Hypoglycemia is called when blood sugar becomes below normal. In hypoglycemia patient has recurrent symptom of weakness, anxiety, confusion, cold feeling, headache, vomiting. Causes of low blood sugar (glucose) are : 
(1) High insulin level in blood due to pancreatic tumor as insulinomas or other cause.
(2) Due to various drugs
(3) Deficiency of various hormones as cortisol, growth hormone.
(4) Other congenital defect as galactosemia.
(5) Other causes as alimentary hypoglycemia & Idiopathic postprandial hypoglycemia.
(6) Autoimmune cause. 

Postprandial: Alimentary, Impaired glucose tolerance, Diet induced, Idiopathic, Postabsorptive hypoglycemia, Endocrine deficiencies, Alcohol, Insulin antibodies
Post absorptive, Insulinomas, Factitious, Insulin, Sulfonylureas

Autoimmune : Insulin antibody, Insulin receptor antibody, Nonislet cell neoplasms
Hormonal deficiencies, Adrenal, pituitary, thyroid, Glucagon
Liver disease-severe: Cirrhosis with speticemia
Inadequate substrate for gluconeogenesis : Uremia, , Alcohol, Drugs 

Diagnosis : We do blood sugar, plasma insulin level which may be high or low, other hormone, GTT, Abdomen ultrasound to reach proper diagnosis then treatment of the cause is done. 
Low blood sugar/glucose in child can be due to neonatal hypoglycemia, hyper insulinemia & other causes. So permanent Treatment :cure of low blood sugar needs accurate diagnosis & then appropriate treatment .
Causes of high insulin are
Pancreatic beta cell tumour called insulinoma.
Insulin resistance, PCOD, Hairan Syndrome Syndrome X
Excess of cortisol & growth hormones.
Anti insulin Antibody. Anti insulin receptor antibody.
& Many more other causes. 
How to avoid Severe Hypoglycemia In Diabetes 

• Don’t make changes in Diet, insulin dose, exercise yourself. 
• Don’t forget to take meal & snacks at proper time
• Take extra snacks before doing unusual exercise.
• Take glucose on slightest symptom.
• If on insulin keep inj. Glucagon (s.c./IV) to treat hypoglycemia.
• Avoid Night-time Hypoglycemia : Nightmares, excess sweating at night, early morning 
headache, for confirmation 3 AM Blood sugar below 60.
• Treatment of severe hypoglycemia : Inj. Glucagon s.c. or shift to hospital for intra venous 
Glucose. 

Adrenal Steroid Hormones (Cushing’s Disease)

In some diseases Adrenal hormone cortisol increases (called Cushing’s disease or syndrome) it leads to weight gain, high blood pressure, stretch marks over body, unwanted hair in female, osteoporosis, weakness, fatigue, roundening of face, thin ness of hand & feet, reddening of cheek, development of high blood pressure & diabetes, darkening of skiin & abdominal protuberance.. Some similar conditions are called pseudo Cushing’s syndrome. There are certain steroid hormone tablets when they are taken orally it leads to weight gain & has lot many more side effects & produce features like Cushing’s syndrome.. When cortisol decreases due to adrenal failure called Addison’s disease the symptoms are darkening of skiin, weight loss, weakness, Giddiness, loss of appetite, vomiting, muscle or joint pains, low blood pressure (hypotension), high sodium, low potassium, high urea, & high calcium for treatment adequate dose of predinisolone & dexamethesone, sometime fludrocortisione is also needed one must know in detail steroid replacement therapy. 

Similarly aldosterone can increase or decrease. 

Congenital adrenal hyperplasia leads to enlarged clitoris in female & development of early pubic hair in male & female, also leads to unwanted hair in female. For diagnosis & monitoring 17 hydroxyprogesterone & other hormones are tested which can be elevated or subnormal. 
Adrenal gland enlargement, (tumors), can also be noted. 
High Blood pressure due to hormone disorder like pheochromocytoma & other hormone disorder is well known. Pheachromocytoma presents with uncontrolled blood presure, headache, palpitation, anxiety. 
Investigation : Urinary Catecholamines, metanephrines & vanilmandellic acid (VMA) are increased then C.T. Scan abdomen & MIBG scan are required. 
Treatment : Certain drugs are effective otherwise surgery is needed. 
Diagnosis : For diagnosis we need hormone test as LH, FSH, Testostrone, Prolactin, Thyroid tests, Antisperm antibody, X-ray skull, USG of Scrotum & Semen C/S to reach correct diagnosis of low sperm count. 
Treatment : Once the cause of low sperm count & motility found then with three months of treatment sperm count becomes normal 

Increased Calcium Level/Parathyroid Level 

Hypercalcemia i.e. increased Calcium Level is called when serum calcium is above normal. Symptoms of elevated calcium due to high PTH level i.e. hyperparathyroidism is excess urination, kidney stone, bone weakness, osteoporosis, bone pains & muscle weakness This is caused by following causes hyperparathyroidism (i.e. high Parathyroid (PTH) hormone), high level of Vitamin D, familial hypercalcemia, multiple endocrine neoplasia Type-I, various malignancies as breast cancer, multiple myeloma & other malignancies without bone metasis, Ectopic high P.T.H. production, thyrotoxicosis, Hyper Vitaminosis A, Sarcoidosis, milk alkali syndrome, Thiazide diuretics, acute renal failure etc. 

Diagnosis of cause of high/elevated calcium, one need to calculate corrected calcium levels, test PTH hormone, parathyroid scanning & urinary calcium testing. 

Treatment : Find out any one of the above cause & treat. Regarding treatment of
hyperparathyroidism there are various drugs which lower calcium value & even PTH value or surgery can be done. 

Low i.e. Decreased calcium (hypocalcemia)

is called when serum calcium is below normal. Symptoms of low calcium are spasm of hand & face muscles ie. tetany, early cataract, abnormal body movements, dry skiin, constipation, anxiety & depression. Subnormal calcium is caused by hypoparathyroidism, pseudohypoparathyroidism, Vitamin-D deficiency, & vitamin D. Resistance, postsurgical, idiopathic, hypomanesemia wilson disease, pancreatitis, acute hyperphosphatemio, any serious critical illness, toxic shock syndrome, malabsorption, calcium chelators. 
Neonatal hypocalcemia can occur in newborn.
 
Diagnosis all above causes diagnosed by investigation of calcium, protein, albumin, parathyroid hormone level & urinary calcium excretion. 

Treatment is possible by treating the cause & supplementing calcium, Vitamin D & others. 
Phosphorus can be high or low due to various metabolic causes.

Rickets & Osteomalacia :

means bone weakness due to less bone formation. Rickets occurs in children & ostcomalacia in adult. The symptoms in child are bone pain, short height, difficulty in walking. In adults osteomolacia presents as bone pain, difficulty in standing from sitting posture. 
Causes of osteomalacia, rickets & elevated alkaline phosphatose are Vitamin D deficiency & Resistance, hypophosphatemic rickets, chronic renal disease & failure, Renal tubular acidosis, fanconi syndrome, Tumoural osteomalacia etc. 

Diagnosis : On Laboratory testing calcium & phosphorus may be low, alkaline phosphatase high & bone is weak on X-ray, PTH level & other relevant test are done.

Treatment : Once the cause is found, treatment can be successfully done by treating the cause & supplementing calcium & VitaminD 

Osteoporosis i.e. Bone Weakness 

Osteoporosis i.e. bone weakness occurs due to excess bone loss, is very common after 50 years of age. It leads to frequent fracture of spine bone & leg bone on minor trauma. 

Cause of osterporosis are estrogen deficiency, hyperparathyroidism, vitamin D deficiency, multiple myeloma, idiopathic, calcium deficiency, cortisol excess, steroid use, chronic inflammatory disease as rheumatoid arthritis, SLE, malabsorption syndrome, thyrotoxicosis, hypogonadism, hyperprolactinemia, cancers, Liver disease, alcohol use, juvenile osteoporosis. 
In male all above cause plus testtosterone deficiency due to hypogonadism is an additional cause for osteoporosis.
 
Dignosis : By various blood test & dexa bone denistometry scan then diagnosis is made. Dexabone scan shows osteopenia i.e. low T score & Z score. 
Treatment offered is treatment of cause, calcium, Vitamin D, female hormone, raloxifene, Tibolon & Biphosphonates & synthetic PTH given with good results.