Endocrinology focuses on the endocrine system of which there are eight major glands located throughout your body. Because the endocrine system impacts all areas of the body, we approach our patients in a big picture way that provides the best treatment of the root causes of health issues. When two or more additional diseases or disorders co-occurs and is interrelated, it’s referred to as a comorbidity. For example, some thyroid disorders can create issues that affect bone density and can directly result in osteoporosis. Our onsite lab allows us to run diagnostic tests that allow us to rule out or confirm diagnoses quickly so we can take action in beginning your treatment plan.

Endocrinologists and Diabetic Care

Diabetes and endocrine care are so interrelated because diabetes is the most common endocrine disease in the United States. Endocrine care and treatment for diabetes includes the health and proper functioning of the pancreas. When the pancreas is in hormone imbalance, the development of hyperglycemia (too high body blood glucose levels) or hypoglycemia (too low blood glucose levels) can be the serious and sometimes life-threatening result.

An endocrinologist helps to manage your diabetes by prescribing insulin, oral diabetic medications, offering a diet plan to follow, and acts as a support base to help keep watch on your blood glucose levels. An endocrinologist will make adjustments and modifications to your treatment depending on results of your diagnostic tests, such as fasting glucose testing, A1C test results, and daily reports of blood glucose levels before and after a meal.

Focus on Education

Atlanta Diabetes Associates provides the resources and education needed to help manage diabetes, thyroid disorders or cancer, osteoporosis and other conditions related to the endocrine system. Managing your condition can be challenging when you look at all the important components of good care that include healthy eating, physical activity, taking the proper medication, daily monitoring of blood glucose levels, monitoring your body for any changes you may experience, and working to reduce your risk for development of complications. But ADA has many educators on staff who are there to help give you all the tools and resources you need to succeed and live a full life.

While it’s true that age is a primary risk factor for osteoporosis, it’s not the only cause. People of all ages can develop low bone mineral density. The earlier you take action with the things you can control, the more you can lower your risk of developing osteoporosis.

Causes

There are three main causes of osteoporosis: advanced age, hormone imbalances, and post-menopause for women.

How to Reduce Risk

Your genes are half the battle, but your lifestyle and environment play a huge part. Even if you already have osteoporosis or osteopenia, following these guidelines can help you manage your condition by building your bones and protecting them from further loss.

• Diet
  • Calcium keeps your bones strong and healthy. So making sure you eat a healthy and balanced diet rich in calcium and vitamin D is critical. Vitamin D helps your body absorb calcium, so it’s an important partner in a bone-healthy diet. There are many studies showing the link between calcium intake and bone mass. Getting enough calcium even as a child is important to future bone health, but a healthy diet at all stages is essential for helping you prevent issues or improve your bone health as you age.
  • Talk to your doctor about what amounts of calcium in your diet are needed for you. The National Osteoporosis Foundation suggests various amounts varied by age and if you’re pregnant or breastfeeding. As a general rule, adults 19-49 years of age need 1,000 mg of calcium daily. If you’re over the age of 50, that rises to 1,200 mg daily.
  • You can find calcium in leafy greens, salmon, fortified orange juice, non-fat milk, low-fat yogurt — and if your diet doesn’t have enough calcium, it’s important to take a supplement. For vitamin D, some people get enough from the sun, but a lot of Americans have deficiencies. Foods rich in vitamin D include oily fish (salmon), egg yolks, vitamin D fortified milk, and supplements. Fruits and veggies are rich in other nutrients that all contribute to bone strength and your health in general.
• Exercise
  • Be sure to talk to you doctor to help create a fitness plan that is safe and appropriate for your health, but still provides benefit.
  • Exercise benefits your muscles to make them stronger, and the same applies to your bones — they become stronger with physical activity.
  • A combination of various weight-bearing, strength-training, and balance exercises are best. Weight-bearing includes high-impact such as dancing or jumping rope, or low-impact such as walking. Strength-training includes lifting weights, using resistance bands or even lifting your own body weight. Balance exercises are great because it can help you avoid falls and possible fractures in the future. Things like Tai Chi or yoga and pilates help to strengthen your legs.
• Talk to your doctor
  • We can test your bone density to measure and diagnose if you have osteoporosis or appear to have more bone loss than is normal (osteopenia). It’s important to get a baseline for your bone density so it can be monitored over time, and appropriate steps can be taken to help you safely strengthen your bones.

Thyroid cancer represents about 4% of all new cancer cases. While it can be scary, most thyroid cancers are highly treatable and in some cases curable with treatment. The thyroid is at the front of the neck near the base of the throat. The thyroid gland is part of the endocrine system, which is a group glands that produce hormones that regulate many bodily functions. The thyroid specifically affects heart rate, blood pressure, temperature and metabolism.

Types

The four types of thyroid cancer are categorized by their cell of origin and their characteristics. Cancers arise from cells that have transformed and begun to abnormally divide and multiply.

1. Papillary (PTC)
   • Most common type: 70-80% are papillary thyroid cancer
   • More common in females (3x more effected than males)
2. Follicular (FTC)
   • Makes up about 10-15% of thyroid cancers
   • More common in females (3x more effected than males)
3. Medullary (MTC)
   • More likely to run in families
   • 5-10% of thyroid cancers
   • Develops from C Cells or parafolicullar cells which produce calcitonin (regulates calcium, phosphate)
4. Anaplastic (ATC)
   • Very rare, less than 2% of thyroid cancers
   • Usually occurs in patients 65+ years

Diagnosis

Your doctor will review your medical history including your family’s medical history, and your doctor will review your history and tests along with your reported symptoms. Initial tests include blood work and a physical exam to check your thyroid gland and surrounding tissues. Other tests include thyroid scans to capture images of the gland and fine needle aspiration (FNA). A few other imaging studies may be used such as CT or MRI scans to help confirm diagnoses. Depending on a tumor’s characteristics, a laryngosopy may also be performed, which is a flexible tube used to examine your layrnx.

After a complete evaluation, your doctor will make a diagnosis and outline a treatment plan.

Treatment

Treatment for thyroid cancer will first be determined by the stage it’s in, which enables your doctor to develop the most effective plan. Thyroid cancer usually includes surgery, though the type of surgery varies depending on a patient’s health and the size of the tumor. Some options are:

• Thyroidectomy
  • This procedure involves removing either partial sections of the thyroid gland, or the whole thyroid.
• Radioactive Iodine Therapy  (RIA or RRA)
  • RIA therapy involves a doctor administering iodine, typically in pill-form. The thyroid cells are the main cell that absorb iodine in your body, and by absorbing the iodine, it destroys remaining cancer cells and thyroid tissues that may remain after a thyroidectomy. Other cells are not effected. With traditional RIA, hypothyroidism occurs because patients aren’t able to continue taking thyroid hormone medications. Symptoms of hypothyroidism include fatigue, depression, forgetfulness, dry skin, constipation, difficulty walking, and forgetfulness.
• RIA with Thyrogen
  • Prior to radioactive idodine therapy, the drug Thyrogen may be administered, which allows patients to continue taking their hormone replacement medications throughout RIA treatments. By doing so, patients won’t experience all the hypothyroidism symptoms during their treatment. Thyrogen is also sometimes used to test for cancer recurrence.
• Radiation Therapy
  • Radiation therapy is rarely used for thyroid cancer, but in some situations may be called for. The goal is to kill cancer cells, shrink tumors, and relieve symptoms.
• Chemotherapy
  • Chemotherapy uses drugs that kill cancerous cells but also kills normal cells. Chemo is rarely used for thyroid cancers except in aggressive cases such as anaplastic thyroid cancer.
• Whole-Body Thyroid Scan
  • Whole-body scans may be performed in conjunction with other tests to monitor therapy progress and detect if the cancer has spread.

Followup Care

The prognosis for patients with thyroid cancer is often good, especially for those under the age of 45, those with small cancers, or papillary thyroid cancers when the tumors are confined to particular areas. But it’s critical for you to periodically follow-up with your doctor to ensure any recurrences or issues are caught immediately. Your doctor will discuss with you how frequent you will need follow-up appointments.

Follow-up care includes keeping up with any medical history updates, physical examinations, ultrasounds, FNA, blood tests, and other imaging tests as your doctor recommends.

Prepare for Your Appointment

Oftentimes so much information is shared between you and your doctor, it can be difficult to recall all the details later. It’s a great idea to bring a friend or family member along with you, keep a notebook during your appointments and even during your treatments to keep track of your experiences and symptoms. Write down questions you may have ahead of time, and then you’ll be able ensure you ask everything you intended to and be able to reference your notes.