bowang0911/MedQuAD huggingface dataset:
Your nervous system carries signals between your brain and other parts of your body through your spinal cord. Nerves are bundles of special tissues that transmit these signals.
                
The signals share information between your brain and body about how things feel. The signals also send information between your brain and body to control automatic body functions, such as breathing and digestion, and to move your body parts.
                
The nerves in your spinal cord branch out to all of your organs and body parts. All your nerves together make up your nervous system.
                
Your nervous system is composed of the
                
- central nervous systemyour brain and spinal cord  - cranial* nervesnerves that connect your brain to your head, neck, and face  - peripheral nervous systemnerves that connect your spinal cord to your entire body, including your organs and your arms, hands, legs, and feet
                
*See the Pronunciation Guide for tips on how to say the the words in bold type.
The treatment for nerve damage from diabetes is based on your symptoms. No treatment can reverse nerve damage; however, it can help you feel better. Your doctor might suggest taking low doses of medicines that both treat other health problems and help the pain of neuropathy. Some of these medicines include
                
- antidepressants  - anticonvulsants, or anti-seizure medicines
                
Other treatment options include
                
- creams or patches on your skin for burning pain  - over-the-counter pain medicines  - acupuncture, a form of pain treatment that uses needles inserted into your body at certain pressure points  - physical therapy, which helps with muscle weakness and loss of balance  - relaxation exercises, such as yoga  - special shoes to fit softly around sore feet or feet that have changed shape
                
Your doctor also can prescribe medicines to help with problems caused by nerve damage in other areas of your body, such as poor digestion, dizziness, sexual problems, and lack of bladder control.
                
Stopping smoking and drinking alcoholic beverages also may help with symptoms.
You can keep your nervous system healthy by taking these steps:
                
- Eat healthy meals and follow the meal plan that you and your doctor or dietitian have worked out.  - If you drink alcoholic beverages, limit your intake to no more than one drink per day for women and two drinks per day for men. Drinking too many alcoholic beverages can make nerve damage worse.
                
More information is provided in the NIDDK health topic, What I need to know about Eating and Diabetes.
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.
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.
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.
Iron is an essential nutrient found in many foods. Healthy people usually absorb less than 10 percent of iron in the food they eat.6 People with hemochromatosis absorb up to 30 percent of that iron.6 People with hemochromatosis can help prevent iron overload by
                
- eating only moderate amounts of iron-rich foods, such as red meat and organ meat  - avoiding supplements that contain iron  - avoiding supplements that contain vitamin C, which increases iron absorption
                
People with hemochromatosis can take steps to help prevent liver damage, including
                
- limiting the amount of alcoholic beverages they drink because alcohol increases their chance of cirrhosis and liver cancer  - avoiding alcoholic beverages entirely if they already have cirrhosis
- Hemochromatosis is the most common form of iron overload disease. Too much iron in the body causes hemochromatosis.  - Inherited genetic defects cause primary hemochromatosis.  - Primary hemochromatosis mainly affects Caucasians of Northern European descent.  - 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; and loss of sex drive. Not everyone with hemochromatosis will develop these symptoms.  - Without treatment, iron may build up in the organs and cause complications, including cirrhosis, diabetes, irregular heart rhythms or weakening of the heart muscle, arthritis, and erectile dysfunction.  - 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.  - Experts recommend testing for hemochromatosis in people who have symptoms, complications, or a family history of the disease.  - Health care providers treat hemochromatosis by drawing blood. This process is called phlebotomy.
Adrenal insufficiency is an endocrine, or hormonal, disorder that occurs when the adrenal glands do not produce enough of certain hormones. The adrenal glands are located just above the kidneys.
                
Adrenal insufficiency can be primary or secondary. Addisons disease, the common term for primary adrenal insufficiency, occurs when the adrenal glands are damaged and cannot produce enough of the adrenal hormone cortisol. The adrenal hormone aldosterone may also be lacking. Addisons disease affects 110 to 144 of every 1 million people in developed countries.1
                
Secondary adrenal insufficiency occurs when the pituitary glanda pea-sized gland at the base of the brainfails to produce enough adrenocorticotropin (ACTH), a hormone that stimulates the adrenal glands to produce the hormone cortisol. If ACTH output is too low, cortisol production drops. Eventually, the adrenal glands can shrink due to lack of ACTH stimulation. Secondary adrenal insufficiency is much more common than Addisons disease.
                

                
1
Adrenal Insufficiency
                
The most common symptoms of adrenal insufficiency are
                
- chronic, or long lasting, fatigue   - muscle weakness   - loss of appetite   - weight loss   - abdominal pain
                
Other symptoms of adrenal insufficiency can include
                
- nausea   - vomiting   - diarrhea   - low blood pressure that drops further when a person stands up, causing dizziness or fainting   - irritability and depression   - craving salty foods   - hypoglycemia, or low blood sugar   - headache   - sweating   - irregular or absent menstrual periods   - in women, loss of interest in sex
                
Hyperpigmentation, or darkening of the skin, can occur in Addisons disease, although not in secondary adrenal insufficiency. This darkening is most visible on scars; skin folds; pressure points such as the elbows, knees, knuckles, and toes; lips; and mucous membranes such as the lining of the cheek.
                
The slowly progressing symptoms of adrenal insufficiency are often ignored until a stressful event, such as surgery, a severe injury, an illness, or pregnancy, causes them to worsen.
                
Adrenal Crisis
                
Sudden, severe worsening of adrenal insufficiency symptoms is called adrenal crisis. If the person has Addisons disease, this worsening can also be called an Addisonian crisis. In most cases, symptoms of adrenal insufficiency become serious enough that people seek medical treatment before an adrenal crisis occurs. However, sometimes symptoms appear for the first time during an adrenal crisis.
                
Symptoms of adrenal crisis include
                
- sudden, severe pain in the lower back, abdomen, or legs   - severe vomiting and diarrhea   - dehydration   - low blood pressure   - loss of consciousness
                
If not treated, an adrenal crisis can cause death.
                

                
Get Treatment for Adrenal Crisis Right Away   People with adrenal insufficiency who have weakness, nausea, or vomiting need immediate emergency treatment to prevent an adrenal crisis and possible death. An injection with a synthetic glucocorticoid hormone called a corticosteroid can save a persons life. People should make sure to have a corticosteroid injection with them at all times, and make sure their friends and family know how and when to give the injection.   Read more under How is adrenal insufficiency treated?
People with adrenal insufficiency who have weakness, nausea, or vomiting need immediate emergency treatment to prevent an adrenal crisis and possible death. An injection with a synthetic glucocorticoid hormone called a corticosteroid can save a persons life. People should make sure to have a corticosteroid injection with them at all times, and make sure their friends and family know how and when to give the injection.
                
Read more under How is adrenal insufficiency treated?
A lack of CRH or ACTH causes secondary adrenal insufficiency. The lack of these hormones in the body can be traced to several possible sources.
                
Stoppage of Corticosteroid Medication
                
A temporary form of secondary adrenal insufficiency may occur when a person who has been taking a synthetic glucocorticoid hormone, called a corticosteroid, for a long time stops taking the medication. Corticosteroids are often prescribed to treat inflammatory illnesses such as rheumatoid arthritis, asthma, and ulcerative colitis. In this case, the prescription doses often cause higher levels than those normally achieved by the glucocorticoid hormones created by the body. When a person takes corticosteroids for prolonged periods, the adrenal glands produce less of their natural hormones. Once the prescription doses of corticosteroid are stopped, the adrenal glands may be slow to restart their production of the bodys glucocorticoids. To give the adrenal glands time to regain function and prevent adrenal insufficiency, prescription corticosteroid doses should be reduced gradually over a period of weeks or even months. Even with gradual reduction, the adrenal glands might not begin to function normally for some time, so a person who has recently stopped taking prescription corticosteroids should be watched carefully for symptoms of secondary adrenal insufficiency.
                
Surgical Removal of Pituitary Tumors
                
Another cause of secondary adrenal insufficiency is surgical removal of the usually noncancerous, ACTH-producing tumors of the pituitary gland that cause Cushings syndrome. Cushings syndrome is a hormonal disorder caused by prolonged exposure of the bodys tissues to high levels of the hormone cortisol. When the tumors are removed, the source of extra ACTH is suddenly gone and a replacement hormone must be taken until the bodys adrenal glands are able to resume their normal production of cortisol. The adrenal glands might not begin to function normally for some time, so a person who has had an ACTH-producing tumor removed and is going off of his or her prescription corticosteroid replacement hormone should be watched carefully for symptoms of adrenal insufficiency.
                
More information is provided in the NIDDK health topic, Cushings Syndrome.
                
Changes in the Pituitary Gland
                
Less commonly, secondary adrenal insufficiency occurs when the pituitary gland either decreases in size or stops producing ACTH. These events can result from
                
- tumors or an infection in the pituitary   - loss of blood flow to the pituitary   - radiation for the treatment of pituitary or nearby tumors   - surgical removal of parts of the hypothalamus   - surgical removal of the pituitary
Adrenal insufficiency is treated by replacing, or substituting, the hormones that the adrenal glands are not making. The dose of each medication is adjusted to meet the needs of the patient.
                
Cortisol is replaced with a corticosteroid, such as hydrocortisone, prednisone, or dexamethasone, taken orally one to three times each day, depending on which medication is chosen.
                
If aldosterone is also deficient, it is replaced with oral doses of a mineralocorticoid hormone, called fludrocortisone acetate (Florinef), taken once or twice daily. People with secondary adrenal insufficiency normally maintain aldosterone production, so they do not require aldosterone replacement therapy.
                
During adrenal crisis, low blood pressure, low blood glucose, low blood sodium, and high blood levels of potassium can be life threatening. Standard therapy involves immediate IV injections of corticosteroids and large volumes of IV saline solution with dextrose, a type of sugar. This treatment usually brings rapid improvement. When the patient can take liquids and medications by mouth, the amount of corticosteroids is decreased until a dose that maintains normal hormone levels is reached. If aldosterone is deficient, the person will need to regularly take oral doses of fludrocortisone acetate.
                
Researchers have found that using replacement therapy for DHEA in adolescent girls who have secondary adrenal insufficiency and low levels of DHEA can improve pubic hair development and psychological stress. Further studies are needed before routine supplementation recommendations can be made.
Adrenal crisis is treated with adrenal hormones. People with adrenal crisis need immediate treatment. Any delay can cause death. When people with adrenal crisis are vomiting or unconscious and cannot take their medication, the hormones can be given as an injection.
                
A person with adrenal insufficiency should carry a corticosteroid injection at all times and make sure that others know how and when to administer the injection, in case the person becomes unconscious.
                
The dose of corticosteroid needed may vary with a persons age or size. For example, a child younger than 2 years of age can receive 25 milligrams (mg), a child between 2 and 8 years of age can receive 50 mg, and a child older than 8 years should receive the adult dose of 100 mg.
The following steps can help a person prevent adrenal crisis:
                
- Ask a health care provider about possibly having a shortage of adrenal hormones, if always feeling tired, weak, or losing weight.   - Learn how to increase the dose of corticosteroid for adrenal insufficiency when ill. Ask a health care provider for written instructions for sick days. First discuss the decision to increase the dose with the health care provider when ill.   - When very ill, especially if vomiting and not able to take pills, seek emergency medical care immediately.
Some people with Addisons disease who are aldosterone deficient can benefit from following a diet rich in sodium. A health care provider or a dietitian can give specific recommendations on appropriate sodium sources and daily sodium guidelines if necessary.
                
Corticosteroid treatment is linked to an increased risk of osteoporosisa condition in which the bones become less dense and more likely to fracture. People who take corticosteroids should protect their bone health by consuming enough dietary calcium and vitamin D. A health care provider or a dietitian can give specific recommendations on appropriate daily calcium intake based upon age and suggest the best types of calcium supplements, if necessary.
- Adrenal insufficiency is an endocrine, or hormonal, disorder that occurs when the adrenal glands do not produce enough of certain hormones.   - Addisons disease, the common term for primary adrenal insufficiency, occurs when the adrenal glands are damaged and cannot produce enough of the adrenal hormone cortisol. The adrenal hormone aldosterone may also be lacking.   - Secondary adrenal insufficiency occurs when the pituitary gland fails to produce enough adrenocorticotropin (ACTH), a hormone that stimulates the adrenal glands to produce cortisol. If ACTH output is too low, cortisol production drops.   - The most common symptoms of adrenal insufficiency are chronic fatigue, muscle weakness, loss of appetite, weight loss, and abdominal pain. The slowly progressing symptoms are often ignored until a stressful event, such as surgery, a severe injury, an illness, or pregnancy, causes them to worsen.   - If not treated, an adrenal crisis can cause death.   - A diagnosis of adrenal insufficiency is confirmed through hormonal blood and urine tests. Imaging studies of the adrenal and pituitary glands can be useful in helping to establish the cause.   - Adrenal insufficiency is treated by replacing, or substituting, the hormones that the adrenal glands are not making.   - Problems can occur in people with adrenal insufficiency who are undergoing surgery, suffer a severe injury, have an illness, or are pregnant. These conditions place additional stress on the body, and people with adrenal insufficiency may need additional treatment to respond and recover.   - People with adrenal insufficiency should always carry identification stating their condition, adrenal insufficiency, in case of an emergency, as well as the supplies necessary to administer an emergency corticosteroid injection.
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.
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.
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.
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.