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Primary Periodic Paralysis (PPP) is a rare genetic condition that affects muscles and causes episodes of muscle weakness and/or temporary paralysis, that can be progressive and debilitating. <sup>1,2

1</sup> Statland JM, Fontaine B, Hanna MG, et al. Review of the diagnosis and treatment of periodic paralysis. Muscle Nerve. 2018;57:522-530.
² Cavel-Greant D, Lehmann-Horn F, Jurkat-Rott K. The impact of permanent muscle weakness on quality of life in periodic paralysis: a survey of 66 patients. Acta Myol. 2012;31:126-133.

Severe hypoglycemia, or severe low blood sugar, occurs when your blood sugar gets so low that you need help to bring it back up. Sometimes people with very low blood sugar may have a hard time thinking straight or controlling their body, get very tired, refuse to eat, pass out, or even have a seizure. It is an emergency situation that needs to be treated immediately. <sup>*

*</sup>National Institute of Diabetes and Digestive and Kidney Diseases. Hypoglycemia. https://www.niddk.nih.gov/-/media/Files/Diabetes/hypoglycemia_508.pdf. Published July 2021.

Endogenous CS is a rare, serious endocrine disorder caused by chronic exposure to elevated levels of cortisol; left untreated, it can be fatal. Often the result of a benign tumor of the pituitary gland that tells the body to overproduce high levels of cortisol for a sustained period of time. CS results in physical and emotional signs and symptoms that are debilitating for those living with CS. It is most common among adults aged 30 to 50 years and is more prevalent in females, accounting for 70% of cases.<sup>*

*</sup> The National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center. Cushing’s Syndrome. Accessed Sept. 14, 2020. https://www.niddk.nih.gov/health-information/endocrine-diseases/cushings-syndrome.

Exercise-Associated Hypoglycemia is characterized by a sudden and exaggerated spike in insulin and drop in blood sugar levels. The condition is triggered by vigorous exercise. Signs and symptoms include fainting (syncope),¹ shakiness, nervousness, sweating, dizziness or light-headedness, sleepiness, confusion, difficulty speaking, anxiety, and weakness.<sup>2

1.</sup> Hyperinsulinemic hypoglycemia, familial, 7; HHF7. OMIM. November 2008; http://omim.org/entry/610021. Accessed 12/4/2013.
^2. Hypoglycemia. NIDDK. November 6, 2012; http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/#symptoms. Accessed 12/4/2013.

Hypothyroidism, also known as underactive thyroid disease, is a condition in which the thyroid gland does not create and release enough thyroid hormone into the bloodstream. Hypothyroidism may not cause noticeable symptoms in the early stages. Over time, untreated hypothyroidism can cause a number of health problems, such as obesity, joint pain, infertility, and heart disease. Hypothyroidism is a fairly common condition that can affect people of all ages, genders, and ethnicities.

Gastroenterology is a branch of medicine concerned with digestive diseases. The practice of gastroenterology concentrates on the diagnosis and treatment of diseases involving the esophagus, stomach, small intestine and large intestine (colon), liver, gallbladder, and pancreas.