Conditions We Treat

Diabetes

Comprehensive evaluation and management of all types of diabetes mellitus

• Type 1 diabetes
• Type 2 diabetes
• Gestational diabetes
• Continuous glucose monitoring
• Insulin pump therapy for patients who are appropriate for this mode of therapy

There are several types of diabetes including type 1 (juvenile), type 2 (insulin-resistant), and gestational (pregnancy) diabetes. This condition is the result of excess sugar in the blood and is a chronic condition in all but gestational cases. Insulin is a hormone in the bloodstream that converts glucose (sugar) from the food you eat into energy. In people with diabetes, the body either doesn’t produce enough insulin or is unable to utilize it effectively. Diabetes treatments are designed to regulate blood sugar levels. Dr. Thomas offers individualized evaluation of your journey with diabetes mellitus. She will discuss the rationale of the different treatment options and offer you a personalized treatment plan. Her office offers continuous glucose monitoring and insulin pump therapy for patients who are suitable for this mode of delivery of insulin therapy. Every effort will be made to support you in your quest to optimal control of your diabetes mellitus in order to prevent both short- and long-term complications of diabetes mellitus.

Thyroid Disease

Complete evaluation of thyroid disorders

• Hyperthyroidism (overactive thyroid gland)
• Hypothyroidism (underactive thyroid)
• Thyroid nodules and goiter evaluation, including ultrasound and thyroid nodule fine needle aspiration (FNA) biopsy when necessary
• Thyroid cancer evaluation and management, including ultrasound and thyroid nodule fine needle aspiration (FNA) biopsy when necessary

The thyroid gland produces hormones that influence other glands and many physiological functions in the body. It is a butterfly-shaped gland in the neck and plays a large role in metabolic processes. Thyroid disorders affect women at a higher rate than men. People with thyroid conditions experience either too much (hyperthyroidism) or too little (hypothyroidism) production of important thyroid hormones including thyroid stimulating hormone (TSH), triidothyronine, (T3), and thyroxine (T4). In pregnancy, your thyroid hormone levels fluctuate and you need close follow-up with an endocrinologist like Dr. Thomas to help achieve optimal thyroid hormone levels. You can also have thyroid nodules, which are growths in your thyroid gland that need evaluation and monitoring. Dr. Thomas is a ECNU (Endocrinology Certification in Neck Ultrasound) certified endocrinologist who  will evaluate you clinically and perform a detailed ultrasound of your thyroid gland and lymph nodes of the neck. For thyroid nodules, she will decide with you whether you need a fine needle aspiration biopsy to check for cancer cells. Not all thyroid nodules require a biopsy, which is why you need an experienced endocrinologist like Dr Thomas to evaluate the thyroid nodule. Dr. Thomas values patient relationships and will discuss all treatment options with you. She will coordinate care with an endocrine surgeon or a nuclear medicine specialist if you need surgery or radioiodine therapy.

Parathyroid Disorders

In-depth assessment using parathyroid ultrasound and treatments aimed at regulating calcium

• Hyperparathyroidism
• Hypoparathyroidism

The four parathyroid glands are located behind the thyroid in the neck. These glands regulate calcium and phosphorous metabolism in the body. Dr. Thomas routinely performs on-site ultrasound for parathyroid disorders to evaluate the condition before developing an individualized treatment plan. She will work closely with an endocrine surgeon to develop a detailed treatment plan if parathyroid surgery is necessary.

Adrenal Gland Disorders

Diagnostic testing, including blood and urine samples, detects adrenal abnormalities, which are treated with hormone replacement and/or drug therapy.

• Adrenal gland insufficiency
• Adrenal gland hormone excess
• Adrenal gland tumors

The adrenal glands are located above the kidneys. They produce many hormones, including aldosterone, glucocorticoids, androgens, and catecholamines (adrenaline) that help your body manage stress and regulate mineral and water balance, blood pressure, and glucose metabolism. Adrenal gland dysfunction can be caused by either impaired adrenal function (adrenal insufficiency or Addison’s disease) or excess adrenal hormones (Cushing’s syndrome or pheochromocytoma). In addition, tumors of the adrenal gland can be either benign (non-cancerous) or malignant (cancerous). Dr. Thomas offers comprehensive evaluation of adrenal disorders, including biochemical analysis of the various hormone levels and radiological evaluation of the adrenal disorder. She will recommend hormone replacement therapy if needed or coordinate with an endocrine surgeon if surgery is needed.

Pituitary Disorders

Extensive assessment of hormone testing and neuroradiology results (MRI or CT) to determine appropriate hormone treatments

• Pituitary gland tumors
• Pituitary gland hormone insufficiency (hypopituitarism)
• Pituitary gland hormone excess (acromegaly or Cushing’s disease)

The pituitary gland is often called the “master gland,” as it controls the secretion of many hormones of the body. It is located in a bony hollow below the brain. Disorders of the pituitary gland include a benign (non-cancerous) growth that can cause excess hormone production (prolactinoma, Cushing’s disease, gigantism), or it can block hormone production (hypopituitarism), or it can be “non-functioning” and produce compressive features on the structures around it. Dr. Thomas will evaluate you clinically and biochemically and recommend appropriate radiological imaging for optimal management of your condition. She will develop a treatment plan and will coordinate further management with expert pituitary surgeons and radiotherapists if needed.

Osteoporosis and Osteopenia

Early detection of bone disease with treatment options and bone loss prevention education

• Osteoporosis
• Osteomalacia
• Paget’s disease of the bone
• Vitamin D deficiency

Osteopenia and osteporosis are bone diseases caused by a reduction of bone mass. This reduction in bone mass increases your risk of fractures. This condition is seen often in post-menopausal women as well as in people with low sex hormone levels (male and female hypogonadism), overactive thyroid hormone levels, on chronic high dose steroids and malabsorption syndromes. Dr. Thomas will evaluate you clinically and screen you with appropriate biochemistry to determine the etiology of the condition. Bone density scans and X-rays will help quantify the bone loss, monitor the efficacy of treatment, and identify any fractures. This will help optimize the appropriate therapy to prevent further bone loss and fractures.

Hypogonadism

Complete analysis and compassionate care for the reproductive system of both men and women

• Hypogonadism – male and female
• Basic reproductive endocrinology
• Polycystic ovarian disease
• Menopause

Hypogonadism is a condition that occurs due to a reduced functional activity of the gonads – the testes in men and the ovaries in women – resulting in a reduction of testosterone in men and estrogen in women. This can cause disturbances in the male and female metabolism, including premature cessation of menstruation, low sex drive, loss of body hair, reduced energy levels, hot flashes, loss of muscle mass and bone mass, and sexual difficulties. Dr. Thomas will evaluate this condition thoroughly, discuss different treatment options to help restore optimal levels of male or female hormone levels, and monitor for side effects of the treatment.

Transsexualism (Gender Dysphoria)

Personalized hormone therapy designed to transition to the gender with which our patient identifies

Coordination with primary care provider and psychologist to help the transition process

Transsexualism, or gender dysphoria, occurs in people who identify psychologically and emotionally with the opposite sex of which they are born.

Dr. Thomas offers compassionate care for transsexuals that allows them to transition into the gender with which they identify. She will coordinate care with the primary care provider and psychologist and develop a treatment plan based on the recent endocrine society guidelines.

The hormone treatments are safe and effective, designed to suppress hormone production related to the biological sex while increasing hormone secretions that support the desired gender. Monitoring for side effects and referral for age-appropriate cancer screening during the hormone treatment is an important part of the treatment plan.