We provide quality care and long term maintenance care for patients with the following medical conditions.
Pediatric and Adult Endocrinology:
- Board Certified Highly Trained Physicians & Staff
- Nutrition Education
- Treatment Care
- ADA Certified Education & Management of Insulin Pumps
- Erie's Diabetes Institute
(See Programs & Services for More Information)
The thyroid gland is a butterfly shaped organ located in the front of the lower part of your neck. The purpose of the thyroid gland is to make thyroid hormone, which travels throughout the blood stream to the rest of the body. Thyroid hormone controls the activity of all the other organs in your body, and thus either too much, or too little thyroid hormone can cause problems. Too much thyroid hormone is called hyperthyroidism and too little, hypothyroidism.
When disorders of the thyroid gland are discovered, they generally involve one of the following concerns.
- 1) Too much thyroid hormone (hyperthyroidism)
- 2) Too little thyroid hormone (hypothyroidism)
- 3) Nodules on the thyroid.
The overproduction of thyroid hormone may lead to one or more of the following symptoms. Not everyone will get these symptoms and some may not have any. The most common symptoms are nervousness, shakiness, irritability, anxiety, difficulty sleeping, palpitations (racing heart), weight loss (sometimes weight gain),increased appetite, muscle weakness, feeling warm and sweaty, increased frequency of bowel movements and perhaps diarrhea. Some people also develop problems with their eyes, with the typical symptoms being bulging eyes, dry, red or tearing eyes, and double vision. Although there are many causes of an overactive thyroid gland, typically, treatment typically involves medication or radioactive iodine. Surgery is not generally necessary.
The underproduction of thyroid hormone may lead to one or more of the following symptoms, fatigue, weight gain, puffiness around your eyes, hands or feet, or constipation. Just as in hyperthyroidism, some people may have no symptoms at all. The treatment of hypothyroidism involves taking a medication called levothyroxine, which is identical to the natural hormone made by your thyroid gland. Once treatment has been initiated and thyroid hormone levels have returned to normal, all symptoms will resolve. Treatment is life long.
Thyroid nodules are growths that occur within the thyroid gland, and can be either non-cancerous or cancerous. Most nodules, about 85%, are not cancerous. The question is how to differentiate between the two. One criteria used is size. If the nodule is less than 1cm ( a little less than 1/2 inch), the nodule can be monitored with ultrasounds. If it is greater than 1cm, a biopsy can be performed. This is an outpatient procedure that can usually be done in the office.
Our bones, the framework that holds us up, are constantly in a state called remodeling, which is the breakdown of bone followed by the formation of new bone. This process starts in childhood and is ongoing throughout our lives. When we are young and growing, more bone is made than is broken down and our bones grow. In our middle years, the processes work about equally. When we are older, especially in woman who are into the menopause, more bone breakdown occurs than does bone formation, which leads to weaker bones that are susceptible to fracture. Based on what was said above, the more bone made as a child and adolescent, the more bone you will have as an adult and senior citizen.
Other than age, there are also other conditions and some medications that may lead to osteoporosis. If your physician suspects that some other cause may be responsible for the osteoporosis, additional testing may be necessary.
The diagnosis of osteoporosis can be made under the following circumstances:
1) a T-score of less than -2.5 on DXA
2) a T-score of greater than -2.5 on a DXA with a fragility fracture
A fragility fracture is fracture of a bone that occurs when a fall occurs from standing height.
A DXA is low dose X-Ray that assesses bone density. The lower the bone density, the greater is the fracture risk. Osteopenia is defined as a T-score of -1 to -2.4. Osteoporosis is defined as noted above.
There are many treatment option now available to treat osteoporosis. The majority of these are classified as antiresorptive, that is, they slow down the bone breakdown process and thus let new bone formation catch up. Medications in this group include Actonel, Atelvia, Boniva, Fosamax, Prolia and Reclast. All of these medications are taken orally except for Prolia which is an injection under the skin every 6 months and Reclast which is taken intravenously once a year. In addition, there is a bone formative agent, Forteo, that is given as a daily injection under the skin for up to 2 years, that directly increases new bone formation. Which of these medications is best for any one patient is a decision between the physician and patient.
Many people are afraid of the side effects of these medications. Although side effects can occur, in general, the risks of not treating the osteoporosis are much greater than the risk of the medication. Bone fractures, especially those most commonly associated with osteoporosis, such as fractures of the hips, spine, wrist, ribs, and collar bone result in significant pain and suffering. Hip fractures, lead to surgery, disability, loss of independence and increased risk of death.