Areas of Practice
Type 2 Diabetes
Type 2 Diabetes is a disorder of insulin action at the target cell; commonly called insulin resistance. Many times, background obesity is what has lead to the development of abnormal glucose tolerance. Lifestyle treatments with appropriate dietary intake and insulin sensitizing activities such as aerobic exercise are the first line therapies. Fortunately, many very effective medications are available to help you and your care team get you to your goals. The decision to start medical therapies should be done in the context of a thoughtful discussion with your physician with respect to your individual health needs.
Type 1 Diabetes
Type 1 Diabetes results from autoimmune destruction of the insulin producing cells of the pancreas. Treatment relies on optimizing the replacement of insulin deficiency through either injections or insulin pumps. The use of technology and new medical therapies are available to improve the quality of lives of patients with type 1 diabetes.
Hypothyroidism
Hypothyroidism is a condition that can result in a decreased quality of life and, if left untreated, commonly caused by autoimmune destruction of the thyroid gland; commonly called Hashimoto’s disease or thyroiditis. Hypothyroidism can also be related to surgery or ablative therapies as well as certain medications. Treatment should be individualized and include appropriate monitoring of and replacement of thyroid hormone.
Thyroid Nodules
Thyroid nodules are quite common and the risk of having them increases with age. Many are discovered incidentally on imaging for other reasons while some are found on physical exam. They are evaluated based on anatomy and function. Some nodules can produce too much thyroid hormone and lead to hyperthyroidism. Others can grow to the point of bothersome physical or casmetic symptoms. Between 5-15% may be cancerous. They require careful evaluation initially and surveillance as deemed ncessary based on the characteristics.
Pituitary Disease
Pituitary disease are a heterogenous group of diseases that include non-biologically active tumors of the pituitary gland and biologically functional tumors of the gland. Any type of pituitary growth can lead to central hormone deficiencies that require careful evaluation. Biologically functional tumors can secrete one or more pituitary hormones in excess leading to physical symptoms. Care of pituitary disease is generally multidisciplinary with endocrinologists , radiologists, and surgeons guiding the care plan.
Adrenal Disease
Adrenal diseases can be anatomic, functional, or both. Adrenal nodules, much like thyroid nodules, can secrete an excess of one of the hormones produced normally by the adrenal gland. These hormones are cortisol, aldosterone, and catacholamines (epinephrine and norepinephrine - commonly referred to as adrenaline). Rarely, these nodules can be cancerous (<1%). Disorders of adrenal hormone excess are managed by a combination of endocrinologists and surgical specialists. When the adrenal gland does not make enough of a specific hormone, that hormone requires replacement. The most common of these would be cortisol deficiency which is known as adrenal insufficiency. A thoughtful evaluation by an endocrinologist should be completed for any adrenal pathology.
Hyperthyroidism
Hyperthyroidism is a disease of thyroid hormone excess. It is managed differently based on the cause of excess thyroid hormone. The most common causes are autoimmune hyperthyroidism (commonly referred to as Graves’ disease), toxic thyroid nodules, and acute thyroiditis. Medical therapies, radiologic therapies, and surgical therapies are available to normalize thyroid hormone levels.
Obesity
Obesity is a complicated disease of energy excess. There are genetic, environmental, and behavioral causes that leaad to energy excess, and resultant obesity. Treatment of obesity involves a holistic approach with a focus on changing environment and behavior with medical therapies available to use to assist in reaching these goals.
Osteoporosis
Osteoporosis is a disease characterized by decreaed bone mineral density placing a person at an increased risk for fracture. While the best treatment for osteoporosis is prevention through adequate nutrional intake and resistance exercise early in life, these therapies have profound benefits throughout the lifetime. If a person has sustained a low trauma fracture or is at risk for low trauma fracture as determined by a bone mineral density study, there are medications available to improve bone density and decrease risk for first or recurrent fracture.
I do not offer:
“Fat Burners”
Hormone Pellets
I work hard to stay up to date on relavent practices. I will always be honest. My job is to offer the best care I can with the best data available. My medical opinion is not always aligned with what someone might think they need. I reserve the right to change my mind about certain practices as new data becomes available.