Atlantic Endocrinology New York City

Managing The Symptoms Of Polycystic Ovary Syndrome

Polycystic ovary syndrome, or PCOS, is a common condition that affects about 1 in 10 reproductive-aged women. PCOS causes the reproductive hormones to be out of balance, which can lead to the ovaries becoming enlarged and developing many small cysts.

Managing the symptoms of Polycystic Ovary Syndrome

At Atlantic Endocrinology & Diabetes Center we know that symptoms of PCOS include irregular or missed periods, hirsutism (excess hair growth on the face and body), acne, glucose intolerance, weight gain or obesity, and elevated cholesterol and triglyceride levels.

Many women with PCOS also struggle with infertility. Additionally, the chronic lack of menstruation puts women with PCOS at a higher risk for uterine cancer.

Identifying your PCOS type

Polycystic ovary syndrome (PCOS) is a condition that causes ovaries to produce abnormal amounts of androgen, or male sex, hormones.

As the name implies, a large number of small fluid-filled sacs called cysts often develop in the ovaries of those affected.

PCOS is a frequently under-diagnosed endocrine disorder affecting 1 in 5 women globally. The first step towards managing this is to identify your PCOS type to understand possible treatment options.

PCOS Types And Treatment

4 Types of PCOS

There are four main kinds of PCOS:

1.Insulin resistance PCOS

Insulin resistance is the most common trigger for PCOS. This is the most common type of PCOS, affecting around 70% of people.

It happens when our cells become “numb” to the effects of insulin, which causes the pancreas to make more insulin than normal.

This type of PCOS comes with struggles with your weight—especially gaining weight around the stomach/abdomen—sugar cravings, as well as symptoms like fatigue or brain fog.

2.Post-pill PCOS

Post-pill PCOS presents in some women after they’ve stopped taking oral contraceptive pills. The pill suppresses ovulation so that you don’t get pregnant.

Once off the pill, women experience an increase in androgen production, which causes symptoms such as acne, hair growth on the body, irregular periods and hair loss on the head.

3.Inflammatory PCOS

Chronic inflammation causes a hormone imbalance by suppressing ovulation (so you don’t make progesterone) and increasing the production of testosterone.

Symptoms of this type of PCOS include headaches and joint pain, fatigue, skin issues like eczema, and bowel problems like IBS.

4.Adrenal PCOS

This type presents itself as a response to unusual amounts of stress. The adrenal organs are responsible for controlling the stress response, and end up producing another form of androgen as a result of stress, causing symptoms similar to the other types of PCOS.

Other causes of PCOS: Some women present symptoms of PCOS but do not get a diagnosis of the four main types of PCOS.

These symptoms are usually caused by vitamin deficiencies, food intolerances, thyroid disease, and malnutrition.

There are also women whose trigger is never found, but the treatments, especially lifestyle modifications, remain helpful in keeping the symptoms in check.

Can I Get Pregnant With it?

Having polycystic ovary syndrome doesn’t mean pregnancy is off the table, but PCOS often leads to a hormonal imbalance that interferes with ovulation.

If you are not ovulating, it is not possible to conceive naturally. However, most cases of PCOS are treatable.

Research has shown that both diet and lifestyle factors can be a good first step in starting to address PCOS and there’s a lot we can try from a nutritional approach to try to bring the symptoms back in balance.

Here are a few tips to get you started:

1. Reduce your sugar intake – when we feel tired or low in mood, we often reach for sugary snacks to get us through the day or to make us feel better.

But this can be making the problem worse and feeding the high blood sugar levels, which in turn can drive hormone imbalances.

If you are feeling tired and in need of a snack opt for a protein based snack like nuts and seeds, or vegetable sticks and hummus. See my blog on blood sugar balance for more tips.

1. Opt for complex carbohydrates like sweet potato, brown rice, wholewheat pasta or brown rice pasta and quinoa instead of white potatoes, white bread or white rice or white pasta.

Carbohydrates all eventually break down into sugars, so going for complex carbohydrates slows down the rate at which they turn into sugar, helping to keep both your blood sugar and hormone levels in balance.

1. Manage your stress levels – living with a condition like PCOS is stressful, but the more stressed we are, the more inflammation there is in the body, the more out of balance our hormones are and the more we hold on to sugar in the bloodstream.

Stress can make conditions like PCOS worse, so doing something every day to help manage the effects of stress on the body can really help. Go for a walk, have a soak in the bath or do some gentle stretches, have a look at my stress blog for more ideas.

Can It Be Cured?

While there is no cure for polycystic ovary syndrome, many of the symptoms are easily treatable making it possible to conceive.

Consult with your healthcare professional at Atlantic Endocrinology & Diabetes Center, New York, to determine the best course of action based on your specific symptoms.

Certain medicines and pills can be taken to manage the symptoms of PCOS. Hormonal birth control like the pill, patch, shot, and vaginal ring can help balance out your menstrual cycle, reduce facial hair, and prevent acne.

Speak with your doctor to determine which method is right for you.

It is possible to induce ovulation in the ovaries using certain medications. The medication will promote the development of one or more mature follicles in the ovaries of women who are unable to ovulate naturally.

There are five major types of medications used: Clomid, aromatase inhibitors like Femara and letrozole, injectable gonadotropins, the GnRH pump, and Bromocriptine. You should consult with your healthcare professional to see which of these medications is right for your unique situation.

What Do Endocrinologists Do For Diabetes?

Managing diabetes is a long-term commitment, and sometimes the guidance of a specialist is needed to stay on track. While primary care physicians play a crucial role in your care.

Take charge of your diabetes with expert care from our top endocrinologist in Queens, NY!

How is Endocrinology Related to Diabetes?

Endocrinology is directly related to diabetes because diabetes is an endocrine disorder that affects how the body regulates blood sugar. The pancreas, an endocrine gland, either doesn’t produce enough insulin—the hormone responsible for controlling blood glucose levels—or the body is unable to use insulin effectively. This lack of insulin function causes elevated blood sugar levels, leading to serious health complications if not managed properly.

Managing diabetes is crucial because its long-term effects can include:

• Cardiovascular diseases
• Kidney damage
• Nerve damage (neuropathy)
• Eye damage (retinopathy)

Given these risks, it’s important to maintain a close watch on blood sugar levels and follow a proper diet and nutrition plan to control the disease.

Endocrinology, together with nutrition, is vital in treating diabetes. Endocrinologists focus on diagnosing and managing endocrine disorders like diabetes by:

• Identifying abnormal blood sugar levels early
• Establishing personalized treatment based on factors like age, lifestyle, genetics, and other medical conditions
• Preventing complications associated with diabetes

Endocrinologists supervise the use of insulin, adjusting doses as needed, educating patients on how to administer it properly, and continuously monitoring blood glucose levels to ensure optimal control. This coordinated care helps prevent the more serious complications of diabetes and improves overall quality of life.nt the more serious complications of diabetes and improves overall quality of life.

What Does an Endocrinologist Do For Diabetes?

An endocrinologist plays a crucial role in managing diabetes mellitus, a condition caused by the improper function of insulin. Insulin is essential for regulating blood sugar levels, but when it doesn’t work correctly, hyperglycemia (high blood sugar) occurs, which can lead to serious health issues.

The body uses insulin to allow glucose (a type of sugar) to enter cells and provide them with energy. Without proper insulin function, glucose builds up in the blood rather than being absorbed by cells, leaving individuals fatigued despite having high levels of sugar in the blood. Endocrinologists help patients manage this imbalance by:

• Monitoring blood glucose levels regularly
• Adjusting insulin therapy to ensure the body can use glucose effectively
• Educating patients on how to properly administer insulin
• Developing personalized treatment plans that consider lifestyle, diet, and other health conditions

Endocrinologists also help prevent complications such as dehydration, which occurs when the body pulls water from cells in an attempt to dilute the excess glucose in the blood, and long-term issues such as nerve, kidney, and eye damage caused by prolonged high blood sugar.

How About type 2 diabetes?

In type 2 diabetes, the body still produces insulin, but the cells become resistant to it, meaning insulin can’t unlock cells to allow glucose in. This results in a similar buildup of glucose in the blood, leading to fatigue, thirst, and dehydration, much like in type 1 diabetes.

Endocrinologists assist patients with type 2 diabetes by:

• Prescribing medications to increase insulin sensitivity
• Monitoring blood sugar levels and adjusting treatment plans as needed
• Providing dietary recommendations to help maintain stable glucose levels
• Offering lifestyle guidance, including exercise routines, to help manage insulin resistance

With the help of an endocrinologist, patients can better manage type 2 diabetes and reduce the risk of complications, ensuring a higher quality of life.

Can Diabetes Lead to Bone Problems?

If you have diabetes mellitus—commonly known as diabetes—you will be aware of potential complications of diabetes that may affect different body organs, including the eyes, kidneys, and heart.

At Atlantic Endocrinology & Diabetes Center we know and understand that there is one more thing risk to consider—and that is your risk for bone diseases.

Compared to people without diabetes, people with type 1 and type 2 diabetes have a higher risk for fractures, especially of the hip.

How diabetes affects bone health

The mechanisms behind diabetic bone disease are not entirely clear. Whether bone fragility happens alongside diabetes or is itself a complication of diabetes is a point of debate.

Diabetes mellitus changes your bone metabolism, which is one of the significant long-term complications we see in diabetes.

Diabetes increases the risk of periodontitis or gum disease. This leads to what we call alveolar bone loss, weakening the bones.

One complication of diabetes is microangiopathy, which is a disease of the small blood vessels. Microangiopathy is a type of microvascular disease related to bone mineral density, bone structure, and bone turnover.

What indicators of bone problems should healthcare professionals look for?

People with diabetes have the same risk factors for fracture as all adults. These risk factors include low BMD, falls, older age, being female, prior fracture, low body mass index, reduced physical activity, use of glucocorticoids, smoking, and consuming too much alcohol.

In patients with diabetes, there are other risk factors to look for, like having the disease for 5 years or longer and high glucose levels. If patients have hypoglycemia, that’s also going to increase their risk for falls and fractures.

At Atlantic Endocrinology & Diabetes Center we also know that some diabetes complications are associated with higher fall and fracture risk. These complications include peripheral neuropathy, poor vision, muscle weakness, and kidney disease NIH external link. They are all targets for treatment.

Bone Diseases Linked to Diabetes

Bone diseases associated with diabetes include osteoporosis, osteopenia, Charcot foot, diabetic hand syndrome, diffuse idiopathic skeletal hyperostosis, frozen shoulder, and Dupuytren’s contracture.

Osteoporosis

One of the most common bone diseases is osteoporosis, characterized by low bone mass and structural deterioration of bone tissues. It can lead to bone instability and increased risk of fractures of the hips, wrists, knees, and spine.

Osteopenia

In osteopenia, bones are weaker than usual. However, bone mass and density are not low enough to cause bones to break easily. Osteopenia can be seen as a middle point between having strong, healthy bones and having osteoporosis.

Charcot Foot

Also known as Charcot neuropathic osteoarthropathy, Charcot foot is a complication of diabetes that causes deformities in the foot and ankle. Symptoms include swelling, redness, and visible deformity.

Diabetic Hand Syndrome

Diabetic hand syndrome, also known as diabetic cheiroarthropathy, is a complication of both type 1 and type 2 diabetes where finger movement is limited, and the hands become waxy and thick. Diabetic hand syndrome is more common in people with long-standing, uncontrolled diabetes.

Diffuse Idiopathic Skeletal Hyperostosis

Diffuse idiopathic skeletal hyperostosis (DISH), also called Forestier disease, is a type of arthritis that affects tendons and ligaments—mainly in the spine. DISH causes tissues to become calcified (hardened) and bone spurs to develop in areas of the spine that connect to bone.

Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, results when ligaments around the shoulder become inflamed and stiff. Both inflammation and diabetes make routine healing harder, causing the shoulder joint to become so stiff that it can make the simplest activities­—like buttoning a shirt­—difficult.

Dupuytren’s Contracture

Dupuytren’s contracture, also called palmar fascia, is a hand condition that gradually causes the connective tissues under the skin of the hand to become thick and severely scarred. While the disease is not always painful, it does restrict movement in the fingers and may cause them to curl and bend towards the palm.

Takeaways

High blood sugar increases the fragility of joints and weakens muscles. Managing BSL and ensuring you get sufficient exercise will help reduce the risk of joint problems.

Complement your exercise with a healthy, nutritious diet, preferably plant-based. Of course, the best solution is to fully reverse your diabetes; and this is realistically achievable through a proper plan involving diet, exercise, stress management, and medical supervision.

Cushing’s Syndrome: Causes, Complications and Treatment

What is Cortisol

‍At Atlantic Endocrinology & Diabetes Center we feel that before discussing Cushing’s, we must first discuss cortisol.

Cortisol is a glucocorticoid (steroid) hormone which plays an important role in glucose and fat metabolism and reducing inflammation.

The hormone is also referred to as the “stress” or “flight-or-fight” hormone, as it, along with epinephrine (adrenaline) is released during “flight-or-fight” situations.

What is Cushing’s Syndrome?

Cushing’s Syndrome is a disorder in which the level of the hormone cortisol increases in the body.

High cortisol causes weight gain around the abdomen, chest, face, and neck.

 Cushing’s Syndrome is a rare condition affecting around 10-15 out of one million people every year.

It strikes adults between 20 and 50 years of age, but it can also occur in children. Cushing’s Syndrome is more prevalent in women than men, contributing to about 70 percent of all cases.

Causes of Cushing’s Syndrome

Cushing’s Syndrome is caused due to the following reasons:

Long-term use of corticosteroid medicines

People who take high doses of corticosteroid medicines for a long time may develop Cushing’s Syndrome.

 Corticosteroids are usually prescribed to treat rheumatoid arthritis, asthma and to prevent rejection after organ transplantation.

Excessive production of the hormone cortisol

Several medical conditions can trigger the adrenal gland to produce too much cortisol, including:

• Tumor in the adrenal gland.
• Tumor of the pituitary gland increases the secretion of adrenocorticotropic hormone (ACTH), causing the adrenal glands to release more cortisol.
• Tumors in the pancreas, lungs, or thyroid can increase the secretion of adrenocorticotropic hormone (ACTH).

Signs and Symptoms

• Weight gain and fatty tissue deposits, particularly around the midsection and upper back, in the face (moon face), and between the shoulders (buffalo hump)
• Pink or purple stretch marks (striae) on the skin of the abdomen, thighs, breasts and arms
• Thinning, fragile skin that bruises easily
• Slow healing of cuts, insect bites and infections
• Acne
• Severe fatigue
• Muscle weakness
• Depression, anxiety and irritability
• Loss of emotional control
• Cognitive difficulties
• New or worsened high blood pressure
• Headache
• Infections
• Skin darkening
• Bone loss, leading to fractures over time
• In children, impaired growth

 Signs and symptoms women with Cushing syndrome may experience

• Thicker or more visible body and facial hair (hirsutism)
• Irregular or absent menstrual periods

Signs and symptoms men with Cushing syndrome may experience

• Decreased sex drive
• Decreased fertility
• Erectile dysfunction

Cushing’s Syndrome treatment

Various treatment options are available for Cushing’s Syndrome, depending on the causes of high cortisol.

Tapering the doses of corticosteroids

If Cushing’s Syndrome is caused due to over-use of corticosteroids, your doctor at Atlantic Endocrinology & Diabetes Center will gradually reduce the dose of the medicine. The doctor will recommend the lowest possible dose of corticosteroids required to manage your disease.

Surgically removing a tumor

If Cushing’s Syndrome is caused due to a tumor in the adrenal glands, pituitary gland, lungs, or pancreas, your doctor will suggest surgery to remove a tumor. It will reduce the production of cortisol hormones in the body. But after the surgery, patients will require hormone replacement therapy to maintain the levels of cortisol.

Radiation therapy

The doctor recommends radiation therapy if a tumor can not be removed via surgery or if a patient is unfit for surgery. In radiation therapy, small doses of radiation are given for six weeks, or a high dose of radiation is given all at once to destroy the tumor cells.

Medications

The doctor may prescribe medications such as Mitotane, Metyrapone, and Ketoconazole to reduce the production of cortisol. These medicines are used when other treatment options such as surgery and radiation therapy do not work.

After complete treatment, most patients observe improvements in the symptoms of Cushing’s Syndrome and recover fully.

How do Hormonal and Chemical Changes Impact Teens

Teens. They can be a whirlwind of emotions, sudden growth spurts, and newfound independence. Ever wonder why this happens? It’s all thanks to a surge of hormonal and chemical changes that take place during puberty.

During the Deen Years Yormones Can Impact

These hormonal changes are like little chemical messengers, instructing your body on how to develop from a child to an adult. Typically starting between ages 8 and 14, this period can last until your mid-20s. It’s no surprise things can feel a bit out of control!

Here’s a breakdown of how these changes impact you:

• Physical Growth: Hormones accelerate growth spurts, leading to changes in height, weight, and body shape.
• Skin Changes: Get ready for breakouts! Hormonal fluctuations can cause acne to appear.
• Brain Development: Alongside your body, your brain is also undergoing construction. This can affect your decision-making skills and emotional regulation.

It’s Not Just Physical

Teenagers often experience intense mood swings, heightened self-awareness, and even feelings of anxiety or depression. While hormones can amplify these emotions, they aren’t the sole cause. Underlying mental health concerns might require additional support from a therapist or counselor.

Remember, You’re Not Alone

These changes are a universal experience for teenagers. While it might feel overwhelming at times, understanding what’s happening can be a big help. It’s like a rite of passage, preparing you for adulthood!

Feeling Down? Seek Support

If you’re experiencing persistent feelings of sadness, worthlessness, or thoughts of suicide, hormones likely aren’t the culprit. These signs might indicate a deeper issue that needs professional help. Don’t hesitate to talk to a parent, trusted adult, or therapist.

Understanding different types of bone cancer

At Atlantic Endocrinology & Diabetes Center we know that bone cancer is relatively rare, accounting for 1% of all cancer cases in the United States.

Quite often, bone cancer is the result of metastasis. This means that cancer from elsewhere has spread to the bone. These cancers show the original cancerous cells and not those associated with bone cancer. In these cases, the cancer is treated by following the original course of treatment for the initial tumor.

But there are also primary cancers of the bone. This means that the cancer starts in the bone. Primary bone cancer is not common. Only 2 of every 1000 cancers diagnosed in the US each year are primary bone cancer. Bones are composed of:

• Osteoid tissue (hard or compact)
• Cartilaginous tissue (tough, flexible)
• Fibrous tissue (threadlike)
• Bone marrow (soft, spongy tissue in the center of most bones)

The type of bone cancer depends on where in the bone it starts.

There are two main types of bone cancer. In adults, cancers that form in the organs and spread to the bones, or metastasize, are the most common and are called secondary bone cancers. Primary bone cancers, also called bone sarcomas, develop in the bones and often spread to other areas.

The primary forms of bone cancer from most common to least common include:

• Osteosarcomas are tumors of the bone and are the most common form of bone cancer. Osteosarcomas are usually diagnosed in young people, but they do occur in older adults. These tumors often form in the arms, legs, or pelvis.
• Ewing tumor (Ewing sarcoma) is the second most common bone cancer in young people and third most common overall. These bone tumors often form in the hip, ribs, shoulder blades, spine, and legs.
• Chondrosarcoma forms in cartilage cells. The risk for this type of cancer increases with age and is rare in patients under 20. Chondrosarcomas are graded by severity from one to three.
• High-grade undifferentiated pleomorphic sarcoma (UPS) is another rare form of cancer that is often found in the soft tissues but can also occur in the bones, especially the legs, arms, and abdomen. It can also occur in areas of the body where radiation was received. UPS is most common in middle-aged and elderly adults.
• Fibrosarcoma is also rare in bones, occurring mostly in the soft tissues. It usually forms in the legs, arms, and jaw and is most common among adults 50 and older.

• Chordoma is a rare bone tumor that most often forms at the bottom of the spine or the base of the skull. It’s commonly diagnosed in older adults.

Giant cell tumor is another primary bone tumor often occurring in young people between age 20 and 30. However, the tumor is noncancerous, or benign, and usually forms near the joints of long bones, such as the shins and thighs.

The secondary types of bone cancer

There are several types of secondary bone cancer. These cancers are slightly different from metastasized bone cancer because they don’t form in the bone cells. Instead, they form in the blood or immune cells found in bone marrow.

The secondary types of bone cancer include:

• Multiple myeloma forms in a type of immune cells called plasma cells that are in the bone marrow. This type of bone cancer may develop as a single tumor but is usually found in several bones.
• Leukemia forms in the blood cells of bone marrow. There are many different types of leukemia. It can happen to people of all ages but is the most common cancer among young people.
• Non-Hodgkin lymphoma develops in the white blood cells of areas in the body that have lymph tissue. Primary non-Hodgkin lymphoma of the bone is a very rare type of lymphoma that forms in the bones.

Bone Cancer Risk Factors

Research is increasing regarding what we know about bone cancer. Scientists are learning more about its causes. Following are common risk factors for the disease:

Genetic Disorders – A small number of bone tumors are believed to be the result of genetic mutations:

• The Li-Fraumeni Syndrome – A mutation of the p53 tumor suppressor gene makes people much more likely to develop several types of cancer, including breast cancer, brain cancer, osteosarcoma, and other types of sarcoma.
• Rothmund-Thomson Syndrome – Children with this syndrome are short, have skeletal problems, and rashes. They also are more likely to develop osteosarcoma.
• Multiple Exostoses Syndrome – Patients with this inherited condition that causes many bumps on a person’s bones can have an increased risk of chondrosarcoma.

Radiation – Exposure to large doses of radiation may increase the risk of developing bone cancer. Radioactive materials such as radium and strontium can also cause bone cancer because these minerals build up in bones.

Thyroid disease: Can it affect a person’s mood?

Have you ever felt as if you’re riding an emotional rollercoaster, unpredictably swinging from lows to highs? While daily stressors undoubtedly impact our moods, sometimes the underlying cause is a health condition like thyroid disease. Could this be the hidden factor behind your mood swings?

The Crucial Role of the Thyroid in Emotional Health

The thyroid gland, situated in the neck, is pivotal for metabolic regulation through its hormone production. Malfunctions in this gland, such as hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid), can upset your hormonal harmony. This imbalance doesn’t just affect your physical health; it extends to your emotional state as well.

How Thyroid Imbalances Affect Mood

Thyroid hormones, particularly T3 and T4, are integral to various bodily functions, including brain function. An imbalance in these hormones can alter neurotransmitter activity, essential for mood regulation, leading to various emotional disturbances.

Symptoms of Mood Changes Linked to Thyroid Health

In Hypothyroidism:

• Depression: Persistent sadness, loss of interest, and a lack of motivation.

• Anxiety: Persistent worry and tension.

• Irritability: Quick to anger and frustration.

• Brain Fog: Problems with focus, memory, and mental clarity.

In Hyperthyroidism:

• Anxiety: Feeling restless and unable to relax.

• Irritability: Low tolerance levels and quick frustration.

• Mood Swings: Rapid and extreme emotional shifts.

• Sleep Issues: Trouble falling or staying asleep.

While other conditions can also cause these symptoms, if you’re experiencing significant mood alterations alongside other thyroid-related symptoms, it’s crucial to consider a thyroid evaluation.

Diagnosing Mood Disorders Linked to Thyroid Issues

Identifying a thyroid-related mood disorder typically involves:

• Blood Tests: These check levels of thyroid hormones to pinpoint hypothyroidism or hyperthyroidism.

• Psychological Assessment: Mental health professionals can evaluate mood symptoms and help rule out other causes.

Be transparent with your healthcare provider about your symptoms during consultations.

Effective Treatments for Thyroid-Related Mood Issues

Fortunately, thyroid conditions are manageable. Treatment aims at hormonal rebalancing:

• Medication: Synthetic hormones treat hypothyroidism, while treatments for hyperthyroidism may include medications, radioactive iodine therapy, or surgery.

• Therapy: Techniques like Cognitive-Behavioral Therapy (CBT) can help manage mood symptoms and improve well-being.

• Lifestyle Adjustments: A balanced diet, sufficient sleep, and effective stress management can support mood stabilization and overall health.

Prevention and Management Tips

• Regular Medical Check-ups: Keep up with thyroid function monitoring and medication adjustments.

• Mood Diary: Documenting mood shifts and potential triggers can help identify trends and refine your treatment plan.

• Emotional Health Practices: Engage in stress reduction activities like yoga or meditation and maintain a supportive social network.

Conclusion

Recognizing the connection between thyroid dysfunction and mood variations is key to managing both your mental and physical health effectively. If you suspect your mood swings may be thyroid-related, don’t hesitate to discuss this with your doctor. Early detection and appropriate treatment can significantly enhance your quality of life by restoring hormonal balance and stabilizing your mood.