Endocrinology

 


What is Diabetes?

Diabetes refers to an illness that influences how your body utilises the blood sugar known as glucose. The sugar is an important source of energy for the cells that make up your muscles and tissues. It is also vital for your brain as glucose is the main source of energy for the brain. Diabetes is known as an ailment of the pancreas (an organ behind your stomach that creates the hormone insulin). If a person is diabetic, the pancreas either cannot produce enough insulin or utilise the insulin properly. Insulin works with glucose in the circulation system to help it enter the body’s cells to be burned for energy. If you are diabetic, regardless of what sort, it implies you have excess glucose in your blood which can lead to medical issues.

Symptoms

People with Diabetes often experience the following symptoms or signs:

  • Dryness in the throat
  • Frequent urination
  • Increase of appetite
  • Weight loss
  • Extreme tiredness
  • Irritability
  • Vision problem
  • Slow-healing sores
  • Frequent infections
Causes

The main causes of diabetes-

  • Fatigue
  • Injury to pancreas
  • High blood pressure
  • Family history of diabetes or acquired propensity
  • Obesity
  • Old age

Risks

A risk factor increases a person’s chance of developing diabetes. These include:

  • Family History
  • Pancreatic diseases
  • Obesity
  • Laziness

Prevention

Here are some tips to help you reduce your risk of diabetes:

  • Eat a balanced diet
  • Be more active
  • Lose weight
  • Go for regular medical check-ups

What is Hypoglycemia?

Hypoglycemia is a condition characterized by an abnormally low level of blood sugar (glucose), your body’s main energy source. Hypoglycemia is commonly associated with the treatment of diabetes. However, a variety of conditions, many of them rare, can cause low blood sugar in people without diabetes. Like fever, hypoglycemia isn’t a disease itself — it’s an indicator of a health problem.

Symptoms

The symptoms or signs of hypoglycemia are:

  • Heart palpitations
  • Fatigue
  • Pale skin
  • Shakiness
  • Anxiety
  • Sweating
  • Hunger
  • Irritability
  • Tingling sensation around the mouth
  • Crying out during sleep

Causes

Some of the reasons behind hypoglycemia are:

  • Having diabetes
  • Excessive alcohol consumption
  • Insulin overproduction
  • Hormone deficiencies
  • Some critical illness

Prevention

The disease can be prevented if you:

  • Exercise regularly
  • Eat frequent small meals
  • If you have diabetes than always carry fast-acting carbohydrates with you

 How is it diagnosed?

The doctors mostly use three criteria for diagnosing hypoglycemia, which are often referred to as Whipple’s triad. This triad includes:

  •  Signs and symptoms of hypoglycemia
  •  Monitoring of low blood sugar when the symptoms occur
  •  Disappearance of the signs and symptoms

 How is it treated?

Treatment of hypoglycemia involves immediate initial treatment to raise your blood sugar level and treatment of the underlying condition that’s causing your hypoglycemia to prevent it from recurring.

Tumor treatment

A tumor in your pancreas is treated by surgical removal of the tumor. In some cases, partial removal of the pancreas is necessary.

Medications

If a medication is the cause of your hypoglycemia, your doctor will likely suggest changing the medication or adjusting the dosage.

What is Addison’s Disease?

The adrenal glands, present on the top of each of the kidneys, are responsible for producing hormones that regulate the body’s metabolism, immune system, blood pressure and other important functions. Addison’s disease is a type of adrenal disorder that occurs when the adrenal glands produce insufficient amounts of hormones (cortisol and aldosterone). This condition arises when the outer layer (cortex) of the adrenal glands gets damaged. The disease can pose a threat to the patient’s life.

Symptoms

The symptoms of Addison’s disease include:

  • Nausea
  • Vomiting
  • Fatigue
  • Pain in the abdomen area
  • Loss of appetite
  • Weight loss
  • Darkening of the skin
  • Low blood pressure
  • Low blood sugar levels
  • Salt craving
  • Muscle ache
  • Stress
Causes

Some causes of Addison’s disease include:

  • Tuberculosis
  • Infections in the adrenal glands
  • Presence of cancer in the adrenal glands
  • Bleeding in the adrenal glands

Risks

The risk of developing Addison’s disease increases if a person:

  • Has cancer.
  • Takes anticoagulants (blood thinners)
  • Has chronic infections like tuberculosis.
  • Has gone through a surgery to get any part of the adrenal gland removed.
  • Has diabetes
    -has Graves’ disease.

Prevention

Prevention of Addison’s disease includes controlling the symptoms, treating the main cause and limiting the risk factors. The disease can be prevented by

  • Treating fungal infections.
  • Controlling diabetes.
  • Identifying the cancer in the patient’s body and treating it. 
  • Treating bacterial infections such as tuberculosis.

How is it diagnosed?

During diagnosis, the doctor examines the medical history of the patient and checks the presence of signs and symptoms of Addison’s disease. The doctor confirms the presence of the disease by carrying out certain tests.

  •  Blood tests
  • ACTH stimulation test
  • Insulin-induced hypoglycemia test
  • Imaging tests

 How is it treated?

The treatment for Addison’s disease focuses on hormone replacement therapy that helps in normalising the level of adrenal hormones which the adrenal glands fail to produce.

 Why choose TX Hospitals?

TX ensures expert care for its patients who are diagnosed with Addison’s disease at the Institute of Endocrinology & Diabetology.

The Endocrinology & Diabetology division offers expert care for various metabolic, pituitary, thyroid and diabetes-related conditions. The institute gives access to a multi-disciplinary team including endocrinologists, diabetic educators, dietitians and a nurse practitioner. The treatment of disorders such as diabetes, obesity, thyroid, PCOS, osteoporosis, as well as less common, and highly complex hormonal disorders is given in concurrence with renowned specialists who are often involved in diabetes care, such as cardiologists, ophthalmologists, nephrologists, and dermatologists as well as primary care physicians.

 What is Hypothyroidism?

Hypothyroidism is a type of thyroid disorder which is caused when the thyroid gland becomes less active and produces fewer hormones than normal. The thyroid gland is a small, butterfly-shaped gland present in the lower neck and is responsible for producing the hormones- triiodothyronine (T3) and thyroxine (T4). These hormones play an important role in controlling the body’s metabolism. Hypothyroidism disturbs the balance of hormones and chemical reactions that occur in the body.

 Symptoms

The signs and symptoms of hypothyroidism may not be visible in the initial stages but as the disease progresses, the following symptoms are seen in the patient:

  • Weakness and fatigue
  • Sensitivity towards cold
  • Constipation
  • Dry skin
  • Weight gain
  • Face feels puffy
  • Muscle pain
  • High cholesterol levels
  • Swelling and ache in joints
  • Irregular menstrual periods
  • Thinning of hair
  • Stress and anxiety
  • Loss of memory

Causes

The causes of hypothyroidism could be any of the following:

  • Autoimmune disease: Autoimmune disease is a disorder in which the immune system starts producing antibodies that damage the body’s own tissues. These antibodies disturb the thyroid’s ability to produce hormones and may lead to hypothyroidism.
  • Congenital disease: The congenital disease is seen in infants who may be born with a defective thyroid gland, an under- developed thyroid gland or with no thyroid gland.
  • Pituitary gland disorder: In this disease, the pituitary gland is unable to produce enough thyroid-stimulating hormone (TSH) which might lead to hypothyroidism.
  • In some cases, women are diagnosed with hypothyroidism during or after pregnancy. If not treated properly, Hypothyroidism may lead to miscarriage, premature delivery or rise in blood pressure during the last three months of pregnancy.
  • Deficiency of iodine: Iodine is an important requirement for the production of thyroid hormones. It is found majorly in seafood, seaweed and plants grown in iodized salt. However, the intake of large quantities of iodine may also cause hypothyroidism.

 Risks

  • The risk of developing hypothyroidism increases with age
  • Having autoimmune diseases like rheumatoid arthritis or lupus which is a chronic inflammatory condition
  • The disease could be transferred through the family genes
  • Treatment with radioactive iodine or anti-thyroid medications
  • Exposure to radiation in the neck or upper chest area
  • Having a thyroid surgery
  • Pregnancy
 Prevention

Hypothyroidism can’t be completely prevented. However, if a person is at a risk of having the disease, he or she should consult a doctor and get a screening test done. One should understand the risk factors, recognise the symptoms, and get an early diagnosis done to prevent complications. The complications may become severe if hypothyroidism is not treated properly.

 How is it diagnosed?

The doctors opt for screening tests when a person is showing symptoms of hypothyroidism like weakness, fatigue, dry skin etc. The doctors also advise old women and expecting mothers to go through screening tests because they are at a higher risk of having hypothyroidism. 

 How is it treated?

The treatment for hypothyroidism involves the use of oral medicines like synthetic thyroid hormone levothyroxine that normalize the hormone levels and helps in restoring the functions of the thyroid gland. The medication also helps in reducing the symptoms of hypothyroidism.

 How choose TX Hospitals?

TX Hospitals ensures expert care for its patients who are diagnosed with hypothyroidism at the Institute of Endocrinology & Diabetology.

The Endocrinology & Diabetology division offers expert care for various metabolic, pituitary, thyroid and diabetes-related conditions. The institute gives access to a multi-disciplinary team including endocrinologists, diabetic educators, dietitians and a nurse practitioner. The treatment of disorders such as diabetes, obesity, thyroid, PCOS, osteoporosis, as well as less common, and highly complex hormonal disorders is given in concurrence with renowned specialists who are often involved in diabetes care, such as cardiologists, ophthalmologists, nephrologists, and dermatologists as well as primary care physicians.

 What is Hypopituitarism?

Hypopituitarism is a rare pituitary gland disorder in which the pituitary gland is unable to produce its hormones in sufficient quantities. The pituitary gland is a small, pea-sized gland situated below the brain, just behind the bridge of the nose. It is responsible for secreting hormones that control the functioning of several other hormone glands in the body like the thyroid gland, the adrenal glands, the ovaries and the testicles. In hypopituitarism, the reduced amount of pituitary hormones disturbs the body’s normal functions, such as growth, blood pressure and reproduction.

 Symptoms

The symptoms of hypopituitarism include:

  • Increased sensitivity towards cold
  • Poor appetite
  • Weakness and fatigue
  • Anemia
  • Swelling in the face
  • Disturbed menstrual cycles
  • Pubic hair loss
  • Infertility
  • Weight loss
  • Low sexual appetite
  • Decreased facial or body hair in men
  • Retarded growth in children
Causes

The causes of hypopituitarism include:

  • Injury to the head
  • Stroke
  • Brain infections like meningitis
  • Radiation treatment
  • Autoimmune inflammation
  • Excessive loss of blood during childbirth
  • Genetic mutations
  • Tuberculosis
  • Inflammatory diseases like sarcoidosis
  • Presence of tumours in the brain or pituitary gland
  • Brain surgery
Risks

The risk of developing hypopituitarism increases if a patient has suffered a recent head injury or has gone through radiation treatment that may have caused damage to the pituitary gland. 

Prevention

The risk of developing hypopituitarism due to child birth can be decreased by taking proper obstetric care. Regular monitoring and health check-ups especially during periods of stress, infections may help in preventing the disease.

How is it diagnosed?

In order to diagnose hypopituitarism, the doctor conducts the following tests to check the levels of various hormones like Adrenocorticotropic Hormone, Growth Hormone and Thyroid Stimulating Hormone etc. in the body. 

How is it treated?

Treatment for hypopituitarism includes treating the underlying cause to completely or partially restore the pituitary function. The doctor opts for certain drugs which act as a replacement for the pituitary hormones that the body would have manufactured in the absence of a pituitary problem. Hormone replacement drugs include:

  • Corticosteroids

These are oral drugs that act as a replacement to adrenal hormones

This medicine acts as a replacement for thyroid hormones.

Sex hormones used for men are testosterone while estrogen or a combination of estrogen and progesterone are used for women to treat hypopituitarism.

The growth hormone, when injected into the skin, promotes growth in children.

How does TX Hospitals provide care?

TX Hospitals ensures expert care for its patients who are diagnosed with hypopituitarism at the Institute of Endocrinology & Diabetology.

The Endocrinology & Diabetology division offers expert care for various metabolic, pituitary, thyroid and diabetes-related conditions. The institute gives access to a multi-disciplinary team including endocrinologists, diabetic educators, dietitians and a nurse practitioner. The treatment of disorders such as diabetes, obesity, thyroid, PCOS, osteoporosis, as well as less common, and highly complex hormonal disorders is given in concurrence with renowned specialists who are often involved in diabetes care, such as cardiologists, ophthalmologists, nephrologists, and dermatologists as well as primary care physicians.

 What is Parathyroid Disease?

Parathyroid glands are four grain like glands that are present in the neck and are responsible for releasing the parathyroid hormone. Parathyroid disease is a hormonal disorder that occurs in one or more parathyroid glands. The parathyroid hormone is responsible for maintaining a normal balance of calcium in the bloodstream. Hyperparathyroidism is the most common type of parathyroid disease and is caused due to over activity of parathyroid glands which leads to an excess of parathyroid hormone in a person’s blood.

The symptoms of parathyroid disease include:

  • Weak and fragile bones
  • Kidney stones
  • Frequent urination
  • Nausea and vomiting
  • Pain in the abdomen area
  • Weakness and fatigue
  • Stress
  • Joint pain
Causes

Parathyroid disease may be caused due to the following:

  • Severe calcium deficiency.
  • Severe vitamin D deficiency.
  • Chronic kidney failure.
  • Presence of a noncancerous growth on the parathyroid glands.
  • Enlargement of two or more parathyroid glands.
  • The presence of a cancerous tumor in the parathyroid glands.
Risks

The following factors increase the risk of parathyroid disease in people:

  • Menopause
  • Severe calcium deficiency
  • Vitamin D deficiency
  • Diseases like endocrine neoplasia
  • Radiation therapy
  • Intake of lithium drug for bipolar disorders
Prevention

Parathyroid disease can be prevented by drinking plenty of water, exercising regularly, quitting smoking and alcohol and avoiding calciumraising drugs like diuretics and lithium

 What are Lipid Disorders?

Lipid disorders are a group of medical conditions which occur due to increased levels of fatty substances like cholesterol and triglycerides in a person’s blood. High cholesterol may lead to development of fatty deposits in the blood vessels which limits the flow of blood through the arteries. Lipid disorders increase the probability of heart disease and may even lead to stroke.

The types of cholesterol are:

  • High-Density Lipoprotein (HDL) Cholesterol: Lipoproteins are substances that carry cholesterol in the blood. HDL cholesterol is also known as “good’ cholesterol because it helps in removing excess cholesterol and preventing cholesterol build up in the blood vessels. This decreases the risk of heart disease.
  • Low-Density Lipoprotein (LDL) Cholesterol: LDL cholesterol is commonly known as bad cholesterol. It grows in the inner walls of the arteries contributing to the formation of cholesterol plaques. Cholesterol plaques can block up arteries resulting in the hardening and narrowing of arteries (atherosclerosis).
Symptoms

A patient suffering from a lipid disorder does not exhibit any prominent signs or symptoms. The disease can only be detected using a blood test. Lipid disorders may cause certain complications like chest pain, heart attacks and strokes when not detected at an early stage.

Causes

Lipid disorders may be caused due to excessive intake of the following saturated or trans fats.

 Saturated fats: These are found in products such as butter, ghee, lard, cream, fat on meat, milk fat and cheese, palm kernel oil, palm oil and cocoa butter. Excessive intake of Saturated fats increases LDL cholesterol.
Trans fats: Transfats are formed during the process of hydrogenation of unsaturated oils. Hydrogenation makes the oil to be more saturated and increases the blood cholesterol level.
Monounsaturated fats: Olive, canola, peanut and sesame oils, almonds and avocados are rich sources of monounsaturated fats. Researchers believe that monounsaturated fats can lower LDL-cholesterol and increase HDL-cholesterol.

Risks

The following factors increase the risk of lipid disorders in people:

  • Unhealthy eating habits. 
  • Accumulation of fat in the waist.
  • No exercise.
  • Tobacco and alcohol intake.
 Prevention

Lipid disorders can be prevented by keeping bad cholesterol levels under check. This can be done by following a healthy and active lifestyle which includes a balanced diet, limiting the intake of saturated and unsaturated fats, increasing fibre intake, exercising regularly and quitting smoking and drinking. 

How is it diagnosed?

Lipid disorders don’t cause any prominent signs and symptoms and are primarily detected using a blood test that is called a lipid panel or a lipid profile test. 

How is it treated?

Treatment for lipid disorders calls for switching to an active lifestyle which includes exercising regularly, quitting smoking and following a healthy diet. However, if these lifestyle changes are unable to normalise the cholesterol levels, the doctor may opt for treatment through medication. The choice of drugs is based on the age of the patient, his current health and the side effects caused by the drug.

·         Statins

Statins help in reabsorbing cholesterol from the artery walls and may reverse lipid disorder.

·         Bile acid binding resins

The liver makes use of cholesterol to produce bile acids. Bile acid binding resins decrease the cholesterol levels indirectly by binding to bile acids which makes the liver use the excess cholesterol to produce bile acids.

·         Cholesterol absorption inhibitors

The small intestine is responsible for absorbing the cholesterol from the food and then releasing it into the blood. Cholesterol absorption inhibitors help in reducing blood cholesterol by limiting the absorption of dietary cholesterol.

·         Injections

Injectable drugs help in absorbing more LDL cholesterol and decrease the overall cholesterol level. The doctor opts for this treatment if other medicines are unable to cure the patient.

·         Omega-3 fatty acid supplements

Omega-3 fatty acid supplements help in decreasing the amount of triglycerides. These supplements should be taken strictly according to the doctor’s prescription.

Gonadal and Menstrual Disorders

Males and females have different gonads; testes and ovaries respectively. Gonadal and menstrual disorders stem primarily from hormone dysfunctions, the ovaries and testes produce many of the same hormones, but in different amounts. Menstrual disorders can include abnormally early or late onset of puberty, very light periods, very heavy periods and irregular or absent periods. They can also affect ovulation, including increasing the risk of ovarian cyst development, problems during pregnancy and the early onset of menopause.