Endocrinology

Find TRUE Care for endocrinology.

The Wilmington Health endocrinologists are specialists who diagnose and treat diseases and conditions related to the glands of the endocrine system. Hormones, produced by these glands, are necessary for reproduction, growth and development, metabolism, and more.

Endocrinology Services

What We Treat

We welcome patients 18 years of age and older. Find out what conditions our specialists treat.

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Ultrasound and Fine Needle Aspiration (FNA) Biopsy Services

Wilmington Health Endocrinology offers ultrasound and FNA biopsy services to patients with abnormal thyroid tests.

Learn More about Ultrasound and Fine Needle Aspiration (FNA) Biopsy Services

Videos

Learn more about Obesity, Hypoglycemia, and Diabetes discussed by Dr. Misaghian-Xanthos!

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Referrals

Find out how you can refer your patient to Wilmington Health’s Endocrinology department.

Learn More about Referrals

Please download, print, and fill out the New Endocrinology Patient Packet, and bring them with you to your first appointment. 

Our goal is to make your referral process as seamless as possible. If you have a patient you would like to refer to Wilmington Health, please download, complete, and fax the form below to 910-341-1900. Please note we will be unable to except referrals faxed to any other fax line.

Please find the Wilmington Health Referral Form here

Diabetes

Types of Diabetes | Complications | Screening | Treatment

DiabetesAccording to the latest figures from the Centers for Disease Control and Prevention (CDC), over 30 million Americans have diabetes mellitus, which is commonly referred to as diabetes. Many of those people have no idea they have diabetes and millions more are at risk of developing it.

Our TYPE 2 DIABETES RISK ASSESSMENT can help you learn more about your own risk factors for the most common type of diabetes, type 2 diabetes.

Simply click on the link for the form. Fill it out online to learn more about how specific things affect the risk of developing type 2 diabetes. When you’re done, you may want to print it out and share it with your doctor. Any information you enter will NOT be saved once you close the window. This is to protect your privacy. When you’re done, simply close the form window, and continue reading.

If you have diabetes, your body has problems converting the food you eat into energy. The danger of this lies in the fact that if untreated, diabetes can damage the eyes, kidneys, nerves, heart and blood vessels. (Read about “The Eye” “Diabetes and Kidney Disease” “Nervous System” “The Heart & Cardiovascular System“) Therefore, whenever present, it’s essential to diagnose, monitor and treat diabetes correctly.

Diabetes mellitus should not be confused with diabetes insipidus (DI). Diabetes insipidus and diabetes mellitus are unrelated, although they can have similar signs and symptoms, like excessive thirst and excessive urination. (Read about “Diabetes Insipidus“)

Below find information to help you learn more about diabetes, its causes, complications and how to live with it.

Insulin and blood sugar

The Liver, Pancreas and GallbladderNormally, the food we eat is broken down into glucose, which is a form of sugar. The glucose passes into the bloodstream, where it is used by cells for growth and energy. For cells to use glucose, however, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. (Read about “Endocrine System“) If the insulin isn’t present, or if the cells don’t respond to it (commonly referred to as insulin-resistance), the glucose stays in the bloodstream, causing a rise in the blood sugar or blood glucose level. When blood sugar levels are too high it’s called hyperglycemia; when blood sugar levels fall too low it’s called hypoglycemia. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says conditions that can lead to hypoglycemia in people with diabetes include taking too much medication, missing or delaying a meal, eating too little food for the amount of insulin taken, exercising too strenuously, drinking too much alcohol, or any combination of these factors.

Types of diabetes

The American Diabetes Association (ADA) and NIDDK say there are different types of diabetes and insulin-resistance:

  • Type 1 diabetes (which has also been called insulin-dependent or immune-mediated diabetes) occurs when your body can’t produce insulin. This is the kind of diabetes that often appears before the age of 18, although it can also strike at any age. Type 1 diabetes is considered an autoimmune disease. An autoimmune disease results when the body’s system for fighting infection, the immune system, turns against a part of the body. (Read about “The Immune System“) In Type 1 diabetes, according to NIDDK, the immune system attacks the insulin-producing cells in the pancreas and destroys them. The pancreas then produces little or no insulin. An individual with Type 1 diabetes requires daily doses of insulin. The insulin can be delivered by injection, or through a pump system, which feeds the insulin into the body through a needle or catheter inserted just under the skin. Healthy meal planning and regular exercise are also a part of treatment for type 1 diabetes.
  • Type 2 diabetes (which has also been called non-insulin-dependent diabetes) is much more common than Type 1 diabetes, affecting some 90 percent of people with diabetes. In this type, your body can produce insulin, but it either doesn’t produce enough or it isn’t using it properly. Someone with Type 2 diabetes uses exercise, healthy meal planning and, in many cases, oral medications or insulin to control blood sugar levels. Type 2 diabetes has been linked with obesity (Read about “Obesity“), and the number of people in the U.S. with Type 2 diabetes is growing.
  • Gestational diabetes is diabetes that is first recognized during pregnancy. It usually disappears once the baby is born. This condition requires careful monitoring throughout the pregnancy (Read about “Prenatal Care“) and can put a woman at higher risk of developing diabetes within 10 years. The ADA says about four percent of pregnant women develop gestational diabetes during pregnancy, and women who were overweight before becoming pregnant are at a higher risk. (Read about “Healthy Pregnancy“) The Centers for Disease Control and Prevention say women who have had gestational diabetes have a 20 to 50 percent chance of developing diabetes in the next 5-10 years. Therefore, any woman who developed gestational diabetes during pregnancy should be sure she is monitored throughout her life. It is very important that she maintain a normal weight and exercise regularly.
  • Pre-diabetes/Insulin Resistance There is also a condition called “pre-diabetes” which may affect over 85 million Americans over the age of 20. The term “pre-diabetes” is being used to describe an increasingly common condition in which blood glucose levels are higher than normal but not yet diabetic. This is also known as impaired glucose tolerance or impaired fasting glucose. Someone with impaired glucose tolerance may also be described as “insulin resistant,” that is, their body produces insulin but isn’t utilizing it correctly, causing blood sugar levels to rise.Insulin resistance is also a factor in metabolic syndrome or syndrome X. (Read about “Metabolic Syndrome“) Other risk factors for metabolic syndrome include a body mass index of over 25 (Read about “Body Mass Index“), high triglyceride levels, family history of diabetes (Read about “Family Health History“), polycystic ovary syndrome (Read about “Polycystic Ovary Syndrome“), sedentary lifestyle, age and ethnicity. The American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE) say metabolic syndrome is an epidemic condition that dramatically increases risk for type 2 diabetes, heart disease and stroke. They estimate that it affects one in three Americans.HHS says most people with pre-diabetes will likely develop diabetes within a decade unless they make changes in their diet and level of physical activity, which can help them reduce their risks. Even before they develop diabetes, their health is still at risk, since they are much more likely to develop high blood pressure, abnormal blood lipids and coronary heart disease. (Read about “Hypertension: High Blood Pressure” “Cholesterol“) Studies have linked obesity to impaired glucose tolerance/pre-diabetes.
  • Latent Autoimmune Diabetes in Adults (LADA) goes by a number of names, according to the ADA. It can also be called type 1.5 or slow onset type 1. NIDDK says that LADA usually shows up after the age of 35 and with signs that the immune system (Read about “The Immune System“) is attacking the cells in the pancreas that make insulin. ADA says people with LADA may not need insulin in the beginning, and they generally are not insulin resistant. However, they most likely will eventually need insulin to control blood sugar. Diet and exercise are also crucial to controlling blood sugar levels. ADA also says people with LADA tend to be physically fit in the way they look, not overweight.

Diabetes can also result from specific genetic conditions (Read about “Genetics“), as well as from surgery, medications, infections, pancreatic disease, and other illnesses.

Symptoms of diabetes

Symptoms of diabetes can vary, but the American Academy of Family Physicians says typical symptoms, especially for Type 1 diabetes, include:

  • frequent urination (Read about “Urinary System“)
  • excessive thirst
  • blurry vision
  • tingling or numbness in the hands and feet (Read about “Paresthesia“)
  • unexplained weight loss despite eating more than usual
  • extreme tiredness or irritability

In Type 2 diabetes there may not be any symptoms, especially initially. This is why screening and lifestyle changes are so important, especially if you have any of the risk factors for diabetes. Type 2 diabetes occurs most often after the age of 40 (although the American Diabetes Association says there is an alarming – potentially lifestyle-related – increase in the number of people under age 40 now developing this kind of diabetes). It’s estimated that millions of people have type 2 diabetes and do not know it. Talk to your doctor about being tested for diabetes, especially if any of the following risk factors apply to you:

  • you have a family history of diabetes
  • you are more than twenty percent over your ideal weight (Read about “Body Mass Index“)
  • you have high blood pressure or high blood cholesterol (Read about “Hypertension: High Blood Pressure” “Cholesterol“)
  • you belong to a racial or ethnic group at higher risk, including Hispanic, African American or Native American (Read about “Minority Health“)
  • you developed diabetes during pregnancy or delivered a large baby (9 pounds or heavier)

Complications of diabetes

Left untreated or uncontrolled, diabetes can cause severe complications including heart disease, stroke, blindness, cataracts (Read about “Cataracts“), kidney disease and nerve damage that could lead to amputation.

  • Diabetic neuropathy – This is the name given to the nerve damage caused by diabetes. NIDDK says symptoms of neuropathy include numbness and sometimes pain in the hands, feet or legs. (Read about “Feet, Ankles and Legs“) Nerve damage can also cause problems with internal organs. The symptoms of neuropathy depend on which nerves and what part of the body is affected. They can include numbness or insensitivity to pain or temperature; tingling, burning, or prickling; sharp pains or cramps; sensitivity to touch; loss of balance and coordination. Symptoms can get worse at night. In addition, neuropathy may be diffuse, affecting many parts of the body, or focal, affecting a single, specific nerve or part of the body. Peripheral neuropathy affects the feet and hands and autonomic neuropathy affects the internal organs.Treatment for neuropathy can include medications to treat the specific symptoms. In addition, careful monitoring and care of the feet, as well as control of blood glucose levels are essential. (Read about “Peripheral Neuropathy“)
  • Blocked ArteryHeart disease and stroke – The American Heart Association (AHA) says diabetes is also a major risk factor for stroke, coronary heart disease and heart attack. (Read about “Coronary Heart Disease” “Stroke“) According to AHA, two-thirds of people with diabetes mellitus die of some form of heart or blood vessel disease, and adults with diabetes are two to four times more likely to have heart disease or suffer a stroke than adults without diabetes. Patients who have suffered from diabetes since childhood, especially if it has been poorly controlled, are at significant risk of developing one of these life threatening problems as early as their 20’s or 30’s.AHA says insulin resistance, a condition where the body cannot use the insulin it produces effectively and a key component of Type 2 diabetes, is associated with blood lipid imbalances. These can include things like an increase in low-density lipoprotein (LDL or so-called bad cholesterol), low levels of high-density lipoprotein (HDL or so-called good cholesterol), and increased levels of triglycerides, all of which are linked to higher risk of heart disease. (Read about “Cholesterol“)AHA adds that people with diabetes may avoid or delay heart and blood vessel disease by controlling both their diabetes as well as the risk factors associated with heart disease. However, studies show many people with diabetes are unaware of their increased risk of heart disease and the importance of taking steps to reduce their risk by careful monitoring and control of blood sugar levels combined with weight loss, blood pressure and cholesterol control, and not smoking. (Read about “Hypertension: High Blood Pressure” “Quit Smoking“)
  • EyeDiabetic retinopathy – Diabetic retinopathy is a potentially blinding complication of diabetes in which the eye’s retina is damaged. ADA says it is more likely to develop the longer someone has had poorly controlled diabetes. Diabetic retinopathy occurs when diabetes damages the tiny blood vessels in the retina. At first, there may not be any changes in vision. Without treatment, eyesight progressively deteriorates. However, with treatment, the National Eye Institute says 90 percent of those with advanced diabetic retinopathy can be saved from going blind. The condition is usually treated with either surgery or laser surgery. It can be detected through annual eye exams. (Read about “Eye Exams“)
  • Kidney disease – Poorly controlled diabetes is the number one cause of chronic kidney failure, which is also called end stage renal disease (ESRD). Diabetes results in 35 percent of new ESRD cases each year. (Read about “Diabetes and Kidney Disease” “Kidney Disease” “Blood Pressure and Kidney Disease“)
  • Diabetic ketoacidosis – In this potential complication, impurities can build up rapidly in the body and cause a medical emergency. The impurities are the by-products of fat metabolism, called ketones. Ketones build up in the blood because not enough insulin is available to burn glucose for energy, and fat is burned rapidly instead. The high level of ketones that results causes acid in the blood, which is dangerous, and the high level of glucose leads to severe dehydration. (Read about “Dehydration“) This can result in low blood pressure, rapid heart rate, and other symptoms. Diabetic ketoacidosis, as the condition is called, is treated with insulin and fluid replacement. In most cases patients are admitted to the hospital, often to the intensive care unit. This is most likely to occur in type 1 diabetes. A similar condition, known as hyperglycemic hyperosmolar state (HHS), can occur in type 2 diabetes, and is also a medical emergency.
  • Diabetic gastroparesis – Poorly controlled diabetes can also affect the nerves that are part of the stomach. It can result in delayed emptying, abdominal distension and bloating and chronic pain. (Read about “Gastroparesis“)
  • Yeast infections – Yeast infections are more common in people with diabetes, especially if the diabetes is not well controlled. Women with diabetes are more likely to have recurrent vaginal yeast infections, according to the National Women’s Health Information Center. (Read about “Vaginal Yeast Infections“) Uncontrolled diabetes also increases the risk of thrush. (Read about “Thrush“)

Screening for diabetes

During a screening, medical personnel will test to see if your blood glucose level is elevated. The fasting plasma glucose test is the preferred test for diagnosing type 1 or type 2 diabetes, according to NIDDK. It is most reliable when done in the morning. You may want to discuss the best time to take the test with your doctor.

NIDDK says a diagnosis of diabetes can be made after positive results on any one of the following tests, with confirmation from a second positive test on a different day:

  • an A1C of greater than or equal to 6.5 percent
  • a random (taken any time of day) plasma glucose value of 200 mg/dL or more, along with the presence of diabetes symptoms.
  • a plasma glucose value of 126 mg/dL or more after a person has fasted for 8 hours.
  • an oral glucose tolerance test (OGTT) plasma glucose value of 200 mg/dL or more in a blood sample taken 2 hours after a person has consumed a drink containing 75 grams of glucose dissolved in water. This test, taken in a laboratory or the doctor’s office, measures plasma glucose at timed intervals over a 3-hour period. (Read about “Laboratory Testing“)

These tests measure whether or not your blood glucose level is higher than what’s considered normal. If it’s high, you may be able to restore your blood glucose level to a normal level through diet and exercise. Your doctor may also prescribe medication or insulin. As with any medication, talk with your doctor about possible side effects or interactions, especially if you’re also on medication for high blood pressure.

Gestational diabetes is diagnosed based on plasma glucose values measured during the OGTT, according to NIDDK. Glucose levels are normally lower during pregnancy, so the levels for diagnosis of diabetes in pregnancy are lower. If a pregnant woman has two plasma glucose values meeting or exceeding any of the following numbers, she is considered to have gestational diabetes:

  • a fasting plasma glucose level of 95 mg/dL
  • 1-hour level of 180 mg/dL
  • a 2-hour level of 155 mg/dL
  • a 3-hour level of 140 mg/dL

Monitoring and treating diabetes

For someone with diabetes, healthy eating, physical activity, oral medications and/or insulin are the basic therapies for controlling blood sugar levels.

Diet – It’s essential that someone with any type of diabetes follow a healthy diet. (Read about “Dietary Guidelines“) You should work with your doctor, registered dietician or healthcare provider to develop a meal plan. This is a guide that tells you how much and what kinds of food you can choose to eat at meals and snack times. By reading food labels (Read about “Food Labels“), buying healthy foods and following your food plan, you can help keep your diet on track.

Monitoring blood sugar – It’s also imperative for anyone with diabetes to monitor their blood sugar level carefully. Options include:

  • Glucose monitors – Most methods of monitoring blood glucose require a blood sample, usually obtained by using an automatic lancing device on a finger. Some meters use a blood sample from a less sensitive area, such as the upper arm, forearm or thigh. The drop of blood is then placed on the end of a specially coated strip, called a testing strip. The strip has a chemical on it that makes it change color according to how much glucose is in the blood. ADA says that it is vital that you compare your test results to the goals you and your healthcare provider established. If you are not meeting your goals at least 75 percent of the time, you need to discuss this with your healthcare provider. Changes may be needed in your medication, insulin, diet or exercise.There are also continuous monitoring systems. A sensor can be inserted under the skin to provide glucose values every few minutes. Continuous measurements must be used in conjunction with fingerstick measurements.
  • A1c test – In addition to daily monitoring of blood sugar, other tests can be used. One is the hemoglobin A1c test. According to the National Diabetes Education Program (NDEP), this test shows the average amount of sugar in your blood over the last 2-3 months. It is a simple lab test done by your healthcare provider. NDEP calls it the best test to find out if your blood sugar is under control and says diabetics should have a hemoglobin A1c test at least twice a year. The American Diabetes Association recommends an A1c target of less than 7 percent for optimal blood sugar control.

Insulin – Insulin is essential for anyone with Type 1 diabetes. People with Type 2 diabetes may need to take insulin as well. The amount of insulin must be balanced with food intake and daily activities. Insulin cannot be taken orally because it would be broken down during digestion. Insulin is usually injected. ADA says, when injected, it must be injected into the fat under your skin for it to get into your blood and keep your blood sugar level as close to normal as possible. Insulin can be injected through a syringe, a pen or through a pump system that feeds the insulin into the body through a needle or catheter inserted just under the skin. There are also different types of insulin. They vary in how soon they start to work, when they reach their full strength, and how long they last in the body. ADA says insulin should never be stored in very hot or very cold locations. When using insulin, blood glucose levels must be closely monitored through frequent blood glucose checking. NIDDK says when blood glucose levels drop too low – a condition known as hypoglycemia – a person can become nervous, shaky and confused. Judgment can be impaired. If blood glucose falls too low, a person can faint. This is considered a medical emergency and emergency personnel should be called. Your healthcare provider can give you instructions on how to deal with milder episodes, and on ways to prevent or minimize them.

There is also a form of insulin that can be inhaled with meals for patients with diabetes requiring mealtime insulin. FDA says it is not a substitute for long-acting insulin. The inhalable insulin must be used in combination with long-acting insulin in patients with type 1 diabetes, according to FDA, and it is not recommended for the treatment of diabetic ketoacidosis, or for patients who smoke.

Medications – In addition to insulin, there are also other medications. ADA says there are different classes of diabetes drugs. Some drugs work to help the body make more insulin. Others sensitize the body to the insulin that is already present. Others slow or block the breakdown of starches and some sugars. Still others enhance the body’s own ability to lower blood sugar. There is also a class of drugs that help improve A1C without causing hypoglycemia by preventing the breakdown of a naturally occurring compound in the body.

The drugs may be used alone or in combination. It’s important to ask your doctor about any side effects to be aware of, as well as any potential interactions. (Read about “Medicine Safety“)

ADA says good control of blood glucose levels, a healthy diet and regular check-ups are the keys to preventing diabetes-related eye and kidney problems:

  • Patients with diabetes should see their eye care professional annually for a dilated eye examination, in order to detect a condition called retinopathy early, and possibly prevent blindness. (Read about “Eye Exams“)
  • They should have regular visits with their healthcare professional, and check-ups for cholesterol, blood pressure, A1c and kidney function, etc.
  • They should examine their feet regularly and see a doctor at once if they notice any sores that are not healing. (Read about “Wound Care“) This is especially important because they may have decreased sensation in their feet as a result of peripheral neuropathy. Infections (Read about “Microorganisms“) may go undetected, leading potentially to gangrene and even the need for amputation.
  • They should maintain a healthy weight, follow their prescribed diet carefully and exercise regularly.
  • They should compare their self-testing blood sugar results daily with their goals of blood-glucose control. If they are not meeting these goals, at least 75 percent of the time, they should notify their healthcare provider. Patients should ask their healthcare provider for their goals if they don’t already know them.

Dental care is also important, including regular check-ups. CDC says that people with diabetes are more likely to have problems with their teeth and gums. (Read about “Oral Health“)

As mentioned above, it is also essential that people with diabetes be aware of their risk of heart disease, stroke, and heart attack, and work to reduce their risks, both by monitoring their diabetes and goals, and by controlling their weight and blood cholesterol with a low-saturated-fat, low-cholesterol diet and regular exercise.

In some cases, where there are severe complications of type 1 diabetes, a pancreas transplant can be considered. (Read about “Transplants“) However, this is a serious, life changing operation, and potential benefits and risks must be weighed carefully.

Ideally, everyone with diabetes should be monitored frequently by a healthcare team knowledgeable in the care of diabetes. The best way to reduce the risk of complications of diabetes is by staying educated about it and by mastering the skills necessary to control your blood glucose levels and keep them as close to the normal range as you can.

Related Information:

    Blood Donation Guidelines

    Pancreatitis

    Primary Immunodeficiency

    Coronary Heart Disease

    Digestive System

    Medicine Safety

    Deep Vein Thrombosis

    Losing Weight

All Concept Communications material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.

© Concept Communications Media Group LLC

Online health topics reviewed/modified in 2021 | Terms of Use/Privacy Policy

Endocrine System

Endocrine SystemThe endocrine system is made up of glands (located throughout the body), hormones (which are made and secreted by the glands into the bloodstream) and receptors in various target organs and tissues (which recognize and respond to the hormones). The endocrine system works to regulate a wide range of biological processes, such as control of blood sugar, growth and function of the reproductive systems, regulation of metabolism and brain and nervous system development. (Read about “Nervous System“)

According to the American Medical Association, the endocrine system includes:

  • Pituitary gland – located in the brain (Read about “The Brain“), the pituitary is sometimes called the “master gland” because it produces a variety of different hormones that influence both other endocrine glands as well as a number of bodily processes.
  • Hypothalamus – located in the brain, this area also produces hormones that control the functions of various other endocrine glands.
  • Pineal gland – located at the base of the brain, it produces the hormone melatonin.
  • Thymus – located behind the breastbone, the thymus is a part of the immune system (Read about “The Immune System“)
  • Adrenal glands – there are two adrenal glands, one located on top of each of the kidneys. The adrenals secrete hormones that influence the body’s metabolism, blood chemicals and body characteristics, as well as influence the part of the nervous system that is involved in the “fight or flight” response to stress. (Read about “Stress“)
  • Thyroid – a butterfly-shaped organ located in the neck, the thyroid produces hormones that affect metabolism, bone growth and other functions. (Read about “Thyroid“)
  • Parathyroids – surrounding the thyroid are four small glands called the parathyroids. (Read about “Parathyroid Glands“) They produce parathyroid hormone, which helps control the amount of calcium in our bodies and how it is used. If the parathyroids don’t balance the calcium in our bodies, this can cause problems such as bone loss (Read about “Osteoporosis“) and kidney stones (Read about “Kidney Stones“), according to the American Academy of Family Physicians.
  • Pancreas – located in the abdomen, the pancreas secretes hormones that help regulate the use of glucose by the body. The pancreas can also be considered a part of the digestive system. (Read about “Digestive System“)
  • Testes in men – secrete hormones that affect sexual development and functions. (Read about the testes in “Genital Health – Male“)
  • Ovaries in women – secrete hormones that affect sexual development and functions. (Read about “The Ovaries“)

Because of the complexity of the endocrine system, a number of diseases and conditions can be traced to problems in this system. Problems with the endocrine system can be referred to an endocrinologist, or physician who specializes in the area. According to the Endocrine Society, endocrinologists can provide treatment for a variety of conditions including menopause, osteoporosis, cholesterol disorders, obesity, and infertility (Read about “Menopause” “Osteoporosis” “Cholesterol” “Obesity” “Infertility“) as well as endocrine-related diseases including the following:

Addison’s disease – see Addison’s Disease
Adrenal insufficiency, chronic – see Addison’s Disease
Cancer, ovarian – see The Ovaries
Cancer, pancreatic – see Pancreatic Cancer
Cancer, parathyroid – see Parathyroid Glands
Cancer, testicular – see Testicular Cancer
Cancer, thyroid – see Thyroid Cancer
Craniopharyngiomas – see Brain Tumors
Cushing’s syndrome – see Cushing’s Syndrome
Diabetes insipidus – see Diabetes Insipidus
Diabetes mellitus – see Diabetes
Graves’ disease – see Thyroid
Growth hormone – see Growth Hormone
Hashimoto’s disease – see Thyroid
Hypercalcemia – see Hypercalcemia
Hyperparathyroidism – see Parathyroid Glands
Hyperthyroidism – see Thyroid
Hypoparathyroidism – see Parathyroid Glands
Hypothyroidism – see Thyroid
Insulin resistance syndrome – see Diabetes
Ovarian cancer – see The Ovaries
Ovarian cysts – see The Ovaries
Pancreatic cancer – see Pancreatic Cancer
Pancreatitis – see Pancreatitis
Parathyroid cancer – see Parathyroid Glands
Pineal region tumors – see Brain Tumors
Polycystic ovary syndrome – see Polycystic Ovary Syndrome
Polyglandular deficiency – see Polyglandular Deficiency Syndromes
Testicular cancer – see Testicular Cancer
Thyroid cancer – see Thyroid Cancer
Thyroiditis – see Thyroid

All Concept Communications material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.

© Concept Communications Media Group LLC

Online health topics reviewed/modified in 2021 | Terms of Use/Privacy Policy

Parathyroid Glands

Endocrine SystemThe parathyroid glands are four pea-sized glands located in the neck. They are part of the endocrine system. (Read about “The Endocrine System“) They are found at the base of the neck near the thyroid gland. (Read about “Thyroid“) Although the names sound similar, the parathyroids and the thyroid are completely separate glands.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says the parathyroid glands secrete parathyroid hormone (PTH), a substance that helps maintain the correct balance of calcium (Read about “Calcium“) and phosphorous in the body. Calcium and phosphorus are important for many bodily processes, including the maintenance of healthy bones and teeth. (Read about “Calcium and Osteoporosis“) PTH regulates the release of calcium from bone, absorption of calcium in the intestine and excretion of calcium in the urine. (Read about “The Urinary System“)

When the amount of calcium in the blood falls too low, the parathyroid glands should secrete just enough PTH to restore the balance.

If the glands secrete too much hormone, as in hyperparathyroidism, the balance is disrupted: blood calcium rises. If the glands secrete too little, hypoparathyroidism can result. Hypoparathyroidism is much less common.

Below, you’ll find information on hyperparathyroidism, hypoparathyroidism and parathyroid cancer.

Hyperparathyroidism

Hyperparathyroidism is when the parathyroids secrete too much parathyroid hormone (PTH). The excess PTH causes blood calcium levels to rise. This condition of excessive calcium in the blood is called hypercalcemia. (Read about “Hypercalcemia“) Hypercalcemia can lead to bone pain, bone loss and other problems. (Read about “Skeletal System“)

In the United States, NIDDK says about 100,000 people develop the disorder each year. Women outnumber men two to one, and risk increases with age.

Hyperparathyroidism can develop in two ways:

  • Primary hyperparathyroidism is a disorder of the parathyroid glands. Most people with this disorder have one or more enlarged, overactive parathyroid glands that secrete too much parathyroid hormone.
  • In secondary hyperparathyroidism, a problem, such as kidney failure, makes the body resistant to the action of parathyroid hormone. (Read about “Kidney Disease“)

According to NIDDK, in 85 percent of people with primary hyperparathyroidism, a benign tumor (adenoma) has formed on one of the parathyroid glands, causing it to become overactive. In most other cases, the excess hormone comes from two or more enlarged parathyroid glands, a condition called hyperplasia. Very rarely, says NIDDK, hyperparathyroidism is caused by cancer of a parathyroid gland (see below).

Excess PTH can cause a number of problems. For example, the bones may lose calcium, and get thinner or more porous. (Read about “Osteoporosis“) In addition, the levels of calcium may increase in the urinary system; that can increase the possibility of kidney stones. (Read about “Kidney Stones“)

Symptoms of hyperparathyroidism range from none at all to nausea, vomiting and fatigue. Hyperparathyroidism is diagnosed when tests show that blood levels of calcium and parathyroid hormone are too high. Due to the high risk of bone loss, a bone density scan is often used. (Read about “DEXA Scan – Dual Energy X-Ray Absorptiometry/Densitometry“) Urine tests and abdominal scans can also be used to check for kidney stones. (Read about “Ultrasound Imaging” “CT Scan – Computerized Tomography“)

Surgery to remove the enlarged gland (or glands) is the main treatment for the disorder, according to NIDDK, and cures it in 95 percent of cases when performed by an experienced surgeon. Surgery does carry the risk of damage to the nerves controlling the vocal cords, which can affect speech. There is also the chance that too much parathyroid tissue will be removed, resulting in hypoparathyroidism (see below). In some cases, drugs may be used to turn off secretion of PTH. NIDDK says there are also cases in which treatment is not needed. Patients who are symptom free, whose blood calcium is only slightly elevated and whose kidneys and bones are normal may wish to talk to their doctor about long-term monitoring.

Hypoparathyroidism

Hypoparathyroidism is considered a rare disorder. Hypoparathyroidism is a disorder that causes lower than normal levels of calcium in the blood due to insufficient levels of parathyroid hormone (PTH). Phosphorus metabolism is also affected.

Symptoms can include:

  • weakness and muscle cramps
  • tingling, burning and numbness of the hands
  • excessive nervousness and/or headaches
  • loss of memory
  • spasms of the face, wrists and feet

According to the Hypoparathyroidism Association, this condition can be inherited, associated with other disorders, or it may result from neck surgery. Treatment centers on restoring calcium and vitamin D to the body. (Read about “Vitamins & Minerals“)

Parathyroid Cancer

Cancer of the parathyroid is called very rare by the National Cancer Institute (NCI). Symptoms for parathyroid cancer include the following according to NCI:

  • bone pain
  • a lump in the neck
  • upper back pain
  • weakness
  • difficult speech
  • vomiting

Problems with the parathyroid are common and very seldom involve cancer, according to NCI. A doctor should be consulted about any symptoms. Diagnostic tests include physical exam, the use of a thin, lighted tube called an endoscope to examine areas inside the body, x-rays, CT scans, MRI, Pet scans and/or biopsy. (Read about “Endoscopy” “X-rays” “CT Scan – Computerized Tomography” “MRI – Magnetic Resonance Imaging” “PET – Positron Emission Tomography” “Biopsy“)

If cancer is present, the doctor will want to learn the stage (or extent) of disease. Staging is a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Staging may involve an examination under anesthesia (Read about “Anesthesia“), x-rays and other imaging procedures, and laboratory tests. (Read about “Laboratory Testing“) Treatment options include surgery, radiation, chemotherapy and biological therapy. (Read about “Radiation Therapy” “Cancer Treatments“) NCI says surgery is the most common treatment. Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or stop them from growing. Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells.

All Concept Communications material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.

© Concept Communications Media Group LLC

Online health topics reviewed/modified in 2021 | Terms of Use/Privacy Policy

Thyroid

Nose, Mouth, NeckThe thyroid is a small, butterfly shaped gland in the front of your neck. It produces hormones that affect your body’s metabolism (how your body converts oxygen and calories to energy). That means the thyroid affects many functions that keep us healthy. Problems result when the thyroid produces either too much or too little hormone. Too much is called hyperthyroidism, too little is called hypothyroidism. The thyroid can also develop growths (nodules) or cancer. Below you’ll find information on all these conditions.

Hypothyroidism

Hypothyroidism is too little thyroid hormone. It affects some 5 million people according to Thyroid Society for Education and Research (TSER). One in 4,000 babies is born with hypothyroidism. If not treated, it results in mental and physical retardation. All newborns in the United States are supposed to be tested for the condition. (Read about “Newborn Screenings“)

Causes of hypothyroidism include:

  • Hashimoto’s disease – the most common cause of hypothyroidism, according to Thyroid Foundation of America (TFA), is Hashimoto’s disease. This is an autoimmune disease (Read about “The Immune System“) in which the immune system attacks and destroys the thyroid gland. It is also called Hashimoto’s thyroiditis. Thyroiditis is inflammation of the thyroid gland. There is some evidence that Hashimoto’s disease can have a hereditary link. The National Women’s Health Information Center (NWHIC) also says it is the most common thyroid disease in the U.S. The Turner Syndrome Society says this happens frequently to women with Turner syndrome. (Read about “Turner Syndrome“)
  • thyroiditis – in addition to Hashimoto’s disease, other less common forms of thyroiditis (inflammation of the thyroid) can result in hypothyroidism
  • surgery or other treatment such as radiation that damages or removes the thyroid (Read about “Radiation Therapy“)
  • lack of iodine in the diet that results in a goiter or a swelling of the gland
  • the natural aging process
  • viral or bacterial infections (Read about “Microorganisms“)

Some of the signs and symptoms of hypothyroidism according to AAFP, TSER and TFA include:

Too little thyroid hormone can also impact a woman’s menstrual cycle and a number of other things too, says TFA. For example, it can affect cholesterol levels (Read about “Cholesterol“) which in turn can result in other health problems such as heart disease. (Read about “Coronary Heart Disease“) In addition, the American Association of Clinical Endocrinologists (AACE) warns women approaching menopause (Read about “Menopause“) that thyroid symptoms sometimes mirror symptoms of menopause. AACE says that women who think they are having perimenopausal or menopausal signs should raise the issue of thyroid disease with their doctor.

Once again, one sign is probably nothing to worry about according to TSER, but if you have concerns, it is important that you see your doctor.

Thyroid problems are often diagnosed with blood tests. (Read about “Laboratory Testing“) Tests can be done to measure the amount of thyroid hormones, as well as the amount of hormone (TSH) produced by the pituitary gland to stimulate the thyroid. Tests can also check for the presence of antibodies. A test can also be done to measure how much iodine is taken up by the thyroid gland. Once the cause is figured out, treatment can be started. With hypothyroidism, the problem can sometimes go away on its own. If it’s caused by an infection, treating the infection can solve the problem. Hormone medication can also be used to replace the thyroid hormone. That – combined with blood tests – can then keep the problem regulated.

Hyperthyroidism

Hyperthyroidism is when the body basically speeds up; too much thyroid hormone is being produced. This can happen for a number of reasons, including:

Graves’ disease – The most common causes of hyperthyroidism, according to the American Academy of Family Physicians (AAFP), is a condition called Graves’ disease. Graves’ disease is a type of autoimmune disease that causes over-activity of the thyroid gland. An autoimmune disease occurs when the body’s immune system becomes misdirected and attacks the body’s own organs, cells, or tissues. (Read about “The Immune System“) The National Women’s Health Information Center (NWHIC) says Graves’ disease affects 2 percent of all women at some time in their lives, most often between the ages of 20 and 40. It also is considered a genetic disease that runs in families. (Read about “Genetics“) Graves’ disease is associated with swelling of the tissue around the eyes and bulging of the eyes. Symptoms of this disease can occur slowly or very suddenly and are sometimes confused with other medical problems. Graves’ disease can also produce no visible symptoms at all.

Thyroiditis – Hyperthyroidism can also be caused by some forms of thyroiditis, which is an inflammation of the thyroid gland. For example, a type of thyroiditis called subacute thyroiditis, which may be caused by a viral infection, can cause a temporary increase in the amount of hormone produced by the thyroid.

Pregnancy – Hyperthyroidism can also develop after pregnancy. (Read about “Healthy Pregnancy“) Postpartum thyroiditis is basically a swelling of the thyroid that occurs in 5-7 percent of women who give birth, and can cause temporarily high levels of thyroid hormone.

Nodules – Some nodules or adenomas can secrete too much hormone, leading to hyperthyroidism. (See thyroid nodules below)

As with all thyroid diseases, hyperthyroidism is more common in women than men, according to the Thyroid Society for Education and Research (TSER). Too much thyroid hormone can affect a woman’s menstrual cycle (Read about “Menstrual Disorders“) and cause calcium (Read about “Calcium“) loss from your bones resulting in osteoporosis (Read about “Osteoporosis“), according to the Thyroid Foundation of America (TFA).

Some of the signs and symptoms of hyperthyroidism according to AAFP, TSER and TFA include:

  • fast heart rate
  • elevated blood pressure (Read about “Hypertension: High Blood Pressure“)
  • nervousness or irritability
  • sweating (Read about “Sweating“)
  • weak muscles (Read about Endocrine Myopathies in “Neuromuscular Diseases“)
  • hands shaking
  • losing weight even though you are eating as much if not more
  • hair loss
  • skin and fingernail changes
  • increased bowel movements
  • goiter or a swelling of the neck
  • in women, decreased and less frequent menstrual flow (Read about “Menstrual Disorders“)
  • in men, slight swelling of the breasts

Just one of these symptoms does not mean you have hyperthyroidism according to TSER, but two or more, or different ones at different times, are a sign you should see your doctor.

Thyroid problems are often diagnosed with blood tests. (Read about “Laboratory Testing“) Tests can be done to measure the amount of thyroid hormones, as well as the amount of hormone (TSH) produced by the pituitary gland to stimulate the thyroid. Tests can also check for the presence of antibodies. A test can also be done to measure how much iodine is taken up by the thyroid gland. Once the cause is figured out, treatment can be started. For hyperthyroidism, there are multiple options. TFA says there are four main therapies for hyperthyroidism:

  • Antithyroid drugs have been in use since the 1940’s and are often successful.
  • Radioactive iodine can be used to destroy some thyroid tissue. The reminder may still be overactive but because there is less tissue, less thyroid hormone is produced.
  • Surgery can be used to remove all or part of the thyroid, with the same result as with radioactive iodine. If all of the thyroid is removed, thyroid medication may be required to replace the missing thyroid hormone.
  • Beta-blocking drugs can be used to block part of the hormone’s actions and relieve many symptoms.

It is interesting to note that many people who suffer from hyperthyroidism and are treated, later in life suffer from hypothyroidism as the body slows down with aging.

Thyroid Nodules

Thyroid nodules are fairly common. You may have a thyroid nodule and not even be able to feel it. Most are benign, meaning they are not cancerous. But even non-cancerous nodules can cause a problem, for example, if they grow large enough to press on your windpipe. A nodule can also produce too much hormone, resulting in hyperthyroidism.

You may be more at risk of developing nodules if you have or have had thyroiditis. People who as children received head or neck x-ray treatments for tonsillitis or other conditions (generally from the 1920s to 1960s) are more at risk, as are people who have been exposed to radiation for other reasons.

If you suspect a nodule, it is important to have it checked. Tests can include blood tests that measure thyroid hormones. (Read about “Laboratory Testing“) Scanning tests such as ultrasound (Read about “Ultrasound Imaging“) or a special thyroid scan can be used. You may also have a biopsy (Read about “Biopsy“), in which a needle is inserted into the nodule to remove a sample of cells.

Tests are important because swelling in the thyroid can be a sign of thyroid cancer. (Read about “Thyroid Cancer“) Again, while most nodules are benign, the National Cancer Institute (NCI) calls thyroid cancer the most common cancer of the endocrine system (Read about “Endocrine System“), so it is essential that you see your doctor if you notice any swelling or suspicious signs. If the nodule is not cancerous, but still growing and/or causing problems, treatment options include surgery to remove the nodule, radioactive iodine which can cause the nodule to shrink, or thyroid hormone suppression therapy.

Thyroid cancer

Although most thyroid nodules are benign, the National Cancer Institute (NCI) calls thyroid cancer the most common cancer of the endocrine system, resulting in about 1 percent of all cancers. The good news is the treatment success rate for thyroid cancer is very high.

(Read about Thyroid Cancer)

All Concept Communications material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.

© Concept Communications Media Group LLC

Online health topics reviewed/modified in 2021 | Terms of Use/Privacy Policy

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