expert type icon EXPERT

Dr. Richard A. Guthrie, M.D.

Endocrinology-Diabetes

Dr. Richard Guthrie practices Endocrinology in Wichita, KS. Dr. Guthrie specializes in preventing, diagnosing, and treating diseases related to hormone imbalance, and the bodys glands in the endocrine system. Endocrinologists are trained and certified to treat a variety of conditions, including menopause, diabetes, infertility, and thyroid disorders, among many others. Dr. Guthrie examines patients, determines means of testing, diagnoses, and decides the best treatment methods.
64 years Experience
Dr. Richard A. Guthrie, M.D.
  • Mount Hope, 20
  • Univ of Mo, Columbia Sch of Med, Columbia Mo
  • Accepting new patients

What are the dangers of HGH?

There are many dangers from taking HGH when it is taken for reasons other than growth hormone deficiency. 1) It is illegal to take it for any reason other than deficiency and can READ MORE
There are many dangers from taking HGH when it is taken for reasons other than growth hormone deficiency. 1) It is illegal to take it for any reason other than deficiency and can only be given by prescription by a physician. If you take it otherwise, you & your supplier can go to jail. 2) HGH elevates blood sugar & may cause diabetes. 3) HGH has been known to cause Mad Cow Disease, though the newer synthetic forms should not do that. 4) When you take HGH and don't have a deficit, you get too much which can cause growth of organs other than bones & muscles. The heart can become enlarged, which will cause the valves to fail to close & may cause heart failure. 5) Too much HGH can cause high blood pressure and several other things, so it should not be taken just to increase height or increase muscle strength. Those who do that are trying to avoid heavy workouts to gain strength. 6) It can be tested for at events & if found, you will be disqualified & lose any winnings & may be barred for life from these activities. 7) HGH is very expensive. Good HGH costs several thousand $/yr. So, play on a level playing field. Do your work & compete fairly!!!

What is the treatment for diabetes?

Your question is hard to answer without knowing if you have Type 1 diabetes or Type 2 diabetes. The treatment is different for each. At your age, I am going to presume you have READ MORE
Your question is hard to answer without knowing if you have Type 1 diabetes or Type 2 diabetes. The treatment is different for each. At your age, I am going to presume you have Type 2 diabetes. This is usually associated with being overweight, so get your weight down. Most Type 2 diabetes can be treated with oral agents for several years. There are many drugs now to use (about 20, so I can't list all of them here). Roughly, they are divided in several groups 1) drugs that stimulate the pancreas to produce more insulin (seldom used these days), 2) drugs that make your own insulin work better (there are many of these & you have probably seen ads on TV), 3) drugs that cause your kidney to excrete sugar in the urine (on TV also), 4) drugs that work on the nucleus of the cell to make your insulin work better, 5) drugs that cause your bowel not to absorb the sugar. And there are more, but this should give you the idea. The most common drug used at least to start is a drug called metformin. This is usually used first because it is cheap, & has few side effects. The above drugs can be used in combinations of 2 or 3 or even 4 together though that is very expensive. People with Type 2 diabetes will usually need insulin after a few years, so don't be surprised if that becomes needed & don't put it off or refuse. If you have Type 1 diabetes, the main treatment is insulin by injection for life. In both diseases, diet, exercise, & lifestyle change is needed to do well. Keep your blood sugar in the normal range to stay free of complications.

Too many diabetes prescriptions?

This is not extreme for the present day. We now have about 20 drugs to treat diabetes and it's not uncommon to take 2-4 of them. They work in different ways. The Farxiga works READ MORE
This is not extreme for the present day. We now have about 20 drugs to treat diabetes and it's not uncommon to take 2-4 of them. They work in different ways. The Farxiga works by blocking the reabsorption of glucose in the kidney, so he excretes it in the urine. Victoza works in several ways 1) it stimulates the pancreas to produce more insulin, 2) it suppress the secretion of another hormone called glucagon that raises blood sugar, 3) it slows stomach emptying so the insulin can keep up with the sugar absorption.4) it affects the brain to decrease appetite. Repaglinide works like sulfofnaluria drug and is little used today because it causes wt. gain & low blood sugar. More commonly, we would use metformin in its place. It is cheaper & does not cause low blood sugar. You can certainly use these drugs together, and may need to, but that is expensive therapy. Keep his cholesterol down & his blood pressure, for elevation of these is dangerous.

What are the signs of diabetes?

Yes, that could well be diabetes. We list 3 signs as important: 1) polyuria - peeing often & a lot 2) polydipsia - increased thirst from the loss of water as urine since the kidney READ MORE
Yes, that could well be diabetes. We list 3 signs as important: 1) polyuria - peeing often & a lot 2) polydipsia - increased thirst from the loss of water as urine since the kidney is trying to get rid of the sugar & must dilute it. (The kidney can't excrete molasses, it's too thick.) 4) polyphasic - this means increased appetite since the body is excreting the sugar not burning it, so it wants more. In spite of increased intake, you may lose weight since the extra you take just goes out in the urine & is not used. Please see your doctor right away & get checked.

Is it normal to gain weight while on an insulin pump?

Yes, some weight gain is usual. Before the pump, she has not been using all her calories, but with the pump & better control she is using them and any excess is stored in the fat READ MORE
Yes, some weight gain is usual. Before the pump, she has not been using all her calories, but with the pump & better control she is using them and any excess is stored in the fat (weight gain). If she is not overweight, I wouldn't worry about it, but if she is becoming overweight for her height, then you may need to cut down on her calorie intake a little. Discuss this with your doctor & a dietician.
Good luck. I hope she likes her pump. I have worn one for 25 years & wouldn't take it off for anything. All the best.

Can my hormone levels cause headaches?

Yes they can but they are not the primary cause of severe headaches. Migraine, tension, tumors, etc. are more common. Find a headache specialist and get all of these causes checked READ MORE
Yes they can but they are not the primary cause of severe headaches. Migraine, tension, tumors, etc. are more common. Find a headache specialist and get all of these causes checked out including hormonal balance. Severe headaches are preventable in modern medicine & treatments are available if the cause is found.

Can kids be diagnosed with diabetes?

YES. Diabetes can occur at any age. People who are overweight, no matter their age, can get diabetes. This is usually Type 2 diabetes. I had a child in my practice get Type 2 diabetes READ MORE
YES. Diabetes can occur at any age. People who are overweight, no matter their age, can get diabetes. This is usually Type 2 diabetes. I had a child in my practice get Type 2 diabetes (in the past called "Adult On-set Diabetes") at age 4 yrs. So it can happen. The early stage of this is called Metabolic Syndrome and usually has no symptoms, but can cause damage. So, see a physician and ask to have him tested for diabetes & Metabolic Syndrome, then work on treating this, if present, & get his wt. under control.

How do Type 1 and Type 2 diabetes differ?

These 2 diseases are different in many ways but both have similar outcomes. Type 1 diabetes used to be called Juvenile Diabetes because it occurred primarily in children. Type READ MORE
These 2 diseases are different in many ways but both have similar outcomes.
Type 1 diabetes used to be called Juvenile Diabetes because it occurred primarily in children. Type 2 was called Adult Onset Diabetes because it occurred primarily in adults. Over the years we have come to know that this age distinction no longer applies. I was 55 yrs. old when I got Type 1 diabetes. I have had 4 yr. child in my practice with Type 2 diabetes. So what is the difference? Type 1 DM is a genetic disease with the genes carried on the area of the chromosome that controls the immune system. When activated (we don't know why or how yet) the immune system attacks the beta cells of the pancreas that make insulin & destroys them. Since the person then cannot make insulin they must take insulin by injection several times a day for the rest of their life. Type 2 diabetes is also genetic but on different chromosomes & different genes. In this disease the pancreas makes insulin, often a lot, but the body cannot use it well. This is insulin resistance. It is associated with obesity, high cholesterol, high blood pressure, etc. These people can for a while, often many years, can be treated with oral meds that either increase insulin secretion, or relieve insulin resistance, lower lipids & control blood pressure. Most of them will require insulin after 5-10 years as the pancreas wears out from overwork. Both diseases can develop complications which shows the the complications are related primarily to a high blood sugar, not their genetics. Complications can be blindness, kidney failure, foot ulcers, nerve damage, cardiac disease, strokes and more if they do not control their blood sugar. Fortunately we now have many tools to do that so we can avoid the complications.

Do diabetics need more sleep?

Yes it could for several reasons. Diabetes interfers with sleep so see a sleep specialist for tests. People with diabetes frequently also have low thyroid so get it checked. Also READ MORE
Yes it could for several reasons. Diabetes interfers with sleep so see a sleep specialist for tests. People with diabetes frequently also have low thyroid so get it checked. Also keep your blood sugars in control so your body is using the sugar for energy instead of wasting it in the urine. If you are overt. get your wt. down. See your Dr. to check these & other things.

Can hypothyroidism hair loss be reversed?

It depends on how long you have the hypo & how severe the hair loss is from the death of the hair follicles from lack of thyroid hormone. If the hypo is picked up early and treated, READ MORE
It depends on how long you have the hypo & how severe the hair loss is from the death of the hair follicles from lack of thyroid hormone. If the hypo is picked up early and treated, there may be many follicles still alive & can grow when they get enough thyroid hormone. But if picked up late, the follicles may all be dead. I don't remember a resurrection since 2000 years ago. So, get treatment early & sufficiently & the hair may come back.

Can type 1 diabetes affect my child's behavior?

Yes it is. There are several reasons for this. 1) he may be rebelling for having the disease. They go through the same kind of phases as we do with mourning a death. He has not READ MORE
Yes it is. There are several reasons for this. 1) he may be rebelling for having the disease. They go through the same kind of phases as we do with mourning a death. He has not progressed the phases to get to acceptance yet. Give him time &/or get counciling with a person who is knows about what a person with diabetes goes through. 2) Both hyperglycemia & hypoglycemia can affect the brain & cause changes so keep his blood sugars as near normal as possible. I suspect though that his problem is acceptance. He has not accepted that he has to have this disease & all the changes it entails, and he is angry at the world, at his parents who gave it to him and feels sorry for himself. All this usually resolves with time but getting some help from someone who knows grief psychology & diabetes would be a good idea. Getting him with other kids with diabetes so he can see that he is not alone with this disease, would help. Diabetes camp can also be helpful. The councilors are usually older people with diabetes who have gone through the same phases your son is and companionship with other campers with the disease can be very helpful. He can see that he is not different and can cope with the problem as he sees others doing. This is a common problem & can be solved. Good luck in finding the proper people for him to be with & have good counciling.

What are the treatment options for type 2 diabetes?

You have just asked the biggest question every person with diabetes should ask. You can get this info in more detail that I have space here so see a good physician who knows diabetes READ MORE
You have just asked the biggest question every person with diabetes should ask. You can get this info in more detail that I have space here so see a good physician who knows diabetes & a good diabetes educator. Simply put, the answer to your question is yes, there are many other treatments. I can't answer the question of lifestyle changes without knowing your status better. I can make only simple answers. A proper diet, exercise, & wt. loss if you are overwt. are vital for your continued welfare. See a good diabetes educator & dietician. A good place to get a life style change program is the YMCA. They have a good program with dietitians & exercise physiologists to help you. Now, as to other medications: there are several classes of other drugs we use today. There about 20 of them, though several of them are "me too" drugs. That is in the same class, different company & name. The main classes we use today are 1) metformin 2) sulfonalureas 3) Glitazone drugs 4) GLP1 Receptor Agonists and 5) SGLP2 drugs. There are others, but are less effective & are seldom used. We also don't use the sulfonalurias much any more since the cause wt. gain & can cause low blood sugar. The first 3 above are generic now and thus cheap. The last 2 are much better drugs & work well, but are expensive, so you need to check with your insurance co. before you commence treatment with them. They may not pay since they are new drugs & are not generic yet. I must also mention that there are 2 other possibilities: 1) insulin - if all else fails, insulin will be needed, but don't fear it (I have taken it for 26 yrs & I'm still in good shape). 2) Most of these drugs can be given together and frequently are. One company just got FDA approval to market a combination pill that has 3 of these drugs in one pill. So, there are a lot of alternatives. If your doctor is not familiar with them, see an endocrinologist who is & get the best care. The most important thing is keep your blood sugar under control & you should do well.

How can I know if my thyroid is healthy?

1) See a physician familiar with thyroid disease, 2) have that physician palpate your thyroid for size & nodules, 3) give the physician a good health history, 4) have the Dr. draw READ MORE
1) See a physician familiar with thyroid disease, 2) have that physician palpate your thyroid for size & nodules, 3) give the physician a good health history, 4) have the Dr. draw blood for a Free T4 (a measurement of amount of thyroid in the blood) and a TSH (thyroid stimulating hormone-the hormone that comes from the pituitary gland & regulates the thyroid). If there are any abnormalities, there are other tests that can be done but these are first to establish whether there is a reason to go further or find there is no thyroid disease.
Good luck.

What are the treatment options for hypothyroidism?

Well you don't have many options. The treatment for hypothyroid is to replace what is missing I. e. take thyroid pills. Treatment is easy-take one thyroid pill per day on an empty READ MORE
Well you don't have many options. The treatment for hypothyroid is to replace what is missing I. e. take thyroid pills. Treatment is easy-take one thyroid pill per day on an empty stomach. The problem is getting the dose of thyroid medicine right. This requires a few visits to the Dr. to draw blood to measure the free thyroxin level & the thyroid stimulating hormone until both are in the normal range, then the test can be checked less often i.e. once or twice a year. That's all there is to it. I have this also & take my thyroid once a day & get checked twice a year. There is really no other treatment for hypothyroid. Give it a try & once you get to normal, you will feel much better.

Does being overweight make it harder for me to lose weight?

Yes it can. When you are overwt. the fat tissue produces hormones that stimulate your appetite & other things that make it harder to lose wt. In addition, when you go on a diet READ MORE
Yes it can. When you are overwt. the fat tissue produces hormones that stimulate your appetite & other things that make it harder to lose wt. In addition, when you go on a diet to lose wt. your body thinks there is a famine & changes your metabolic rate making it harder to lose wt. The best way to lose wt. is see a DR. who specializes in that area & get their advice. There are medicines that will help as well as diet & exercise. It can be done. I have lost 25 # in 3 mo. using a drug called a GLP1 along with diet & exercise. Good luck.

How long is a oral glucose tolerance test?

The standard time for an OGTT is 3 hours, but it could be longer. Why are you getting it? If for diabetes, only the 2 hr. value is used for diagnosis so only a 2 hr. test is needed. READ MORE
The standard time for an OGTT is 3 hours, but it could be longer. Why are you getting it? If for diabetes, only the 2 hr. value is used for diagnosis so only a 2 hr. test is needed. If they are looking for low blood sugar (hypo-glycemia), the a 5 hour OGTT is needed since the hypoglycemia is usually seen toward the end of the test. In my practice, I rarely do an OGTT since it is time consuming, expensive, and gives little information that I can get by other tests less traumatic, less expensive & less time consuming. Question your Dr. as to why it is being done.

How are thyroid evaluations performed?

There may be several steps though most of the time only 2 steps. 1) see your physician & have him/her feel your neck to see if your thyroid gland is enlarged or has nodules 2) READ MORE
There may be several steps though most of the time only 2 steps. 1) see your physician & have him/her feel your neck to see if your thyroid gland is enlarged or has nodules 2) the DR. should draw blood & send to the lab for analysis for a free T4 & TSH. If they have found enlargement they may want to get a measurement of thyroid antibodies 3) If no enlargement or nodules this is all that is needed. If the is enlargement or nodules then a thyroid sonogram (ultrasound) should be performed. 4) if enlargement or nodules, then a biopsy should be performed. This can be done in the office with local numbing of the area. This is to see if the nodules are benign (usually) or malignant (uncommon). There are blood tests for cancer as well but are not needed if no enlargement or nodules. I hope this helps.

Can human growth hormone pills cause cancer?

Human Growth Hormone (HGH) does not, as far as we know does NOT cause cancer. It is a growth stimulant so it might speed up the growth of a cancer already there. BUT how are you READ MORE
Human Growth Hormone (HGH) does not, as far as we know does NOT cause cancer. It is a growth stimulant so it might speed up the growth of a cancer already there. BUT how are you getting HGH to take by mouth? HGH is a protein hormone and is digested by the gut like a piece of meat. Thus it must be given by injection not by mouth. I suspect what you are taking is not HGH but a pill that they say stimulates HGH secretion. There are no studies of this over-the-counter (you get by mail at an inflated price) pill. I think taking it is a waste of money. Please see a physician for advice about what you are thinking of taking.

Will my diabetes go away if I start eating right?

Diabetes is an inherited disorder that has environmental triggers. The genetic part was there from conception & can never go away. The environmental factor can be changed. I presume READ MORE
Diabetes is an inherited disorder that has environmental triggers. The genetic part was there from conception & can never go away. The environmental factor can be changed. I presume you have Type 2 diabetes & here the environmental factors can be changed & the diabetes better & easier to control. Diet & exercise are 2 of the factors that can be changed. If diet is bad & exercise little you will put on weight. Being overwt. causes your body to resist the action of your insulin & puts a strain on the insulin producing mechanism. If the problem persists the pancreas eventually is overwhelmed & the cells begin to die & the diabetes gets worse. So if you can get on a proper diet & exercise plan & lose wt. the insulin resistance will decrease & the strain on the insulin cells of the pancreas will reduce & you'll get better. But if you slip-back, remember that the genetic factors never go away so the diabetes will come back. Good luck!

What does a thyroidectomy do to cholesterol?

It may or may not. A high cholesterol can have many causes one of which is genetics i.e. inherited. Another is consuming too many high cholesterol foods & finally hypothyroid. READ MORE
It may or may not. A high cholesterol can have many causes one of which is genetics i.e. inherited. Another is consuming too many high cholesterol foods & finally hypothyroid. If you have a mass on the thyroid, it could be causing hypothyroid & thus your cholesterol. If your thyroid level is normal, then the mass is not effecting the cholesterol in which case the removal of the thyroid will have no effect on your cholesterol level. Depending on how much of the thyroid is removed, you may get hypothyroid after surgery & the low thyroid will have an effect on the chol. Treatment with thyroid replacement should correct this problem. In any event you should have the tumor removed especially if a biopsy or certain blood tests strongly suggest it could be malignant. And get your cholesterol by any means necessary & there are good medicines now to do that.