Patient Education
Thyroiditis: Inflammation of the thyroid, usually from a viral infection or autoimmune condition. Thyroiditis can be painful or have no symptoms at all.
Hyperthyroidism: Excessive thyroid hormone production. Hyperthyroidism is most often caused by Graves disease or an overactive thyroid nodule.
Hypothyroidism: Low production of thyroid hormone. Thyroid damage caused by autoimmune disease is the most common cause of hypothyroidism.
Graves disease: An autoimmune condition in which the thyroid is overstimulated, causing hyperthyroidism.
Thyroid cancer: An uncommon form of cancer, thyroid cancer is usually curable. Surgery, radiation, and hormone treatments may be used to treat thyroid cancer.
Thyroid nodule: A small abnormal mass or lump in the thyroid gland. Thyroid nodules are extremely common. Few are cancerous. They may secrete excess hormones, causing hyperthyroidism, or cause no problems.
Thyroid storm: A rare form of hyperthyroidism in which extremely high thyroid hormone levels cause severe illness.
Thyroid ultrasound: A probe is placed on the skin of the neck, and reflected sound waves can detect abnormal areas of thyroid tissue.
Thyroid scan: A small amount of radioactive iodine is given by mouth to get images of the thyroid gland. Radioactive iodine is concentrated within the thyroid gland.
Thyroid biopsy: A small amount of thyroid tissue is removed, usually to look for thyroid cancer. Thyroid biopsy is typically done with a needle.
Thyroid stimulating hormone (TSH): Secreted by the brain, TSH regulates thyroid hormone release. A blood test with high TSH indicates low levels of thyroid hormone (hypothyroidism), and low TSH suggests hyperthyroidism.
T3 and T4 (thyroxine): The primary forms of thyroid hormone, checked with a blood test.
Thyroglobulins: A substance secreted by the thyroid that can be used as a marker of thyroid cancer. It is often measured during follow-up in patients with thyroid cancer. High levels indicate recurrence of cancer.
Other imaging tests: If thyroid cancer has spread (metastasized), tests such as CT scans, MRI scans, or PET scans can help identify the extent of spread.
Antithyroid medications: Drugs can slow down the overproduction of thyroid hormone in hyperthyroidism. Two common antithyroid medicines are methimazole and propylthiouracil.
Radioactive iodine: Iodine with radioactivity that can be used in low doses to test the thyroid gland or destroy an overactive gland. Large doses can be used to destroy cancerous tissue.
External radiation: A beam of radiation is directed at the thyroid, on multiple appointments. The high-energy rays help kill thyroid cancer cells.
Thyroid hormone pills: Daily treatment that replaces the amount of thyroid hormone you can no longer make. Thyroid hormone pills treat hypothyroidism, and are also used to help prevent thyroid cancer from coming back after treatment.
Recombinant human TSH: Injecting this thyroid-stimulating agent can make thyroid cancer show up more clearly on imaging tests
Your pancreas makes a hormone called insulin. It's what lets your cells turn glucose from the food you eat into energy. People with type 2 diabetes make insulin, but their cells don't use it as well as they should. Doctors call this insulin resistance.
At first, the pancreas makes more insulin to try to get glucose into the cells. But eventually it can't keep up, and the sugar builds up in your blood instead.
Usually, a combination of things cause type 2 diabetes, including:
Genes. Scientists have found different bits of DNA that affect how your body makes insulin.
Extra weight. Being overweight or obese can cause insulin resistance, especially if you carry your extra pounds around the middle. Now type 2 diabetes affects kids and teens as well as adults, mainly because of childhood obesity.
Metabolic syndrome. People with insulin resistance often have a group of conditions including high blood glucose, extra fat around the waist, high blood pressure, and high cholesterol and triglycerides.
Too much glucose from your liver. When your blood sugar is low, your liver makes and sends out glucose. After you eat, your blood sugar goes up, and usually, the liver will slow down and store its glucose for later. But some people's livers don't. They keep cranking out sugar.
Bad communication between cells. Sometimes cells send the wrong signals or don't pick up messages correctly. When these problems affect how your cells make and use insulin or glucose, a chain reaction can lead to diabetes.
Broken beta cells. If the cells that make the insulin send out the wrong amount of insulin at the wrong time, your blood sugar gets thrown off. High blood glucose can damage these cells, too.
Type 1 diabetes happens when your immune system destroys cells in your pancreas called beta cells. They’re the ones that make insulin.
Some people get a condition called secondary diabetes. It’s similar to type 1, except the immune system doesn’t destroy your beta cells. They’re wiped out by something else, like a disease or an injury to your pancreas.
Insulin is a hormone that helps move sugar, or glucose, into your body's tissues. Cells use it as fuel.
Damage to beta cells from type 1 diabetes throws the process off. Glucose doesn’t move into your cells because insulin isn’t there to do it. Instead it builds up in your blood and your cells starve. This causes high blood sugar, which can lead to:
Dehydration. When there’s extra sugar in your blood, you pee more. That’s your body’s way of getting rid of it. A large amount of water goes out with that urine, causing your body to dry out.
Weight loss. The glucose that goes out when you urinate takes calories with it. That’s why many people with high blood sugar lose weight. Dehydration also plays a part.
Diabetic ketoacidosis (DKA). If your body can't get enough glucose for fuel, it breaks down fat cells instead. This creates chemicals called ketones. Your liver releases the sugar it stores to help out. But your body can’t use it without insulin, so it builds up in your blood, along with the acidic ketones. This combination of extra glucose, dehydration, and acid buildup is known as "ketoacidosis" and can be life-threatening if not treated right away.
Damage to your body. Over time, high glucose levels in your blood can harm the nerves and small blood vessels in your eyes, kidneys, and heart. They can also make you more likely to get hardening of the arteries, or atherosclerosis, which can lead to heart attacks and strokes.
Polycystic ovary syndrome is a problem in which a woman's hormones are out of balance. It can cause problems with your periods and make it difficult to get pregnant. PCOS also may cause unwanted changes in the way you look. If it isn't treated, over time it can lead to serious health problems, such as diabetes and heart disease.
Most women with PCOS grow many small cysts on their ovaries. That is why it is called polycystic ovary syndrome. The cysts are not harmful but lead to hormone imbalances.
Early diagnosis and treatment can help control the symptoms and prevent long-term problems.
Most women with PCOS grow many small cysts on their ovaries. That is why it is called polycystic ovary syndrome. The cysts are not harmful but lead to hormone imbalances.
Early diagnosis and treatment can help control the symptoms and prevent long-term problems.
Being obese means having so much body fat that your health is in danger. Having too much body fat can lead to type 2 diabetes, heart disease, high blood pressure, arthritis, sleep apnea, and stroke.
Because of these risks, it is important to lose weight even if you don't feel bad now. It is hard to change eating habits and exercise habits. But you can do it if you make a plan.
How do you know if you are obese?
You can use a measurement called a body mass index, or BMI, along with your waist size, to decide whether your weight is dangerous to your health. The BMI is a combination of your height and weight. If you have a BMI of 30 or higher, unhealthy eating patterns, and too little physical activity, your extra weight is putting your health in danger.
Use the Interactive Tool: Is Your BMI Increasing Your Health Risks? to find out your body mass index.
Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke.
The term "metabolic" refers to the biochemical processes involved in the body's normal functioning. Risk factors are traits, conditions, or habits that increase your chance of developing a disease.
The five conditions described below are metabolic risk factors. You can have any one of these risk factors by itself, but they tend to occur together. You must have at least three metabolic risk factors to be diagnosed with metabolic syndrome.
- A large waistline. This also is called abdominal obesity or "having an apple shape." Excess fat in the stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips.
- A high triglyceride level (or you're on medicine to treat high triglycerides). Triglycerides are a type of fat found in the blood.
- A low HDL cholesterol level (or you're on medicine to treat low HDL cholesterol). HDL sometimes is called "good" cholesterol. This is because it helps remove cholesterol from your arteries. A low HDL cholesterol level raises your risk for heart disease.
- High blood pressure (or you're on medicine to treat high blood pressure). Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and lead to plaque buildup.
- High fasting blood sugar (or you're on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes
Insulin is a hormone made by your pancreas. It allows your cells to use glucose (sugar) for energy. People with insulin resistance have cells that don’t use insulin effectively. This means the cells have trouble absorbing glucose, which causes a buildup of sugar in the blood. If your blood glucose levels are higher than normal, but not high enough to be considered type 2 diabetes, you have a condition called prediabetes.
It’s not entirely clear why some people develop insulin resistance and others don’t. Being overweight or obese are the leading risk factors. A sedentary lifestyle can also cause prediabetes or type 2 diabetes, especially if you’re also overweight.
Insulin resistance often doesn’t trigger any noticeable symptoms, especially in the early phases. You could be insulin resistant for years without knowing, especially if your blood glucose levels aren’t checked.
Insulin resistance may also damage your blood vessels without you realizing it. This can increase your risk of heart disease and stroke.
If you have insulin resistance, you’re at significant risk for progressing to diabetesMost women have menstrual periods that last four to seven days. A woman's period usually occurs every 28 days, but normal menstrual cycles can range from 21 days to 35 days.
Examples of menstrual problems include:
- Periods that occur less than 21 days or more than 35 days apart
- Missing three or more periods in a row
- Menstrual flow that is much heavier or lighter than usual
- Periods that last longer than seven days
- Periods that are accompanied by pain, cramping, nausea, or vomiting
- Bleeding or spotting that happens between periods, after menopause, or following sex
Examples of abnormal menstruation include the following:
- Amenorrhea is a condition in which a woman’s periods have stopped completely. The absence of a period for 90 days or more is considered abnormal unless a woman is pregnant, breastfeeding, or going through menopause (which generally occurs for women between ages 45 and 55). Young women who haven't started menstruating by age 15 or 16 or within three years after their breasts begin to develop are also considered to have amenorrhea.
- Oligomenorrhea refers to periods that occur infrequently.
- Dysmenorrhea refers to painful periods and severe menstrual cramps. Some discomfort during the cycle is normal for most women.
- Abnormal uterine bleeding may apply to a variety of menstrual irregularities, including: a heavier menstrual flow; a period that lasts longer than seven days; or bleeding or spotting between periods, after sex, or after menopause.
There are many causes of abnormal periods, ranging from stress to more serious underlying medical conditions:
- Pelvic inflammatory disease. Pelvic inflammatory disease (PID) is a bacterial infection that affects the female reproductive system. Bacteria may enter the vagina via sexual contact and then spread to the uterus and upper genital tract. Bacteria might also enter the reproductive tract via gynecologic procedures or through childbirth, miscarriage, or abortion. Symptoms of PID include a heavy vaginal discharge with an unpleasant odor, irregular periods, pain in the pelvic and lower abdominal areas, fever, nausea, vomiting, or diarrhea.
- Endometriosis. The endometrial tissue that lines the uterus breaks down every month and is discharged with the menstrual flow. Endometriosis occurs when the endometrial tissue starts to grow outside the uterus. Often, the endometrial tissue attaches itself to the ovaries or fallopian tubes; it sometimes grows on the intestines or other organs in the lower digestive tract and in the area between your rectum and uterus. Endometriosis may cause abnormal bleeding, cramps or pain before and during periods, and painful intercourse.
- Uterine polyps or fibroids. Uterine polyps are small benign (noncancerous) growths in the lining of the uterus. Uterine fibroids are tumors that attach to the wall of the uterus. There may be one or several fibroids that range from as small as an apple seed to the size of a grapefruit. These tumors are usually benign, but they may cause heavy bleeding and pain during periods. If the fibroids are large, they might put pressure on the bladder or rectum, causing discomfort.
- Birth control pills. Most birth control pills contain a combination of the hormones estrogen and progestin (some contain progestin alone). The pills prevent pregnancy by keeping the ovaries from releasing eggs. Going on or off birth control pills can affect menstruation. Some women have irregular or missed periods for up to six months after discontinuing birth control pills. This is an important consideration when you are planning on conception and becoming pregnant. Women who take birth control pills that contain progestin only may have bleeding between periods.
- Stress and lifestyle factors. Gaining or losing a significant amount of weight, dieting, changes in exercise routines, travel, illness, or other disruptions in a woman's daily routine can have an impact on her menstrual cycle.
- Polycystic ovary syndrome In polycystic ovary syndrome (PCOS), the ovaries make large amounts of androgens, which are male hormones. Small fluid-filled sacs (cysts) may form in the ovaries. These can often been seen on ultrasound. The hormonal changes can prevent eggs from maturing, and so ovulation may not take place consistently. Sometimes a woman with polycystic ovary syndrome will have irregular periods or stop menstruating completely. In addition, the condition is associated with obesity, infertility, and hirsutism (excessive hair growth and acne). This condition may be caused by a hormonal imbalance, although the growth and acne). This condition may be caused by a hormonal imbalance, although the exact cause is unknown. Treatment of PCOS depends on whether a woman desires pregnancy. If pregnancy is not a goal, then weight loss, oral contraceptive pills, and the medication Metformin® (an insulin sensitizer used in diabetes) can regulate a woman’s cycles. If pregnancy is desired, ovulation-stimulating medications can be tried.
- Premature ovarian insufficiency. This condition occurs in women under age 40 whose ovaries do not function normally. The menstrual cycle stops, similar to menopause. This can occur in patients who are being treated for cancer with chemotherapy and radiation, or if you have a family history of premature ovarian insufficiency or certain chromosomal abnormalities. If this condition occurs, see your physician.
Other causes of abnormal menstruation include:
- uterine cancer or cervical cancer
- medications, such as steroids or anticoagulant drugs (blood thinners)
- medical conditions, such as bleeding disorders, an under- or overactive thyroid gland, or pituitary disorders that affect hormonal balance
- complications associated with pregnancy, including miscarriage or an ectopic pregnancy (the fertilized egg is implanted outside the uterus; for example, within the fallopian tube)
Excessive or abnormal hair loss is known as alopecia, and there are several kinds. What all hair loss has in common, whether it's in men or women, is a symptom of something that's gone wrong in your body. Your hair will remain on your head where it belongs unless hormone imbalance, disease, or some other condition occurs. That condition may be as simple as having a gene that makes you susceptible to male or female pattern baldness or one of the forms of alopecia areata, or it may be as complex as a whole host of diseases.
Hair loss can be a symptom of a short-term event such as stress, pregnancy, disease, or medication, which can all alter hair's growth and shedding phases. In these situations, hair will grow back when the event has passed. Once the cause of the loss is addressed, hairs go back to their random pattern of growth and shedding, and your problem stops.
The first two types of hair loss in women are associated with dihydrotestosterone (DHT), a derivative of the male hormone, testosterone.
Androgenetic Alopecia
The majority of women with androgenetic - also called androgenic - alopecia have diffuse thinning on all areas of the scalp. (Men rarely have diffuse thinning but instead have more distinct patterns of baldness.) Some women have a combination of two pattern types.
Androgenic alopecia in women is due to the action of androgens, male hormones that are typically present in only small amounts. Androgenic alopecia can be caused by a variety of factors tied to the actions of hormones, including some ovarian cysts, taking high androgen index birth control pills, pregnancy, and menopause.
Just as in men, the hormone DHT appears to be at least partially to blame for the miniaturization of hair follicles in women suffering with female pattern baldness. Heredity plays a major factor in the disease.
Telogen Effluvium
When your body goes through something traumatic like child birth, malnutrition, a severe infection, major surgery, or extreme stress, it can impact your hair. Many of the 90% or so of hairs in the growing (anagen) or transitional (catagen) phases can actually shift all at once into the resting (telogen) phase
About six weeks to three months after the stressful event, the shedding phenomenon called telogen effluvium may begin. It is possible to lose handfuls of hair at a time when in full-blown telogen effluvium.
For most who suffer with this, complete remission is probable as long as severely stressful events can be avoided. For some women, however, telogen effluvium is a mysterious chronic disorder and can persist for months or even years without any true understanding of the triggering factors or stressors.
Anagen Effluvium
Anagen effluvium occurs after any insult to the hair follicle that impairs its cellular-level mitotic or metabolic activity. This hair loss is commonly associated with chemotherapy. Since chemotherapy targets rapidly dividing cancer cells, your body's other rapidly dividing cells -- such as hair follicles in the growing (anagen) phase -- are also greatly affected. Soon after chemotherapy begins, approximately 90% or more of hairs in the anagen phase can fall out.
Alopecia Areata
An inappropriate inflammatory reaction is behind alopecia areata. A person's own immune system attacks the roots of hair follicles. Symptoms include patchy shedding of hair, which sometimes develops quite suddenly. About 70% of patients recover their hair within two years, whether or not they receive treatment.
Traction Alopecia
This condition is caused by localized trauma to the hair follicles from tight hairstyles that pull at the hair over time. If the condition is detected early enough, the hair will regrow. Braiding, cornrows, tight ponytails, and extensions are the most common styling causes of traction alopecia
The exact cause of acne is unknown, but doctors believe it results from several related factors. One important factor is an increase in hormones called androgens (male sex hormones). These increase in both boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy or starting or stopping birth control pills can also cause acne.
Another factor is heredity or genetics. Researchers believe that the tendency to develop acne can be inherited from parents. For example, studies have shown that many school-age boys with acne have a family history of the disorder. Certain drugs, including androgens and lithium, are known to cause acne. Greasy cosmetics may alter the cells of the follicles and make them stick together, producing a plug.
Factors That Can Make Acne Worse
Factors that can cause an acne flare include:
- changing hormone levels
- oil from skin products (moisturizers or cosmetics) or grease encountered in the work environment (for example, a kitchen with fry vats)
- pressure from sports helmets or equipment, backpacks, tight collars, or tight sports uniforms
- environmental irritants, such as pollution and high humidity
- squeezing or picking at blemishes
- hard scrubbing of the skin
- stress
The doctor may prescribe one of several drugs to treat women with this type of acne:
- Birth control pills. To help suppress the androgen produced by the ovaries
- Low-dose corticosteroid drugs, such as prednisone or dexamethasone. To help suppress the androgen produced by the adrenal glands
- Antiandrogen drugs such as spironolactone. To reduce the excessive oil production.
The amount of body hair you have is largely determined by your genetic makeup. Hirsutism may arise from excess male hormones called androgens, primarily testosterone. Hirsutism may also be due to a family trait.
A combination of self-care and medical therapies provides effective treatment for many women with hirsutism.
Medications taken for hirsutism usually take several months before you see a significant difference in hair growth. Medications may include:
- Oral contraceptives - Birth control pills or other hormonal contraceptives, which contain the hormones estrogen and progestin, treat hirsutism by inhibiting androgen production by your ovaries. Oral contraceptives are a common treatment for hirsutism in women who don't want to become pregnant. Possible side effects include dizziness, nausea, headache and stomach upset.
- Anti-androgens - These types of drugs block androgens from attaching to their receptors in your body. The most commonly used anti-androgen for treating hirsutism is spironolactone (Aldactone). Because these drugs can cause birth defects, it's important to faithfully use contraception while taking them.
- Topical cream - Eflornithine (Vaniqa) is a prescription cream specifically for excessive facial hair in women. It's applied directly to the affected area of your face and helps slow new hair growth, but doesn't get rid of existing hair.
In adult males, hypogonadism may alter certain masculine physical characteristics and impair normal reproductive function. Signs and symptoms may include:
- Erectile dysfunction
- Infertility
- Decrease in beard and body hair growth
- Decrease in muscle mass
- Development of breast tissue (gynecomastia)
- Loss of bone mass (osteoporosis)
- Fatigue
- Decreased sex drive
- Difficulty concentrating
- Hot flashes
- Hormone replacement - For hypogonadism caused by testicular failure, doctors use male hormone replacement therapy (testosterone replacement therapy, or TRT). TRT can restore muscle strength and prevent bone loss. In addition, men receiving TRT may experience an increase in energy, sex drive, erectile function and sense of well-being.
- Assisted reproduction - Although there's often no effective treatment to restore fertility in a man with primary hypogonadism, assisted reproductive technology may be helpful. This technology covers a variety of techniques designed to help couples who have been unsuccessful in achieving conception.
With pituitary disorders, you often have too much or too little of one of your hormones. Injuries can cause pituitary disorders, but the most common cause is a pituitary tumor.
Pituitary gland disorders can affect many different parts of the body. Conditions such as acromegaly, Cushing's syndrome, hypothyroidism (underactive thyroid), and hypogonadism (low sex hormone levels) all may result from pituitary gland disease.
With adrenal gland disorders, your glands make too much or not enough hormones. In Cushing's syndrome, there's too much cortisol, while with Addison's disease, there is too little. Some people are born unable to make enough cortisol.
Causes of adrenal gland disorders include:
- Genetic mutations
- Tumors including pheochromocytomas
- Infections
- A problem in another gland, such as the pituitary, which helps to regulate the adrenal gland
- Certain medicines
Osteoporosis means “porous bone.” Viewed under a microscope, healthy bone looks like a honeycomb. When osteoporosis occurs, the holes and spaces in the honeycomb are much larger than in healthy bone. Osteoporotic bones have lost density or mass and contain abnormal tissue structure. As bones become less dense, they weaken and are more likely to break. If you’re 50 or older and have broken a bone, ask your doctor or healthcare provider about a bone density test.
You can find out whether you have osteoporosis or if you should be concerned about your bones by getting a bone mineral density (BMD) test.
Although there is no cure for osteoporosis, there are steps you can take to prevent, slow or stop its progress. In some cases, you may even be able to improve bone density and reverse the disorder to some degree. Getting enough calcium and vitamin D are essential to bone health. There are also medications available to reduce the risk of broken bones. These medicines either (1) slow or stop bone loss or (2) rebuild bone.
The parathyroid glands produce parathyroid hormone, which helps maintain an appropriate balance of calcium in the bloodstream and in tissues that depend on calcium for proper functioning.