Dr Eric Daiter has served Monmouth and Middlesex Counties of New Jersey as an infertility expert for the past 20 years. Dr. Daiter is happy to offer second opinions (at the office or over the telephone) or new patient appointments. It is easy, just call us at 908 226 0250 to set up an appointment (leave a message with your name and number if we are unable to get to the phone and someone will call you back).
"I always try to be available for my patients since I do understand the pain and frustration associated with fertility problems or endometriosis."
"I understand that the economy is very tough and insurance companies do not cover a lot of the services that might help you. I always try to minimize your out of pocket cost while encouraging the most successful and effective treatments available."
Acromegaly is characterized by chronic excess circulating growth
hormone concentrations. Growth hormone secretion occurs with 3-8
pulses each day during the adolescent years and this growth hormone
appears to stimulate the local production of IGF-1 (somatomedin-C).
IGF-1 then acts locally on target tissues to mediate the growth
hormone effects. When this syndrome develops in childhood there
is a tremendous linear growth of bones resulting in clinical "gigantism."
If this syndrome develops as an adult, most of the bones will
not respond to elevated growth hormone since they have stopped
growing due to the fusion of their growth plates (epiphyses).
Bones without epiphyses will grow with elevated growth hormone,
including facial bones. The clinical appearance of acromegaly
* enlargement of distal extremities with very big hands
* widening of the spaces between the teeth due to growth
of the jaw and fascial bones
* carbohydrate intolerance or frank diabetes mellitus
Clinical situations associated with elevated growth hormone concentrations
include poorly controlled diabetes mellitus, chronic illness or
malnutrition, and stress. These situations differ from acromegaly
since they are associated with a low IGF-1 level.
The initial screening test for acromegaly is the circulating growth
hormone concentration, ideally drawn after fasting in the morning
at the bedside before the person ambulates. False positives are
not uncommon, so all positive values must be followed up with
either a glucose suppression test (2 hours after a 100 gm glucose
load the normal GH is less than 2 ng/ml while in acromegalics
it is greater than 5 ng/ml) or an IGF-1 concentration (care must
be taken to draw and process blood according to the laboratory
specifications since fluctuations in levels are otherwise encountered,
false negative IGF-1 concentrations may reflect a low concentration
of the IGF binding proteins).