What is endocrinology?

Endocrinology is a specialized branch of medicine that deals with the diagnosis and treatment of conditions that involve hormones. Patients with problems involving the hormone-secreting endocrine glands present a wide array of symptoms, signs, syndromes and conditions, many of which are interrelated.

Some of the common conditions treated by Dr. Akshay Jain include: Full spectrum of Diabetes (Type 1, Type 2, Pregnancy-related diabetes and Diabetes Prevention), Medical Weight Management Clinic, Thyroid Disorders including thyroid cancer, Osteoporosis/ Osteopenia, Cholesterol management, Polycystic Ovary Syndrome (PCOS or PCOD), Female hormone conditions like menopausal hormone replacement therapy and hirsutism (facial hair), Male hormonal disorders like Low Testosterone, Calcium imbalance, Growth Disorders, Pituitary gland disorders and Adrenal gland conditions, among others. Our team is also actively involved in ongoing research for diabetes and other endocrine disorders

Polycystic Ovarian Syndrome (PCOS/ PCOD)

In this endocrine condition, women with PCOS grow many small cysts on their ovaries. The cause of polycystic ovary syndrome (PCOS) is not fully understood, but genetics may be a factor. It is generally due to hormonal imbalance. It can cause problems with your periods and make it difficult to get pregnant

Polycystic ovary syndrome (PCOS) tend to start gradually. Hormone changes that lead to PCOS often start in the early teens, after the first menstrual period. Symptoms may be especially noticeable after a weight gain. Normally, the ovaries make a tiny amount of male sex hormones (androgens). In PCOS, they start making slightly more androgens. Most striking features stopping of ovulating,  acne, and  extra facial and body hair. The body may have a problem using insulin, called insulin resistance; this increases chance of getting diabetes.

At our endocrine clinic, a general line of treatment is determined after through physical examination and investigations such as ultrasonography and hormonal investigations. Baseline treatments such as exercise, foods, weight management and medications are the key treatments for PCOS.

Adrenal and Pituitary Disorders

The adrenal glands in our body are typically located right above the kidneys. These produce a variety of hormones that are crucial for life. Adrenal disorders can be caused by too much or too little of a particular hormone leading to diabetes, high blood pressure, osteoporosis, and other health issues. Adrenal insufficiency occurs when the adrenal glands don’t make enough cortisol, and sometimes, aldosterone. Symptoms include fatigue, muscle weakness, decreased appetite, and weight loss. Some people experience nausea, vomiting, and diarrhoea. Adrenal insufficiency is treated with hormones that replace the hormones your body is lacking. On the other hand, excessive production of cortisol leads to a condition known as Cushing’s Syndrome that leads to excessive weight gain, facial  hair,muscle weakness and other health issues.

Pituitary gland disorders can affect growth, metabolism, energy, blood pressure and many other functions are regulated by the pituitary gland. The pituitary gland is a tiny organ, the size of a pea, found at the base of the brain. As the “master gland” of the body, it produces many hormones that travel throughout the body, directing certain processes or stimulating (causing) other glands to produce other hormones. The pituitary gland works other glands in the body as part of our endocrine system. Because the pituitary gland is located close to the brain, disorders may also affect the nervous system. Pituitary  tumours are also one of the main reasons for endocrine disorders.

The pituitary gland produces hormones, such as these, that affect many other glands in the body:

• Prolactin, to stimulate milk production after childbirth
• Growth hormone, to stimulate childhood growth and maintain a healthy body composition in adults
• Adrenocorticotropic (ACTH), to stimulate the production of cortisol, an important stress hormone that helps maintain blood pressure and blood glucose levels
• Thyroid-stimulating hormone (TSH), to regulate the body’s metabolism and energy
• Luteinizing hormone (LH) and follicle-stimulating hormone (FSH), to regulate testicular function in men and ovarian function in women

Related disorder occurs in the above areas of functioning if there is an abnormality in the pituitary gland affecting the above hormone productions.

Diabetes Care

Diabetes is a disease in which the body’s blood glucose (sugar) level is too high. Normally, the body breaks down food into glucose and carries it to cells throughout the body. The cells use a hormone called insulin to turn the glucose into energy.

The two main types of diabetes are type 1 and type 2. In type 1 diabetes, the body doesn’t make any insulin. This causes the body’s blood sugar level to rise.

In type 2 diabetes, the body’s cells don’t use insulin properly (a condition called insulin resistance). At first, the body reacts by making more insulin. Over time, though, the body can’t make enough insulin to control its blood sugar level.

When blood sugar is uncontrolled, it predisposes to complications such as extreme fatigue, vision loss, kidney damage, frequent infections, heart attacks, strokes, depression and even death. These dangerous complications are easily avoidable if blood sugar is well-controlled.

Our clinic collaborates with doctors for every aspect of Diabetes Care; including Endocrinologist, Nephrologists, Ophthalmologists, Dietitians, Diabetes educators etc. We also have cutting edge technology available including management with continuous glucose monitoring(CGM), insulin pump therapy etc. Our team strongly believes in preventative aspect of diabetes care and will work with you for prevention of worsening of diabetes and associated complications.

Cholesterol imbalance

Elevated cholesterol levels are one of the risk factors for heart disease, stroke, and peripheral artery disease. The mechanism involving cholesterol in all three diseases is the same; plaque buildup within arteries decreases blood flow affecting the function of the cells and organs that these blood vessels supply.

• Atherosclerotic heart disease or narrowed coronary arteries in the heart can cause the symptoms of angina (chest pain), when the heart muscle is not provided with enough oxygen to function.
• Decreased blood supply to the brain may be due to narrowed small arteries in the brain or because the larger carotid arteries in the neck may become blocked. This can result in stroke.

 

Low testosterone

Testosterone is a hormone found in humans. Men have much higher levels of testosterone than women. Production increases during puberty and starts to decrease after age 30. For each year over age 30, the level of testosterone in men starts to slowly dip at a rate of around 1 percent per year. A decrease in testosterone level is a natural result of aging.

Testosterone helps maintain a number of important bodily functions in men, including:

• sex drive
• sperm production
• muscle mass/strength
• fat distribution
• bone density
• red blood cell production

Because testosterone affects so many functions, its decrease can bring about significant physical and emotional changes.

Hypercalcemia/ Hypocalcemia– Calcium Imbalance

Calcium is important for healthy bones and teeth, as well as for normal muscle and nerve function. Normal blood calcium levels are maintained through the actions of parathyroid hormone (PTH), kidneys and intestines. Hypocalcaemia is an electrolyte imbalance and is indicated by a low level of calcium in the blood. Hypercalcemia is a condition associated with high calcium.

Causes include Vitamin D abnormalities, PTH (parathyroid hormone) level disorders, kidney failure, Magnesium deficiency, Alcoholism, Certain types of medications may also cause calcium imbalance. There are genetic conditions that can lead to this disorder as well.

Treatment involves identification of underlying cause for calcium imbalance and tackling the problem accordingly.

Thyroid disease

Thyroid disease is widely prevalent. The condition may manifest as an underactive thyroid gland (hypothyroidism) or an overactive thyroid gland (hyperthyroidism). Symptoms differ on the respective condition.

Symptoms of thyroid disease:

• Nervousness and tremor: (hyperthyroidism).
• Mental fogginess and poor concentration: Mental functioning can be affected in both hyperthyroidism (elevated levels of thyroid hormone) and hypothyroidism (too low levels of thyroid hormones).
• Menstrual changes: Hypothyroidism is sometimes associated with excessive or prolonged menstrual bleeding, while hyperthyroidism can be characterized by scanty or reduced menstrual flow.
• Fluid retention is often a sign of an underactive thyroid gland.
• Racing heartbeat: seen in hyperthyroidisms
• Aches and pains
• Weight gain
• High cholesterol levels: An increase in blood cholesterol levels can occur in individuals with hypothyroidism.
• Heat intolerance: intolerance to higher temperatures.
• Feeling cold: Conversely, those with an underfunctioning thyroid may feel constantly cold.

 

We diagnose and treat patients with thyroid disorders including hypothyroidism, hyperthyroidism, thyroid nodules and thyroid cancer.

Thyroid treatment basically involves

v Identifying the risk factors

v Treat the underlying cause

v Thyroid Replacement Therapy

v Radioactive iodine, Anti-thyroid medications or surgery

v Nutritional supplementation

v Life style modification

v Diet management

v Prevention and treatment of complications

Our endocrinology department is supported by state of the art diagnostic services. The clinic carries out a complete thyroid profile, ultrasound, fine needle aspiration cytology.

Weight Management Centre

When your weight is in a healthy range:

• Your body more efficiently circulates blood.
• Your fluid levels are more easily managed.
• You are less likely to develop diabetes, heart disease, certain cancers and sleep apnea.

Obesity is defined simply as too much body fat. Your body is made up of water, fat, protein, carbohydrate and various vitamins and minerals. If you have too much fat — especially around your waist — you’re at higher risk for health problems, including high blood pressure, high blood cholesterol and diabetes.

Being obese can:

• raise blood cholesterol and triglyceride levels.
• lower “good” HDL cholesterol. HDL cholesterol is linked with lower heart disease and stroke risk, so low LDL tends to raise the risk.
• increase blood pressure.
• induce diabetes. In some people, diabetes makes other risk factors much worse. The danger of heart attack is especially high for these people.

Obesity increases the risk for heart disease and stroke. But it harms more than just the heart and blood vessel system. It’s also a major cause of gallstones, osteoarthritis and respiratory problems.

Being certified by the American Board of Obesity Medicine, Dr. Jain focuses on medical management of overweight and obesity conditions. The protocol delivers an international evidence-based management for safe and effective weight loss. HCF