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Thyroid cancer forms in the cells of the thyroid – a “butterfly” shaped gland located at the base of the neck. Treating thyroid cancer varies depending on the type. Types of thyroid cancer include:
Generally there are no signs when Thyroid cancer begins, however as it grows the signs and symptoms include:
Test for thyroid cancer include:
Thyroid nodules are lumps that form within the thyroid, the small “butterfly” shaped gland at the base of the neck. These nodules may be entirely cystic, meaning there are no solid components detectable within the fluid. Alternatively, the nodules may be complex, and contain both fluid and solid components.
In most cases, thyroid nodules do not cause symptoms and are not considered dangerous. However in some cases, these nodules become enlarged and make it hard to swallow or breathe. If the nodules produce extra levels of thyroxine the following symptoms can occur:
For benign nodules, treatment includes:
Diagnosing thyroid nodules requires:
If a thyroid nodule is filled with fluid, it is called a cyst. Thyroid cysts are lumps containing fluid that appear in regions, in and around the thyroid gland – Thyroid cysts are the enlarged fluid-filled regions that form within the thyroid gland. They may be small (less than 1 cm) or quite large and sometimes arise very suddenly. Thyroid nodules may be entirely cystic, in which case there are no solid components detectable within the fluid. Cystic nodules may get larger suddenly due to hemorrhage or bleeding within a smaller pre-existing nodule.
Cysts range in sizes from small to large and can grow quite rapidly causing symptoms such as:
Treatments for thyroid cysts include:
Diagnosing thyroid nodules requires:
The pituitary gland consists of different types of pituitary cells and each of them produces special hormones that are released into the bloodstream that affect other organs in the body.
Pituitary adenomas are mostly benign tumors that develop in the pituitary gland. One characteristic of adenomas is that they only stay within the pituitary gland, instead of spreading to other parts of the body.
The classifications of pituitary adenomas are separated into several different types depending on their properties:
Pituitary tumors occur when tumor cells produce an excess of one or more hormones, it is known as functional adenoma. Pituitary tumors occur from one of these specialized cells:
If they do not release an active hormone, they are known as clinically non-functioning adenomas.
Pituitary adenoma symptoms vary depending on whether they are hormone-producing or clinically nonfunctioning. Hormone-producing pituitary adenomas overproduce and release excessive amounts of active hormones into the bloodstream. Other symptoms include:
There are a number of treatment options for pituitary tumors:
Tests used for diagnosing pituitary tumors include:
Diabetes Mellitus is a collection of disorders that affects the amount of glucose in the blood. Glucose is a vital source of energy for the brain and the body’s tissue cells. When someone has diabetes, they have excess levels of glucose in the blood. Chronic diabetes conditions include:
Latent autoimmune diabetes of adults (LADA diabetes): We had a patient, who was diagnosed to have diabetes for almost 10 years, survived after coma, did her best to manage the condition (counting carbohydrates, checking blood glucose level, etc.), but still failed to keep it under control. Within the 10 years period she went to see quite a number of doctors: endocrinologists, dieticians, some of them diagnosed 1 type of diabetes, meanwhile others said it was type 2.
The patient was very disappointed and even frustrated, because none of the recommendations could help her to control and manage her glucose levels and succeed in controlling the condition. She came to us for some other treatments, but at the same time she wanted to get a second opinion on her diagnosis. The doctor, who is one of the best endocrinologists in Singapore, active participant of scientific life, who is continuously being invited to speak in many international meetings all over the world, explained that the main problem was that she does not have either 1 or 2 type of diabetes, she has LADA.
Sometimes, LADA is referred to as type 1.5 diabetes. Though it is not the official term but it perfectly illustrates the fact that LADA is a form of type 1 diabetes that shares some characteristics with type 2 diabetes.
As it is a type 1 diabetes disorder, the body’s immune system attacks and kills off insulin producing cells.
LADA is often mistaken for type 2 diabetes as it develops over a longer period of time in children or younger adults. On the other hand, type 1 diabetes in children tends to develop quickly (sometimes within the span of a few days) LADA develops on a slower rate, sometimes over a period of years.
A doctor may initially diagnose LADA as type 2 diabetes in patients over the age of thirty five due to the slower onset of diabetes symptoms.
Yes, LADA can often be misdiagnosed as type 2 diabetes. This is due to the patient’s age and the slower onset of symptoms.
If LADA is incorrectly diagnosed as type 2 diabetes, this could lead to inappropriate treatment methods that could cause poorer diabetes control and could accelerate the loss of insulin producing ability.
Clues that can give rise to a clinical suspicion of LADA instead of type 2 diabetes include:
IMPORTANT: Some patients with LADA can show features of metabolic syndrome. This may complicate or delay a diagnosis of LADA.
Symptoms of diabetes can vary depending on the amount of blood sugar elevation. For chronic diabetes (type 1 and type 2), the symptoms include:
Treatments for type 1 & 2 diabetes include:
Effective and safe use of the pump requires; commitment to checking blood glucose at least 4 times a day (every day), using carbohydrate counting and adjusting the insulin doses according to blood glucose levels, carbohydrate intake, and physical activity
Treatment and screening of diabetes includes on site:
Did you know that your skeleton loses old bone and forms new bone? New bone forms quicker than old bone is lost during your childhood and teenage years. Around the age of twenty, your bones start to get denser and reach their peaks. You may start to lose more bone than you form and the process speeds up as you age. When this happens, the bone becomes less dense and weak. This may lead to conditions such as osteoporosis.
Osteoporosis is the weakening of bones to the extent that mild physical stresses, such as bending or even coughing can cause bones to fracture. These fractures happen mostly in the hip, wrist or spinal region. The body constantly breaks down bone and then replaces it but with osteoporosis, the body can’t create enough new bone tissue fast enough to keep up with the removal of old bone tissue. The precursor to osteoporosis is osteopenia-when bone density is below normal peak density but not enough to be classified as osteoporosis.
Generally, women are more prone to osteoporosis. This is due to the fact that they can lose up to twenty percent of their bone mass in the five to seven years after menopause. After menopause or after surgical removal of ovaries, the decrease in oestrogen (hormone that protects the bones) leads to bone loss and increases the risk of fractures.
Men can also be affected by osteoporosis although it is relatively less common. Both the oestrogen and testosterone are important for bone health in men. Poor lifestyle habits such as excessive alcohol intake, smoking or extreme thinness can lower the level of such hormones in your body leading to bone loss.
Building strong and healthy bones during childhood and adolescence can help to prevent or delay the disease later on in life.
Symptoms of osteoporosis include:
The type of treatment that may be recommended is based on an estimate of the risk of breaking a bone in the next ten years using information such as the bone density test.
Treatment might not include medication and might focus instead on lifestyle, safety and modifying risk factors for bone loss if the risk is not high.
Treatment options for osteoporosis include:
Diagnostic services for osteoporosis include:
Polycystic ovarian syndrome (PCOS) is a disorder of the endocrine system and occurs commonly among women of reproductive age.
Patients with PCOS may have enlarged ovaries that contain small collections of fluid. They are known as follicles and are located in each ovary that can be seen during an ultrasound exam. The exact cause of PCOS is unknown.
To reduce the risk of long-term complications such as type 2 diabetes and heart disease, early diagnosis and treatment along with weight loss may be beneficial.
Signs of polycystic ovarian syndrome generally occur shortly after a woman begins having her period (menarche). These signs include:
PCOS may make the following conditions more likely especially if obesity is also a factor:
Treatment of PCOS tends to focus more on the management of the individuals concerns such as infertility, hirsutism- the abnormal growth of hair on a women’s face or body- , ache or obesity. For treatment of obesity a doctor might encourage:
Other treatments include:
Your doctor may prescribe medication to:
Alternatively, a skin patch or vaginal ring that contains a combination of oestrogen and progestin may be used to treat the condition as well. You won’t be able to conceive during the time that you take this medication to relieve your symptoms.
Another approach to treat this condition if you’re not a good candidate for combination birth control pills is to take progesterone for ten to fourteen days every one to two months. This type of therapy helps to regulate your periods and offers protection against endometrial cancer. However, it doesn’t improve androgen levels and it doesn’t prevent pregnancy. If you wish to avoid pregnany, the progestin-only minipill or progestin-containing intrauterine device are better choices.
An oral medication known as metformin (Glucophage, Fortamet) may be prescribed for type 2 diabetes to improve insulin resistance and lowers insulin levels. This may help with ovulation and lead to regular menstrual cycles. It also slows the progression to type 2 diabetes if you already have pre-diabetes. It also aids in weight loss if you follow a diet and an exercise program.
If clomiphene and metformin doesn’t help you conceive, your doctor may recommend using gonadotropins. They are follicle-stimulating hormone (FSH) and luteinizing hormone (LH) medications that are administered by injection.
Another medication is letrozole (Femara). It is unclear how letrozole works to stimulate the ovaries but it may help with ovulation when other medications fail.
It’s important that you work with a reproductive specialist and have regular ultrasounds to monitor your progress and avoid problems when taking any type of medication to help you ovulate.
There’s no one-way to diagnose PCOS, however some testing methods include:
Cholesterol is the waxy substance found in fats in the blood (lipids). Although having some cholesterol is important for cell growth, having too much can increase the risk of heart disease.
If cholesterol levels are too high, fatty deposits can form in the blood vessels, making it hard for the blood to flow through the arteries. This is what is known as hyperlipidemia.
Hypolipidemia, on the other hand is when there are unusually low levels of fat in the blood. This is often referred to as low blood cholesterol.
Typically, high cholesterol doesn’t cause any symptoms. In the vast majority of cases, the only real symptoms may cause an emergency event.
Atherosclerosis: A form of heart diseases occurs when there is too much cholesterol in your blood and it builds up in the walls of your arteries. When this happens, the arteries become narrowed and blood flow to the heart muscle is slowed down or blocked.
Blood carries oxygen to the heart and when not enough blood and oxygen reach your heart, you may experience chest pain. On the other hand, if the blood supply to a portion of the heart is completely cut off by a blockage, this can result in a heart attack.
Cholesterol and Coronary Heart Disease: Coronary heart disease is the main risk from high cholesterol. When your cholesterol level is too high, it can build up in the walls of your arteries. Over a period of time, this build-up known as plaque can cause atherosclerosis (hardening of the arteries). This causes arteries to become narrowed which will slow the blood flow to the heart muscle. A reduce in blood flow can result in angina (chest pain) or a heart attack if a blood vessel gets blocked completely.
Cholesterol and Stroke: Atherosclerosis may cause arteries that lead to the brain to become narrowed and even blocked. If a vessel carrying blood to the brain is completely blocked, you could have a stroke.
Cholesterol and Peripheral Vascular Disease: High cholesterol has also been linked to peripheral vascular disease. These are the diseases of blood vessels outside the heart and brain. Fatty deposits build up along artery walls and affect blood circulation in this condition. This mainly occurs in arteries that lead to the legs and feet.
Cholesterol and Diabetes: Diabetes can upset the balance between HDL and LDL cholesterol levels. Patients who have diabetes tend to have LDL particles that stick to arteries and damage blood vessel walls more easily. Glucose (sugar) attaches to lipoproteins (a type of cholesterol-protein package that enables cholesterol to travel through blood). Sugar-coated LDL stays in the bloodstream longer and may lead to the formation of plaque. Patients with diabetes tend to have low HDL and high triglyceride (another kind of blood fat) levels. Both of these conditions can boost the risk of heart and artery disease.
Cholesterol and High Blood Pressure: High blood pressure (hypertension) and high cholesterol also are linked. As your arteries hardened and becomes narrowed with cholesterol plaque and calcium, the heart has to strain much harder to pump blood through them. This results in blood pressure becoming abnormally high. High blood pressure is also linked to heart disease.
High blood cholesterol can be treated with:
Low blood pressure treatment focuses on the underlying cause.
Talk to your doctor about the other drugs you are taking (including herbals and vitamins) and their impact on cholesterol-lowering drugs. You should avoid drinking grapefruit juice while taking certain types of cholesterol-lowering drugs. This is because it can interfere with the liver’s ability to metabolize these medications.
Blood tests: Lipid panel tests are the only way of diagnosing high cholesterol. These tests measure:
CT COROS: A computerized tomography (CT) coronary angiogram is an imaging test that explores health of the arteries that supply your heart with blood. This test is essential to determine severity of possible narrowings and blockages in your heart blood vessels
Obesity is a disorder characterized by high amounts of body fat.
It occurs over a period of time when you consume more calories than you burn off. The balance between calories-in and calories-out is different for each person. The factors that might affect your weight include:
Although it affects many people on a cosmetic level, it can cause a lot of troubles within the body including:
The body mass index (BMI) is a statistical measurement derived from your height and weight. It is considered an effective way to estimate healthy body weight and measures not only the percentage of body fat, but also muscles distribution in the body to give you the idea of your “problem” areas. The calculation of BMI is derived by dividing the patient’s body weight (kg) by their height in meters squared
The diagnosis of obesity involves calculating the patient’s body mass index (BMI). A BMI of 30.0 or more is considered obese. A BMI of 40.0 is considered extremely obese.
Reaching a healthy weight and then maintaining it is the goal of any obesity treatment regime. A number of professionals can aid in this process, such as:
Weight-loss regimes may consist of:
The most common bariatric surgery procedures are:
Each of these surgeries has its own advantages and disadvantages.
The Roux-en-Y Gastric Bypass also known as gastric bypass is considered the ‘gold standard’ of weight loss surgery.
The procedure consists of two components, the first component involves a small stomach pouch that is approximately one ounce or thirty milliliters in volume, is created by dividing the top of the stomach from the rest of the stomach. Next, the first portion of the small intestine is divided and the end of the divided small intestine will be connected to the newly created stomach pouch.
The procedure is complete once the top portion of the divided small intestine is connected to the small intestine further down. The connection allowed the stomach acids and digestive enzymes from the bypassed stomach. The first portion of the small intestine will eventually mix with the food.
The gastric bypass works by several mechanisms. First of all, it is similar to most bariatric procedures. The newly created stomach pouch is much smaller and facilitates significantly smaller meals, which means fewer calories are consumed. There will be less digestion by the smaller stomach pouch and also a section of the small intestine will no longer have food going through it, thus there will be less absorption of calories and nutrients.
Most importantly, changes in the gut hormones due to the re-routing of the food stream will produce changes that promote satiety, suppress hunger, and reverse one of the primary mechanisms by which obesity induces type 2 diabetes.
The Laparoscopic Sleeve Gastrectomy – often called the sleeve – is performed by removing approximately 80 percent of the stomach. The remaining stomach is a tubular pouch that resembles a banana.
Firstly, the new stomach pouch holds a considerably smaller amount than the normal stomach does and it helps to significantly reduce the amount of food that can be consumed, which means less calories are consumed. However, the greater impact seems to be the effect on the gut hormones. A number of factors including hunger, satiety, and blood sugar control are impacted.
As shown by short term studies, the sleeve is as effective as the roux-en-Y gastric bypass in terms of weight loss and improvement or remission of diabetes. Evidence also suggests that the sleeve is effective in improving type 2 diabetes without weight loss. The rate of complication falls between the adjustable gastric band and the roux-en-y gastric bypass.
This procedure is also known as the band. It involves an inflatable band that is secured around the upper portion of the stomach. This creates a small stomach pouch above the band and the rest of the stomach below the band.
Consuming a small amount of food will satisfy hunger and promote the feeling of fullness in the smaller stomach pouch. The level of fullness depends on the size of the opening between the pouch and the remainder of the stomach. Adjusting the band with sterile saline (injected through a port placed under the skin) can alter the size of the stomach opening.
Repeated adjustments are done gradually to reduce the size of the opening. The view that the band is a restrictive has been challenged by studies that show that food passes quickly through the band. Food remaining in the pouch above the band was not related to the absence of hunger or feeling satisfied. It is also known that there is no malabsorption so the food is digested and absorbed as it would be normally.
The impact of the band seems to be that it reduces hunger which in turn helps the patients to reduce the amount of calories consumed.
For patients with a BMI 30 and above the following tests apply: