Functional hypothalamic amenorrhea (FHA) occurs when the hypothalamic-pituitary-ovarian sequence is suppressed due to an energy deficit usually caused by stress, weight loss, excessive exercise and disordered eating, leading to hypogonadism. The diagnosis is of exclusion, and a clinical examination with complementary blood and imaging tests must be performed. Treatment aims to correct the causes, guide adequate nutrition and physical activity. The combined estrogen can be used to restore menstrual cycles and preserve bone mass. We present the case of a 21-year-old patient with primary amenorrhea and hypogonadotropic hypogonadism, with a history of stress linked to low self-esteem, intense ballet activity during puberty and rigidity in eating. Physical examination showed complete pubertal development and low body mass index (16.9 kg/m2). Decreased serum levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH), and normal levels of prolactin (PRL), thyroid stimulating hormone (TSH). Bone densitometry showed osteoporosis of the femur and lumbar spine. After weight restoration, physical activity monitored by a professional, and prescription and combined oral hormone therapy, the patient started menstrual cycles.
Autoimmune polyglandular syndromes (APSS) are associations of two or more endocrine diseases of autoimmune origin that affect between 5-10% of the population. The grouping of these diseases depends on genetic and environmental factors, their different presentations allow the distinction of the subtypes of APS. The objective is to report the case of a patient with type III A polyglandular autoimmune syndrome, characterized by Hashimoto's thyroiditis and type 1 diabetes mellitus associated with hyperprolactinemia and Gilbert's syndrome. The patient began to show the symptoms of the syndrome at the age of 10 progressively. The treatment of each disease is being carried out, with no specific treatment for the syndrome in the literature.
Objective: The present study aimed to evaluate and compare the effects of intermittent fasting, low carb and hypocaloric diets on weight control, lean and lipid mass and lipid and glycemic profiles in obese volunteers. Methods: This is a randomized clinical trial in which the sample consisted of a 30 individuals group, of both sexes, aged between 18 and 40 years with Body Mass Index (BMI) > 25 kg/m² and with similar organic conditions in which they were divided into 3 groups and submitted to the above mentioned diets for 30 days. Results: The results revealed by anthropometry, bioimpedance and laboratory tests show that when the values in the groups are compared separately, we have significant variables. Conclusion: Thus, the hypocaloric diet showed better results, mainly in weight and BMI (body mass index), which helps to control possible patient comorbidities. And in relation to laboratory tests, the Low carb diet and intermittent fasting had good results with reduced levels of blood glucose, total cholesterol, triglycerides, High-density lipoprotein (HDL), Low-density lipoprotein (LDL) and Very low-density lipoprotein (VLDL).
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