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Thyroid: is a gland in the lower portion of the neck that produces thyroid hormone and calcitonin.
The thyroid gland is a butterfly shaped organ that wraps around a front part of our windpipe (trachea) and feeding pipe (esophagus), just below the Adam's apple.

Thyroid hormone: develops mainly from the iodine that we consume with our daily nutrition.

Thyroid hormone regulates multiple systems in the body including; heart, cholesterol metabolism, energy levels, fertility, digestion, and other important functions.

Calcitonin: plays a role in calcium metabolism.
Thyroid hormone production is regulated by pituitary gland (master gland in the brain), and depends on the amount of thyroid hormone that a person has in the body, and our need for thyroid hormone to regulate all our important functions.
During the first trimester of pregnancy, maternal thyroid hormone controls development of important organs (brain, nervous system) in the fetus. Fetal thyroid does not begin functioning until the end of the first trimester. After that, the fetus depends on maternal iodine intake to produce adequate amount of thyroid hormone. Therefore pregnant women need to maintain an adequate (about 200 microgram/day) iodine intake during the pregnancy.

Thyroid function tests              Thyroid and weight              Thyroid in elderly                 Thyroid in pregnancy

​Under-active thyroid hypothyroidism: a condition where your thyroid gland does not produce enough thyroid hormone to meet your body needs. Since thyroid hormone controls all energy metabolism in our body, as well as our nervous, digestive, cardiovascular, reproductive and other important systems in our body; symptoms of under-active thyroid may include: weight gain, fatigue, loss of memory and concentration, dry skin, hair loss, constipation, irregular menstrual cycles, and feeling cold all the time. Under-active thyroid typically caused by inflammation of the thyroid, thyroiditis, but can occur after thyroid surgery, treatment with radioactive iodine, insufficient iodine intake, and other conditions and medications (example: amiodarone). Treatment includes administration of synthetic thyroid hormone thyroxine.
Over-active thyroid hyperthyroidism is a condition, when your thyroid gland produces too much of thyroid hormone. Excess of thyroid hormone may lead to rapid weight loss, despite increased appetite, fast heart beats, hand shakes, frequent bowel movements, hair loss, feeling hot all the time, irregular menstrual cycles, and other symptoms. Over active thyroid can be caused by thyroid inflammation, antibodies that stimulate thyroid, Graves disease, or overactive thyroid nodules. Treatment can include thyroid medications, radioactive iodine, or thyroid surgery.
Thyroid inflammation, thyroiditis, can be caused, most of the time, by antibodies that stimulate or suppress thyroid hormone production, leading to over, or under-active, thyroid. The symptoms of this are related to the degree and type of thyroid dysfunction, and can manifest as pain in the neck, or enlarged thyroid. Not everybody with thyroiditis can have abnormally functioning thyroid. Treatment of thyroiditis depends on the nature of inflammation, degree, and type of thyroid dysfunction.
Thyroid nodule: a localized growth within thyroid gland. It can be filled with solid tissue (solid nodule), fluid (cystic nodule), or be filled with a mixture of both (mixed nodule). Many people have thyroid nodules (either one nodule, or many- multinodular goiter), but only 4-5% of nodules are cancerous. Nodules can produce too much thyroid hormone- hot nodules or be metabolically inactive- cold nodules, but both types can potentially contain cancer. Nodules that are big (more than 1 cm), solid or mixed in nature, rapidly growing, or have concerning radiographic characteristics that typically undergo aspiration biopsy to determine if they contain cancer. 

​​Thyroid cancer: typically diagnosed as a result of the thyroid nodule biopsy, but can be an accidental finding during thyroid surgery, preformed for the big thyroid gland(goiter). Prognoses for most cases of thyroid cancer is usually excellent, with 95% chance to be alive 10 years after diagnosis. Risk factors to develop thyroid cancer include; prior therapeutic radiation to the head/neck area, and family history of thyroid cancer. Treatment includes removal of thyroid gland and any affected lymph nodes in the neck, in some cases treatment with radioactive iodine, and use of thyroid hormone to prevent regrowth of thyroid gland. During the evaluation for thyroid cancer, patients may be asked to follow a diet that's low in iodine to improve diagnostic accuracy or effectiveness of treatment.

Thyroid biopsy: a procedure when content of the thyroid nodule (or parathyroid gland or lymph node next to thyroid) is aspirated (taken) for analysis, to check for cancer. During the procedure, the patient is placed on their back with a pillow placed under their shoulder blades so that the neck is stretched out and the thyroid becomes more accessible. After skin on the neck is cleaned and numbed with anesthetic, a very fine needle is inserted in the area of interest. At least three passes are taken to obtain an adequate amount of cells that is necessary to make a correct diagnosis. After that, skin is cleaned and an ice pack is applied to minimize any bruising in the neck. As with any biopsy, complications include: bleeding/bruising at the side of the biopsy. The physician, prior to performing the procedure, will discuss indications and possible complications of the procedure, and what to do afterwords. Overall procedure lasts about 30 min and no specific preparations are required, except some patients may be asked not to take medications that can increase chance of bleeding for several days prior to procedure. 

Radioactive iodine: thyroid gland uses iodine to make thyroid hormone and it is the only organ in the body that takes up and accumulates iodine. Radioactive isotopes of iodine are used for testing of thyroid function (thyroid uptake and scan), identification of thyroid cancer spread, recurrence (iodine whole body scan), or treatment of thyroid cancer or overactive thyroid. Physician, who administer radioactive iodine, will discuss indications and risks with a patient who is considered a candidate for radioactive iodine treatment or diagnostic procedure. 

Diabetes: a condition when glucose (sugar), that is normally used as a major source of fuel for our body, can not be used effectively due to inadequate or insufficient production of hormone insulin. Diabetes can be caused by destruction of the pancreas organ that normally produces insulin, by either autoimmune process (type 1 diabetes), long standing history of diabetes, inflammation, or surgical removal. Type 2 diabetes is thought to be caused by constellation of genetic and environmental factors (steroids), then the pancreas does not make enough insulin and the body becomes resistant to normal or even high levels of insulin. Rare causes of diabetes include genetic defects of insulin structure, secretion, or action (MODY).
Classic symptoms of high blood sugar are: increased thirst, frequent urination, blurry vision, or fatigue after a heavy meal. But these symptoms can happen when sugar levels are very high. Modestly elevated blood sugars can occur without significant symptoms. Screening people who have high risk to develop diabetes (family members of diabetics, women with history of gestational diabetes, individuals who are of Black, Hispanic or Native American ethnicity or those who are overweight) can identify diabetes or prediabetes (impaired glucose tolerance) on early stages, before its complications develop. Complications of diabetes are serious and can lead to significant disability: heart disease, strokes, nerve damage, kidney failure, eye damage, erectile dysfunction, fertility problems, frequent infections, or even death.
Treatment of diabetes always consists of adherence to diet with controlled amount of carbohydrates and a lifestyle with focus on physical activity and avoidance of smoking or substance abuse. Some patients need to be treated with insulin, and some benefit from non-insulin oral or injectable medications that improve their own insulin production, or insulin sensitivity. Recently bariatric surgery was approved as possible treatment modality for selected patients. Care for diabetes in pregnancy  is especially important since it impacts health of both mother and developing fetus.
Recipes for patients with diabetes                Insulin pump therapy                  Personal continuous glucose monitoring 
Resources for diabetics                                  Medtronic       Carelink                                      Enlite          Libre           DEXCOM G5
Carbohydrate counting tools                       Omipod                                              

Meal resources                                                  Closed-loop 670G Medtronic
Low blood sugars                                              Tandem                                                                                                Resources from manufacturers
Diabetic nerve damage                                                                                                                                                        Journey For Control (Merck)
Diabetic eye damage                                                                                                                                                              COACH (Sanofi)                               
Erectile dysfunction                                      V-go delivery                                                                                            Cornerstone4Care (Novo)
Diabetic foot disease                                                                                                                                                               Fit2Me (AstraZeneca)                                    Diabetes and heart                                        Prediabetes                                                                                                  Lilly for Better Health 

Diabetic kidney disease                                Non-diabetic hypoglycemia          Bariatric surgery

​Diabetes and gum disease                           

MEDICARE recently approved DEXCOM G5 and LIBRE continuous glucose sensors for following patients with Diabetes:

1. Patients who perform four or more blood glucose checks per day utilizing a home blood glucose monitor (BGM),
2. Who are treated with insulin via 3 or more daily injections (MDI) or a continuous subcutaneous insulin infusion (CSII) pump,
3. Who requires frequent adjustments to their insulin treatment regimen by the patient on the basis of therapeutic CGM testing results, and
4. Has been in for an evaluation of their diabetes control with the prescribing practitioner within the past 6 months.

MUST have Diabetes and meet all of above criteria to qualify.                                                                                                                           

High blood cholesterol is associated with increased risk for cardiovascular disease: heart attacks, strokes, or blockages in feet circulation. High cholesterol  can develop due to genetic predispositions, from a certain diet, or from a combination of both. Treatment includes dietary modifications- limited animal fat consumption, and medications, if clinically indicated. 

Pituitary gland: a pea sized gland located in our brain that regulates production of multiple hormones, and regulates directly, or indirectly, all of the functions of our body. The main hormones produced or released from pituitary gland include: Growth hormone, Adrenocorticotropic hormone, Folliculostimulating and Luteinizing hormones (regulates fertility and sex hormone production), Thyroid Stimulating hormone, Prolactin, Vasopressin, and Oxytocin. Tumors of pituitary gland  or surrounding brain tissue, brain strokes, traumas, genetic defects, surgeries or illnesses that can affect the pituitary gland, can lead to over or underproduction of the above hormones. Symptoms associated with pituitary disorders  and treatment choices can vary and generally depend on the cause of the problem and what hormones are over/under produced. 

Adrenal glands are 2 small glands that are located above our kidneys. They have three layers, and produce multiple hormones: catecholamines, cortisol, aldosterone, and sex hormones androgens (regulate reproduction). Adrenal glands can be affected by tumors, genetic defects, systemic illnesses, or bleeding that can lead to over/under production of the above hormones. Treatment can include surgery or medications, and generally depends on the cause of the problem.
Adrenal fatigue            
Adrenal insufficiency            Congenital adrenal hyperplasia                 Myth vs fact

Disorders of elevated calcium can be caused by variety of reasons, most commonly abnormal intake of calcium or vitamin D, or abnormal production of parathyroid hormone. Often disorders of calcium metabolism are associated with kidney stones, weakening of the bones: osteoporosis in women and men, osteopenia, or abnormalities of the vitamin D metabolism. Treatment depends on the cause of the problem and may include diet, surgery or medications.

Low testosterone in men, or hypogonadism, is a condition that men are born with, due to genetic conditions, or can develop due to a variety of conditions; including problems in their pituitary glands, testes, or systemic illness. After identifying the cause, treatment frequently includes administration of testosterone.

Excessive testosterone production in women is associated with increased body hair growth, hirsutism and polycystic ovarian syndrome: condition associated with infertility, sleep apnea, metabolic syndrome, and diabetes.

Menopause is the time in a woman's life when the function of the ovaries ceases. It can be due to natural process, medications like chemotherapy, certain medical conditions, or surgery when ovaries were removed.