Dr Eric Daiter has successfully served thousands of patients with ovulation problems over the past 20 years. If you have questions, or you are simply not getting the care that you need, Dr Eric Daiter would like to help you at his office in Edison, New Jersey or over the telephone. 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 reproductive 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."
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Anorexia nervosa is characterized by a morbid fear of obesity. The reason for this disorder is not clear but many believe it originates because of an inability to cope with sexuality and represents the woman’s desire to return to a prepubertal state. The mortality rate with anorexia nervosa is high (5-15%) so a heightened index of suspicion is warranted. These women are typically success, appearance and achievement oriented with a tendency to be overachievers. The diagnosis is based on standard criteria, including
refusal to maintain a normal body weight, with loss of 25% of original body weight or a weight of 15% below normal for age and height
special attitudes regarding food, including a distorted body image with the feeling of personal obesity
one of a variety of signs or symptoms, including lanugo hair, bradycardia, overactivity, episodes of bulimia, or vomiting
no known medical or psychiatric disorder leading to the weight loss
In addition to the historical and physical findings, laboratory evaluation may reveal
normal TSH and free T4 but low T3 and high reverse T3, simulating the “euthyroid sick state.” This may be a nonspecific response to starvation in which energy is conserved by preferentially converting T4 to reversed T3 (which is less bioactive)
low FSH and low LH concentrations, resulting in hypogonadotropic hypogonadism
increased plasma cortisol level (which can be used to distinguish the lab findings of anorexia from panhypopituitarism)
Extensive hormonal evaluation is not clinically necessary when the diagnosis is clear. Treatment can be difficult but often a careful frank discussion revealing the relationship between the ovulatory dysfunction and anorexia is all that is required. Treatment is more difficult in the presence of denial, due to noncompliance, and referral to an appropriate counselor may be required.