Advanced Endocrine & Diabetes Hospital And Research Center

There was an era where we had deadly infections like plague and polio causing death of thousands of people. We still have occasional outbreak of swine flu, but by and large, infections are quite controlled. The new killer diseases are caused because of the lifestyle we have adapted and the damage we have done to the environment. High intake of processed foods, artificial chemicals in our foods, sedentary lifestyle with very minimal to no physical activity, couching over the computers; the list is quite long.

All these have led to diseases like diabetes and cancer that were not so common about say few decades ago:

Detailed observation has revealed that both these new epidemiologic diseases have a close correlation. There are factors, which induce diabetes and diabetes in turn and in some cases, diabetes inducing agents, can cause cancer also. It has also been observed that mortality is severely increased if diabetic patients are diagnosed with cancer. There are two types of diabetes. While type 1 is mostly hereditary, type 2 is lifestyle induced and the age at which this is being diagnosed is taking a severe plunge. Adolescents and teenagers are being diagnosed for diabetes. Cancer, on the other hand, is of various types (leukaemia, melanoma, myeloma, etc.) and can affect various organs (lung, breast, prostate, stomach, liver, etc.).

The medical community is yet to decipher the disease pattern of both these conditions. While there is no definite correlation between diabetes and all types of cancer, some types of cancer are definitely correlated with a definite reason identified, pancreatic and liver cancer for instance. The high amounts of insulin that diabetic patients are exposed to causes changes in liver and pancreas including fatty liver and cirrhosis, here the incidence of cancer is higher. The linkage is not very clear in lung and intestinal cancers and also there is no link between prostate cancer and diabetes.

Diabetes is considered as a state of chronic inflammation and leads to conditions like hyperinsulinemia (higher levels of insulin in the blood) hyperglycemia (higher levels of sugar in the blood). These are believed to aggravate the neoplastic process of cancer formation, thereby inducing cancer at a greater pace and also increasing the mortality rates.

The following are risk factors that are applicable to both age, physical activity, diet, obesity, drinking and smoking. It is also possible that onset of one can be followed by the other. As noted earlier, more detailed research is awaited to establish a definite linkage, but the correlation cannot be ignored at all.

Both these new epidemics are here to stay and since they have a common set of factors, we need to work on ways to contain them.

Cholesterol is a vital component, which helps the body to make healthy cells. This wax like component is found in the lipid of the blood. An increased cholesterol count elevates the risk of heart diseases in a person. It thickens the vessels of the arteries resulting in less oxygen flow in the heart. This, in turn, increases the chances of a stroke. High cholesterol can happen from lifestyle habits and inheritance. It is completely treatable and preventable.

What causes high cholesterol?
The blood carries the cholesterol which is attached to the proteins. The combination of cholesterol and protein is known as the lipoprotein. Primarily there are two different kinds of cholesterol that the lipoprotein carries:

• Low-density lipoprotein: LDL is the bad guy that carries all kinds of cholesterol present in the body. It eventually rests on the walls of the arteries, making it narrow and hard.
• High-density lipoprotein: This is the good guy which scans the excess cholesterol and take them back to the liver.

Ideally, the body should have low LDL and high HDL. But often the reverse happens, resulting in high cholesterol and cardiac diseases. Factors such as unhealthy diet, inactivity for most of the day and obesity is responsible for the same. Even the genetic set up can play a hand in a high count of LDL in the body. There is nothing that can be done in this case except to seek medical help.

6 factors that put you at risk:

1. Poor diet: Cholesterol levels are dramatically increased when baked products and saturated fats are consumed in an excess amount. Other high cholesterol food products include dairy products, processed fats and red meat. Refraining from this food items will drastically reduce the chances of getting high cholesterol in the body.
2. Obesity: Obesity results from too much of fat storage in the body. It not only fatigues a person faster, but puts a person at high risk of getting cholesterol. The body mass index should be always lesser than 30 to abstain the risk of cholesterol.
3. Waist circumference: A waist circumference of more than 40 inches in men and 35 inches in women can increase the risk of cholesterol.
4. Diabetes: This is one of the major causes of high cholesterol. It not only damages the artery lining, but results in higher LDL and lower HDL.
5. Less workout: Leading a life which is devoid of exercise and jogging can increase the chances of getting high cholesterol. Exercise boost HDL count in the body and mitigates the risk of low HDL.
6. Smoking: The blood vessel walls get damaged with smoking. The blood vessels start accumulating fatty acids thereby increasing the chances of getting high cholesterol.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Diabetes is very restrictive - living with the disease however does not imply that you stop enjoying. By bringing about certain changes in your lifestyle, you can still live your life to the fullest. For better management of your disease, these are some of the changes that you can make to improve your blood sugar levels and keep your condition under control.

1. Stay fit with physical activity
The first lifestyle change you can make is to increase your level of physical activity. This can help you in burning extra calories, thereby keeping your blood sugar levels in check. Spending 30 minutes a day exercising is ideal.
If you’re not fond of exercising or don’t have the time for it, even performing simple activities like walking, vacuuming or doing your laundry can help to lower glucose levels while burning calories.

2. Maintain a healthy BMI
Likewise, try to lose those extra kilos that may be weighing you down and increasing your sugar levels. You don’t have to lose all the weight in one go, you can do so little by little. To lose weight gradually and consequently achieve a healthy BMI, you must have more of fruit and vegetables and less of sugary items and processed food along with exercising regularly.

3. Make the right food choices
When it comes to food, you should consume whole grain foods instead of refined carbohydrate alternatives. Make every meal a balanced one with starches, fats and proteins included in the right amount. Furthermore, avoid beverages that come with high sucrose or fructose content, as they don’t offer much in terms of nutrition, and instead just add to your calorie count. Some of the foods you can include in your diet are bitter gourd, cinnamon, green tea, amla, jamun etc.

4. Have a fixed quantity of food
Apart from knowing the right foods to eat and the balance that you need to maintain between the different types, it is also important to know about portion sizes and carbohydrate count. This is because among the different food classes, it’s chiefly carbohydrates that influence your blood glucose levels. So, you need to keep track of the amount of carbohydrates that you’ve consumed in order to arrive at the right insulin dosage.
In addition to keeping count of your carbohydrate consumption, understanding the right portion sizes for the different types of food is also extremely vital for better management of your ailment. Measuring cups and spoons should be employed to arrive at the right quantities of food.

5. Eat your meals at fixed timings
As a diabetic, you should not go longer than 5 hours without eating as it can cause your blood sugar levels to fall dramatically, making you feel weak and faint. Instead you should have your meals at fixed hours, spacing them out at regular intervals. This will ensure your blood sugar levels are always at an optimum point.

6. Control your stress
Stress is a risk factor for Type 2 diabetes. When you’re under stress, your body produces stress hormones (cortisol) that can cause your blood sugar levels (and even blood pressure)to rise. So, preventing or controlling stress becomes necessary to keep your diabetes under control.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3 Symptoms to identify vitamin d deficiency

Vitamin d deficiency is caused when your body does not get enough exposure to the sun that is the primary source of vitamin d for your body. It is crucial for the health of your bones, skin and neurological system, therefore, its deficiency may lead to a number of problems and risks such as rickets, osteoporosis, multiple sclerosis etc.

Here is a list of four symptoms that can help you to identify if you suffer from a deficiency of vitamin d.

1. Bone pain and muscle weakness

Adults who suffer from a deficiency of vitamin d feel a lot of achiness and pain in the bones and muscles of their body. Also, they are troubled with joint stiffness and fatigue that lowers the overall quality of their life.

2. Fits of sadness and grief

Exposure to the sun (and hence, vitamin d) improves the level of the neurotransmitter serotonin in your body that is responsible for lifting your spirits. However, deficiency of vitamin d prevents you from having a more positive outlook towards life. So, another symptom that can help you identify that your body is deficient in vitamin d is that you've got a lot of blues.

3. A lot of head sweat

If your head sweats a lot, you can be assured that you suffer from an acute deficiency of vitamin d. Head sweating is another prominent symptom associated with vitamin d deficiency. If you wish to discuss any specific problem, you can consult an endocrinologist.

The body produces a number of chemicals called hormones which are essential for the regulation of various functions including growth and metabolism. These hormones are produced by endocrine glands which are located in various parts of the body. One such important gland is the pituitary gland which produces the important growth hormone. This is essential for regulating optimal growth during the growing years and for maintaining proper amounts of body fat, muscles, and bones in the later years of life.

Causes: Deficiency of the growth hormones can occur due to a number of causes, some of which are listed below. It can be congenital (present at birth) or acquired later in life.
The congenital issue could be due to problem in the pituitary gland structure, leading to complete absence or reduced secretion of the hormone.
With age, there is a decrease in the amount of secretion. However, infections, injuries, brain tumors, surgery and radiation can also lead to altered amounts of secretion.

Symptoms: While growth hormone deficiency can occur at any age, symptoms differ depending on the age when the deficiency sets in.
In the early ages:

• Lower rate of growth for a given age
• Delayed developmental milestones
• Delayed onset of puberty
• Short stature/reduced height
• Younger looking compared to other children their age
• Fat deposition around the waist
• Delayed dental development

When the deficiency sets in during the later years, there is

• Low energy levels, constant tiredness
• Decreased strength
• Decreased exercise tolerance
• Decreased overall muscle mass
• Thin and dry skin
• Increased fat deposition and weight gain around the waist
• Changes in social behavior including alternate cycles of anxiety and depression
• Lack of motivation
• History of pituitary tumors
• High levels of fat and cholesterol

 

The diagnosis depends on the age of the person

• Blood tests are carried out to check the hormone levels in circulation
• In children, in addition to the hormone levels, x-rays to see the status of growth plates is very helpful.
• An insulin hypoglycemia test where insulin is given intravenously to see the levels of the growth hormone after 30 minutes.
• Total cholesterol levels, low-density lipoprotein (LDL) cholesterol, apolipoprotein B, and triglyceride levels can be used to supplement the above tests.
• CT scan and/or MRI of the brain may be needed if tumors are suspected.

Treatment: Once diagnosed, replacement therapy is given as shots a few times a week under the skin. This restores normal growth and helps in controlling the symptoms in adults too.
In cases of tumor, radiation or surgery may be required, but most cases are managed with hormone replacement.
Watch out for the symptoms if your child has delayed developmental milestones and early intervention can help restore growth and function to normal levels. If you wish to discuss about any specific problem, you can consult an endocrinologist.

Enlarged pancreas can result beacuse of factors such as: 

1. An abscess in your pancreas: This refers to a dangerous formation inside the pancreas. Neglecting its occurrence can also turn out to be fatal. An abscess is a cavity containing pus that further infects the rest of the organ. Presence of harmful bacteria in the pancreas leads to such a case.
2. A cyst in the lining of your pancreas: Epithelial cysts in the pancreas can also cause the organ to swell up. Such cysts are mostly benign but they are accompanied by disabling pain.
3. Pancreatitis is one disease with an array of threats: Highly active enzymes within the organ can make its tissues wear down thus, affecting the size of your pancreas. If you are an alcoholic, you are more prone to develop this condition. It could also be contracted due to an excess of calcium or fats in the blood.
4. Cancer of the pancreas is dreadful too: Due to the unanticipated growth of cancer cells in the pancreas, the organ grows bigger. A person suffers from excruciating pain under the influence of this condition.
5. Pseudocysts in the pancreas can have serious ill effects: When benign cysts become unmanageably harmful, they result into pseudocysts. The cysts contain remains of your tissues and other damaging fluids that can increase the size of the pancreas.

An enlarged pancreas surfaces in the form of these symptoms:

1. The kind of stool you pass indicates a lot about your health. Oily poop can be indicative of an enlarged pancreas. Persisting diarrhea can also be a symptom of pancreatic ailments.
2. You may even experience an accelerated pulse rate.
3. You may feel feverish continually. Bouts of fever can impede your free movement and general health.
4. Health issues with your pancreas can make you suffer from jaundice. It could be a one- time affair or it could reappear from time to time.
5. Constant queasiness could hint at some underlying problem in your pancreas.
6. You may even lose more than a few pounds over a short span of time. Such a thing should not be taken lightly as it not only makes you look sick but also degrades your immunity. If you wish to discuss any specific problem, you can consult an endocrinologist.

The pituitary gland is a small, pea-sized attached to the base of the brain. It controls growth, functioning and development of other hormonal glands. Deficit of one or more pituitary hormones is a state of Hypopituitarism. This clinical term is used by endocrinologists to mean that one or more pituitary glands are deficient. In hypopituitarism, the pituitary gland does not produce the normal amounts of hormones.

Causes-

Hypopituitarism has the following causes—

1. Brain tumours

2. Sarcoidosis (A lung disorder)

3. Tumours in the pituitary gland

4. Hemochromatosis (Too much iron in the body)

5. Tumours in hypothalamus (Controls the production of hormones)

6. Histiocytosis X (A rare autoimmune disease where the immune cells damage the organs)

7. Tuberculosis

8. Stroke

9. Sheehan syndrome (Excessive blood loss during childbirth)

10. Lymphocytic hypophysitis (An inflammation in the pituitary gland)

11. Radiation treatments like chemotherapy

Symptoms-

Symptoms depend on which hormones is not being produced.

• Adrenocorticotropic Hormone (ACH): Lack of ACH affects the adrenal glands (endocrine glands producing hormones) and cortisol (steroid hormone). Symptoms include—

  • Fatigue

  • Low sodium levels

  • Loss of weight

  • Pale skin

• Thyroid-stimulating Hormone (TSH): Deficient TSH mostly affects the thyroid (produces growth-regulating hormones) gland. The symptoms are—

  • Fatigue

  • Weight gain

  • Skin dryness

  • Sensitivity to cold

  • Constipation

• Luteinizing hormone (LH): Low luteinizing hormone in women affects their ovaries and ovulation. Symptoms include-

  • irregular periods

  • loss of libido

  • infertility

In men, lack of LH affects their testes and sperm production. Symptoms include-

1. • loss of libido

   • erectile dysfunction

   • impotence

   • infertility.

• Follicle-stimulating hormone (FSH): This hormone affects men and women the same way the luteinizing hormone does. Thus the symptoms are the same.

• Growth Hormone: In children, the growth hormone affects their bone, fat and muscle. They have the following symptoms—

  • Lack of height

  • Increase in body fat

  • Abnormal peak bone mass (bone tissue present after the skeleton matures)

In adults, the whole body is affected. Body fat increases while muscle and bone mass decreases.

• Prolactin: Prolactin deficiency only affects women. The prolactin hormone gets the production of milk started after childbirth. Lack of prolactin thus affects breastfeeding.

• Antidiuretic Hormone (ADH): The kidneys are affected by lack of ADH. Symptoms include—

  • Diluted urine

  • Frequent urination

  • Feeling excess thirst

• Oxytocin: Lactation and childbirth are affected by lack of oxytocin. If you wish to discuss about any specific problem, you can consult an endocrinologist.

Symptoms, causes, and medications for PCOS

Hi! I’m Dr. Ravi from Kukatpally, Endocrinologist. Today we are going to learn about PCOS, it is Polycystic Ovarian Syndrome. In Polycystic Ovarian Syndrome, a woman will have irregular periods and acne, unwanted facial hair and also hair loss from the head. There will be difficulty in conceiving. And usually there will be overweight and obesity with this Polycystic Ovarian Syndrome. So what causes this Polycystic Ovarian syndrome? In PCOS patients, their ovaries won’t work normally. Every month one follicle will enlarge and mature and it will rupture releasing an egg. In PCOS multiple follicles will enlarge and they won’t rupture. And over a period of time, these follicles will accumulate. Now if you do a scan, a number of follicles will be there.

So what are the symptoms of this Polycystic Ovarian Syndrome? It contains as I told you, irregular menstruation periods, acne and androgen features just like facial hair and hair fall and the third one is irregular menses in the background of insulin resistance. These PCOS patients will have health related issues-hormonal and other problems. So they need to be evaluated, if they have high cholesterol, high blood sugar, high BP, other things, they need to get monitored and get treated accordingly.
Now we learn about what lab tests they need, okay, they need hormonal tests, blood sugars, cholesterol and they need to undergo some ultrasound scans, abdomen with the ovaries. Okay, these are the lab tests they need, and what is the treatment for PCOS? First thing is weight loss, if you lose weight around 5%, around 4-5 kgs, 50% of people, this Polycystic Syndrome will resolve. So, weight loss with diet and exercise is an important thing along with lifestyle modification and weight loss, some medications like birth control pills, they won’t acute the PCOS but the thing is they will ameliorate all problems with the…..so if you use birth control pills, your cycles will be regular, your unwanted facial hair will reduce. So these birth control pills are good, and they will protect the uterus from cancer if you use those birth control pills. Another drug is Anti-Androgens so they will block hormonal action

Side effects of these Anti-androgens like aldosterone, the thing is you will need to monitor the lever enzymes and also there is weight gain. That means water retention in the body. Okay, these are the two side effects for anti-androgens. Another drug we use is Metformin. Usually, we use that for controlling high blood sugar. But the thing is those who use this Metformin their insulin resistance will get controlled reduced and leading to normal…..cycles and other things in PCOS patients. So this can also be useful. Another one is individualizing problems; the thing is if an elderly person will come with this PCOS if their concern is they don’t want excess facial hair, so the best thing is anti-androgens. If a married person comes with PCOS, their main problem is to get a reproduction, to conceive, to get children. For them, we will use ovulation-inducing drugs. And if another married woman comes with PCOS and her complaint is hair fall and unwanted facial hair, we use another drug or local ointment to reduce facial hair or laser, these things. So, individualizing treatment depending on their problem is an issue in the treatment of PCOS.

Now, lastly, can a PCOS woman lead a normal life? Yes. The thing is whatever problem they are having there are good medicines and everything. They can lead a normal life with regular medication and regular doctor visit. So, don’t worry about PCOS.
 

The thyroid gland, in the lower front of the neck, releases hormones in the bloodstream that affect almost every part of your body, from your brain and heart, to your skin and muscles. It also controls metabolism which is the process of changing the food you eat into energy. When the thyroid gland does not produce enough thyroid hormone, it is called hypothyroidism.

Symptoms of hypothyroidism include:

1. Constipation
2. Hair loss and dry hair
3. Dry skin
4. Fatigue
5. Sensitivity to cold
6. Decreased heart rate
7. Goitre (swollen thyroid glands)
8. Weight gain and difficulty in losing that weight
9. Persistent jaundice

Hypothyroidism is not curable, but it can be controlled with the right medication. Along with taking your medicines, you can also adopt the following lifestyle changes:

1. Eat right: While there is no specific diet for hypothyroidism, you should consume vegetables, fruits, whole grains, healthy fats and lean proteins. Since gaining weight is a common symptom of hypothyroidism, eating the right things can help you maintain your weight.
2. Regular exercise: Exercising can reduce stress, improve energy and help you maintain your optimum weight. Aerobics (for example, cardio), flexibility and strengthening workouts can help with hypothyroidism. Other than that, light weightlifting, yoga and walking, are also beneficial. Do not forget to consult your doctor before you start on any of these exercises.
3. Reduce stress: Hypothyroidism is chronic, and the one thing that worsens chronic diseases is stress. Stress has serious repercussions on your overall health. So it is important to reduce your stress as much as you can. Meditate daily, at least for five minutes, and schedule a weekly massage to deal with your stress.
4. Get enough sleep: Fatigue is a symptom of hypothyroidism; you feel tired and sluggish throughout the day. The best way to counter this is to establish a schedule for sleeping. Try to sleep and wake up every day at the same time in the night and in the morning. Generally, sleeping for seven to eight hours is recommended. If you wish to discuss about any specific problem, you can consult a endocrinologist and ask a free question.