The So Called Golden Years…let’s hope so!
Aging is inevitable (We hope!), which is great because it means we get wiser, right? While our minds and souls are enriched by the collective wisdom of the preceding years, what about our bodies? (more…)
The Body’s Quarterback: The Pituitary Gland
Guest post by H. Marie Williams
One of my favorite roles as a physician is educating patients during the process of taking care of them. When patients come to my office for an evaluation regarding a specific condition (thyroid, diabetes, pituitary, bone) I start by asking them what they know about the disorder. Often, even if the patient has had the condition for many years, I can teach them something about how their body works. In this post, I aim to teach you all something about the pituitary gland, part of the body’s endocrine system.
Function of the Pituitary Gland
The pituitary gland is a pea-sized structure located in the brain directly behind the eyes. Despite its small size, I think of the pituitary gland as the “quarterback” of the body. This quarterback relays the signals from the “head coach”—a small section of the brain called the hypothalamus—to the rest of the glands of the body. These interactions make up the so-called hypothalamic-pituitary axis. The hormones from the pituitary gland control reproduction, thyroid function, breastfeeding, growth, our stress response and much more.
The best part of this whole system is that it makes sense. The head coach (the hypothalamus) knows what plays to call based on the feedback it gets from the rest of body. For example, if the circulating level of thyroid hormone is low, then the hypothalamus will receive this message and communicate with the pituitary gland to increase the stimulatory signal to the thyroid to produce more hormone.
When the Pituitary Gland is Compromised
Many different types of conditions can compromise the function of the pituitary gland. Some of these conditions send out excess hormone and some may cause a deficiency in a specific hormone. Of course, since the pituitary gland is the quarterback, this can cause many changes in the body.
Adenomas May Produce Extra Hormone…
A pituitary tumor is an abnormal growth in the pituitary gland. These are generally non-cancerous growths called adenomas. An adenoma may be producing extra hormone, such as prolactin, which is the hormone that regulates breastfeeding. A high prolactin level may cause breast discharge and disrupt the menstrual cycle. This condition, called a prolactinoma, can generally be treated with medication.
…Or Cause a Deficiency
Other adenomas do not produce hormone, but may affect the normal hormone production by the pituitary gland. For example, testosterone deficiency in males may be caused by a large pituitary adenoma, which has decreased the stimulatory signals to the testes.
I hope this basic overview provides you with insight into how the pituitary gland helps create balance in our complex body.
To find an excellent doctor who is right for you, please call our Physician Referral Service at 866.804.1007.
The Impact of Sleep on Appetite and Metabolism
We have all heard of “beauty sleep,” but the impact of sleep quality and quantity goes way beyond our physical appearance. Research has begun to clearly delineate the importance of getting a good nights rest on health, so maybe we should start talking about “healthy sleep.”
A few facts for you from a National Sleep Foundation Poll:
* 1 in 3 American adults report having sleep problems.
* The percentage of young American adults sleeping less than 7 hours has doubled over the last 40 years.
* Cumulative sleep loss over the work week for many adults may account to one full night of sleep loss.
What do these statistics mean to me?
Research has demonstrated that sleep deprivation negatively affects several important hormones that directly regulate our appetite and metabolism. Our bodies are innately programmed to regulate our energy balance, essentially matching the energy we take in with the energy we expend.
The yin and yang of energy balance are ghrelin and leptin. Ghrelin is a protein that is produced mainly by the stomach that stimulates appetite; it is why your stomach growls when you are hungry. On the other hand, leptin is a hormone released by fat cells that signals when you are full (sometimes it’s hard to listen to this one!). Several research studies on sleep deprivation have shown that leptin levels decrease and ghrelin levels increase in response to a lack of sleep, which causes an increase in appetite (specifically for high-calorie and high-salt food) throughout the day. In a review of long-term research studies, short sleep duration is associated with a risk of being overweight or obese in the future.
Lack of sleep has also been shown to increase the release of stress hormones, specifically cortisol, which decreases the body’s sensitivity to insulin (a regulator of blood sugar). An elevation in stress hormone levels may also elevate blood pressure, a risk factor for heart attacks and strokes. Just as lack of sleep may be risk factors for these conditions, it may also make them more difficult to control so improving sleep may also be a valuable treatment.
Living in the “city that never sleeps” can make it difficult to shut it down at night. The good news is that it will still be there when you wake up! If you have trouble falling asleep or staying asleep at night, please talk to your doctor to evaluate if there is a possible medical reason.
Good night and sleep tight!
Gregory B. Dodell, MD, is an Endocrinologist ta St. Luke’s and Roosevelt Hospitals.
Why Diabetes is Different for Men
Much of what makes men with diabetes different from women with diabetes has to do with muscles — and how they use them.
Dr. Gerald Bernstein, director of FDI’s Diabetes Management Program, is a young-at-heart endocrinologist who knows firsthand how muscles affect the way insulin acts in the body. “After running was no longer an option for me, I went to the gym. I noticed that resistance training, using machines and weights, not only made my muscles bigger, it made me lose weight. And, to my great joy, my diabetes was easier to manage!” (more…)
Pancreatic Cancer: A Fighting Chance
Guest blog post by Michael Wayne, DO.
Pancreatic cancer is a silent killer. Unfortunately, the majority of patients have an advanced stage of the disease by the time they come to a doctor’s office with complaints. Science does not yet have any early markers, such as simple, reliable blood or urine tests, to help detect this deadly cancer or to determine if you are at risk for pancreatic cancer.
Still, there are things to keep in mind that can possibly give you a better edge on the odds:
* If you have a family history of pancreatic cancer, you should speak to your doctor about genetic testing and/or other possible screenings.
* If you have unexplained weight loss, new onset of diabetes as an adult or a worsening of previously controlled diabetes, talk to your doctor about the possibility of pancreatic cancer screening. When patients have any of the symptoms mentioned above, they should get either a CT scan or an MRI of the abdomen.
* Unexplained back pain can be another presenting sign of pancreatic cancer and should be investigated thoroughly.
If anything abnormal is found in the imaging tests, then there are other tests we can do to determine if this is pancreatic cancer. If we suspect pancreatic cancer, hopefully we can catch it at an early stage when it is more likely to be treated successfully.
Michael Wayne, DO is surgical director at the Center for Digestive Health and the Chief of Pancreato-biliary Surgery at Beth Israel Medical Center.
A Doctor Wears an Insulin Pump to Better Understand
Chronic disease is exactly that, chronic. Therefore, a diagnosis of any chronic disease is life altering. I spend the majority of my days doing my best to take care of patients with diabetes. For their sakes, I ask them to be compliant, that is, to follow the many guidelines carefully so they stay as healthy as possible and avoid long-term complications of their disease.
Many times, a patient’s condition is not well controlled due to barriers that are preventing his successful compliance such as depression, poor insight into the disease, failure to adjust to the change in lifestyle that comes with the condition, or denial. Addressing these compliance barriers will hopefully facilitate future success in preventing complications.
In an attempt to understand a patient’s challenges to stay compliant, I decided to live the life of one of my patients for a bit. I recently wore an insulin pump for 72 hours. This was an extremely insightful experience! (more…)