This post was written by Gerald Bernstein, MD, Director of the Friedman Diabetes Institute at Mount Sinai Beth Israel.
One of today’s greatest public health issues is the growing number of people with diabetes mellitus, most commonly type 2 and most often (but not always) associated with excess weight. To appreciate the scope of the problem, it is important to understand the true nature of the disease. (more…)
Polycystic ovary syndrome, commonly known as PCOS, is one of the most common female endocrine disorders.
A syndrome is a group of signs and symptoms that occur together to characterize a particular condition. The definition of PCOS includes irregular periods, signs of excess androgenic hormones (masculine hormones) such as acne and excess hair growth, and an exclusion of other causes of an elevation of androgens. Although the name indicates the presence of cysts on the ovaries, not all women with PCOS have cysts (and not all women with ovarian cysts have PCOS). (more…)
This post was written by Gerald Bernstein, MD, Director of the Friedman Diabetes Institute at Beth Israel Medical Center.
The wonderful actor Tom Hanks said a mouthful when he told late-night talk show host David Letterman that he was recently diagnosed with type 2 diabetes, a condition in which the body does not produce or properly use insulin. Tom Hanks to me is everyman, best characterized in his movie “Saving Private Ryan.” He looks like a regular guy and, from what I can tell from the general media, he is—not too heavy, not too thin (except for during movie roles he played as an AIDS patient and a castaway), and apparently realistic about life and work in general.
What Hanks said that is so important is that his blood sugar was somewhat elevated when he was in his 30s, meaning he had prediabetes. He was also wise enough to know that the eventual progression to clinical diabetes was inevitable. As with everything else about Hanks, this news was a piece of life and he is dealing with it. (more…)
Remember those skeletons that hung in many of our elementary school classrooms growing up? The one component of those models is bone: humans are born with up to 270 of them! It is clearly important for us to protect this crucial framework in order to preserve a high quality of life.
One concern as we get older is osteoporosis, a condition of thin and porous bones. Aging, which we cannot prevent (at least not yet!), is the greatest risk factor for osteoporosis. Bones thin over time because the hormones estrogen and testosterone—which are important to maintaining bone density—both decline with age. We all know bone fractures can be debilitating, especially for the elderly, so, as with all medical conditions, prevention is paramount. (more…)
For most of us, when we hear “vitamin D,” our mind conjures up the image of a glass of milk. This is fair, since fortified milk does contain vitamin D. But what if I told you milk might not be the best source of vitamin D, and in fact, there’s a whole lot more to know about this nutrient? (more…)
The thyroid gland got its name from the Greek word for “shield,” due to its physical appearance in the neck. In many ways, it acts like a shield by protecting our bodies from losing functional balance. The thyroid gland produces and releases thyroid hormone, which is crucial in regulating overall metabolism (the physical and chemical processes in the body that convert or use energy). Digestion, weight, temperature regulation and reproduction all are affected by the thyroid gland.
The thyroid gland works like a thermostat via its connection with the brain. If there is not enough thyroid hormone in the blood stream, the brain will stimulate the thyroid gland to produce and release more. Blood tests are an easy way to detect both the level of thyroid hormone circulating in the blood — generally free thyroxine (T4) — and the stimulating signal from the brain (TSH, or thyroid stimulating hormone). The most common thyroid problems involve abnormal production of thyroid hormone.
Hypothyroidism is the term used to describe an underactive thyroid.
Symptoms include:
• Fatigue
• Feeling colder than usual
• Changes in skin and hair
• Weight gain
A common cause of hypothyroidism is Hashimoto’s thyroiditis, an autoimmune disorder in which cells in the body prevent the thyroid from producing and releasing enough thyroid hormone. Other causes include surgical removal of the thyroid gland for thyroid cancer; treatment of hyperthyroidism (an overactive thyroid gland) with radioactive iodine; or being born with an underactive thyroid gland.
The treatment for hypothyroidism is to replace thyroid hormone in the form of a pill taken once a day, preferably by itself and on an empty stomach so that it is fully absorbed. The dose is easily adjusted based on blood tests.
Hyperthyroidism describes an overactive thyroid gland.
Symptoms include:
• Increased sweating
• Heart palpitations
• Increased anxiety
• Diarrhea
• Weight loss
A number of conditions can cause hyperthyroidism. Opposite to hypothyroidism, cells in the blood stream called antibodies make the thyroid gland secrete an excessive amount of thyroid hormone.
The two most common treatments for hyperthyroidism are radioactive iodine and medication. Radioactive iodine works by destroying part of the thyroid gland to restore a normal level of thyroid hormone in the body; however, it is possible that hypothyroidism may then develop. Radioactive iodine has the benefit of generally being a more permanent treatment, although medications used to treat hyperthyroidism can be very effective in certain people, too. Just as in hypothyroidism, blood tests should be done routinely to monitor treatment.
Thyroid cancer can develop and, in the majority of cases, is curable by surgical removal of the thyroid gland by an experienced surgeon. Radioactive iodine may be used after surgery to destroy any small remaining cancer cells. An endocrinologist should be directly involved in monitoring care.
Extremes of thyroid function can certainly have an impact on your quality of life; the beauty is that with the correct diagnosis and management, these conditions can be greatly improved!
To find an excellent doctor who is right for you, please call our Physician Referral Service at 866.804.1007.