CONDITIONS WE TREAT

Type 1 Diabetes Mellitus: Type 1 diabetes is usually caused by an autoimmune process which ultimately impacts the insulin production created by the pancreas. The pancreas has 2 main functions, arguably the most important one is to make insulin. The human body cannot maintain its normal functions without insulin in the bloodstream. When insulin levels are low and blood sugars are high this causes dehydration. Many patients learn they have diabetes mellitus type 1 the first time because of an acute infection (diabetes mellitus reduces your immune system) or because of a diabetic ketoacidosis.

Type 2 Diabetes Mellitus: Type 2 diabetes is often referred to as a lifestyle disease. 90% of type II diabetics are overweight or obese. Managing reduction and carbohydrate ingestion, increasing physical activity, and often medications which promote weight loss and do not cause hypoglycemia can be very beneficial and the management of type 2 diabetes. Complications of diabetes can include burning tingling numbness of the feet, small amounts of protein leaking from the kidneys, and visual changes as high blood sugars affect the small capillaries and small nerves of the body. Type 2 diabetes carries a much higher cardiovascular risk, therefore management of blood pressure and cholesterol are also important.

Thyroid Nodules: Fortunately, most thyroid nodules are benign. Unfortunately, thyroid carcinoma is the fastest growing cancer amongst all cancers. Radiation is likely the most commonly associated risk factor for thyroid cancer, however we screen patients for aberrations in their thyroid anatomy with a noninvasive test called ultrasonography. Some thyroid nodules can be symptomatic, such as causing voice changes or trouble swallowing. Most thyroid nodules are asymptomatic and are simply found incidentally.

Hyperthyroidism: This is a devastating condition in which the metabolism of the individual is increased. The cardiovascular system, the nervous system, the digestive system, and integumentary system are all affected. For example, patients have off and profound weight loss, palpitations and tachycardia with anxiety difficulty sleeping, with fine tremor and often present with diarrhea, hair loss and dryness in the skin. There are several causes of hyperthyroidism, some which may require total thyroidectomy.

Hypothyroidism: The most common cause of hypothyroidism is Hashimoto's thyroiditis. This occurs in certain endemic regions as often as 1 and every 5 women. Pregnancy seems to be a risk factor for the development of Hashimoto's which usually develops into hypothyroidism. Hypothyroidism is the opposite of hyperthyroidism and that very often patients have weight gain constipation dry skin hair loss bradycardia however fatigue is persistent for both hyper and hypothyroidism.

Metabolic Syndrome: Insulin resistance, hypertriglyceridemia, elevated cholesterol, borderline elevation of blood pressure with associated abnormal weight gain, overweight status or obesity all contribute to the metabolic syndrome. Often patients present with irregular menstrual cycles inflammation of the liver inability to lose weight and weight gain with worsening metabolic parameters and increased intra-abdominal fat with increased hip to waist ratio. Your waist-to-hip ratio compares your waist measurement to your hip measurement. Higher ratios can mean you have more fat around your waist. This can lead to a higher risk for heart disease or diabetes.

Obesity: The consequence of weight gain is often more weight gain. The body is quite adept at increasing its weight, and is very resistant to losing any weight gain. Risk factors for obesity are likely inclusive of childbearing, inactivity, sports injury limiting activity, excess carbohydrate or fat in the diet with social, and medical consequences. There are exceptional treatment options for obesity now. The new medical dogma, in regards to management of obesity, is that this is a chronic disease and medications used to treat the disease are considered appropriate and expected to take lifelong.

PolyCystic Ovarian syndrome (PCO): This is the most common endocrine disorder affecting women of reproductive age. It is associated with excess facial hair and acne, irregular cycles and sometimes infertility. Some women will not have menses for months or years, risk factors also include development of overweight status, obesity and diabetes. Very often PCO is a manifestation of the metabolic syndrome

Osteoporosis: Osteoporosis is a decline in the density of bone health over time. There are multiple treatments for osteoporosis including anabolic and antiresorptive medications. It is often diagnosed with a bone density (DEXA), however any fragility fracture should be considered the same as having the diagnosis of osteoporosis. Osteoporosis while increasing the risk for fractures actually carries very high mortality late in life.