another.  Trypsin is a enzyme catalyst, which allows the catalysis of chemical reactions.   The ending product of the break down is amino acids not sugar.  Know high on a protein diet continuously for years can hurt the body also.


Enzymes deal with breaking down our foods because they take a major role in what we call the process digestion in the human body.  but notice what the ending result is of mostly every ingredient in our 4 food groups is; SUGAR.  It because of the food has some sugar in it but also the chemical reaction with the enzyme to allow the food to break down into smaller compounds to be utilized in the body with send through the entire digestion process.


There are risks with eating just high protein diets for long periods of time.  You put yourself at risk for:  Osteoporosis:  Research shows that women who eat high protein diets based on meat have a higher rate of bone density loss than those who don’t. Women who eat meat lose an average of 35% of their bone density by age 65, while women who don’t eat meat lose an average of 18%. In the long run, bone density loss leads to osteoporosis.

Kidneys:  A high protein diet puts strain on the kidneys.  It is well known that patients with kidney problems suffer from eating a high protein diet which is due to the high amino acids levels.                         A high-protein diet may worsen kidney function in people with kidney disease because your body may have trouble eliminating all the waste products of protein metabolism.

However, the risks of using a high-protein diet with carbohydrate restriction for the long term are still being studied. Several health problems may result if a high-protein diet is followed for an extended time:

Some high-protein diets restrict carbohydrate intake so much that they can result in nutritional deficiencies or insufficient fiber, which can cause health problems such as constipation and diverticulitis.

Some high-protein diets promote foods such as red meat and full-fat dairy products, which may increase your risk of heart disease.

If you want to follow a high-protein diet, do so only as a short-term weight-loss aid.  Also, choose your protein wisely. Good choices include fish, skinless chicken, lean beef, pork and low-fat dairy products. Choose carbs that are high in fiber, such as whole grains and nutrient-dense vegetables and fruit.

It’s always a good idea to talk with your doctor before starting a weight-loss diet. And that’s especially important in this case if you have kidney disease, diabetes or other chronic health condition.

So if you want to continue on high protein diets longer than 6 months know how to alkalize the body chemicals to decrease the proteins and there are supplements that can do that via the pharmacy or look up even online.

Before changing your always do a diet check with your doctor to make sure its cleared ok by the doctor since he knows your entire medical history.


“Information from the ongoing COVID-19 pandemic suggests that this virus is spreading more efficiently than influenza, but not as efficiently as measles, which is highly contagious.”


COVID-19 and where we are at; including other pandemics in history!

Global coronavirus epidemic outbreak concept – 3D illustration

Coronavirus Cases:






Now Let Us Look At 1918-1919 H1N1 Swyne Flu statistics

CDC states: “The 1918 influenza pandemic was the most severe pandemic in recent history. It was caused by an H1N1 virus with genes of avian origin. Although there is not universal consensus regarding where the virus originated, it spread worldwide during 1918-1919. In the United States, it was first identified in military personnel in spring 1918. It is estimated that about 500 million people or one-third of the world’s population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States.”

So H1N1 affected 500 million people  1/3 of the world at that time.

H1N1 by 1918 killed 50 million deaths.

Covid-19 is not even close in numbers.  No comparison and there was a lock down 6 weeks in the US for H1N1 1918 to 1919. 

The 100-year anniversary of the 1918 pandemic and the 10-year anniversary of the 2009 H1N1 pandemic are milestones that provide an opportunity to reflect on the groundbreaking work that led to the discovery, sequencing and reconstruction of the 1918 pandemic flu virus. This collaborative effort advanced understanding of the deadliest flu pandemic in modern history and has helped the global public health community prepare for contemporary pandemics, such as 2009 H1N1, as well as future pandemic threats. ”

By the numbers of both pandemics this is shown to be true (Covid -19 compared to our deadliest pandemic 1918-1919 Swine Flu=The Spanish Flu doesn’t even come close in numbers of how many affected and killed).

Covid over 500,000 affected and H1N1  over 5,000,000. See the difference and we will get through this.

H1N1 in 2009-2010:

“From April 12, 2009 to April 10, 2010, CDC estimated there were 60.8 million cases (range: 43.3-89.3 million), 274,304 hospitalizations (range: 195,086-402,719), and 12,469 deaths (range: 8868-18,306) in the United States due to the (H1N1)pdm09 virus.”.
Ending line, history does repeat itself and there have been pandemics worse, similar, or less but significant in count to be called a pandemic.
We needed to lock down but now we are ready to reopen.   God willing it stays that way and by history pandemics the research on Covid-19 will get better in treating and being prepared for this.  Also, our economy will get better in time.