We talked with Stanislav Khan, an endocrinologist and nutritionist, author of the book “Passions for the Thyroid Gland”.
You will find out, is it possible prevent endocrine diseases, which doctor to go to if you feel tired all the time, why see an endocrinologist if you are obese and is it necessary check your hormones periodically.
Go see a doctor
Our articles are written with love for evidence-based medicine. We refer to authoritative sources and seek comments from doctors with a good reputation. But remember: responsibility for your health lies with you and your doctor. We do not write prescriptions, we give recommendations. Whether to rely on our point of view or not is up to you.
What endocrine diseases remain undiagnosed for a long time? Why?
Patients with type 2 diabetes often come to the doctor for the first time when the situation is already advanced – often they do not even come themselves, but under pressure from children, parents, spouses. I call diabetes a silent killer that is silent, but gradually destroys the body and leads to serious complications. As a rule, such patients have other serious problems, such as high cholesterol and hypertension.
Previously, type 2 diabetes was considered an age-related disease, unlike type 1 diabetes
which usually manifests itself in childhood or adolescence. Now I have thirty-year-old patients with this diagnosis.
Is it possible? prevent endocrine diseases? How?
Alternative medicine practitioners often promise to find and cure the cause of a disease before it occurs. But in reality, many factors influence the development of endocrinological diseases.
Let’s take autoimmune thyroiditis as an example.
– This is a very common thyroid disease, and it would be It’s great to learn how to prevent it. Its development is influenced by complex interactions in the immune system, genetic factors, environmental conditions and much more. Which of these factors should be eliminated as the cause of the disease?
Promises to find the cause of the disease sound tempting, but implementing a lot in life in the case of endocrine diseases is almost impossible. With one exception: it is possible to prevent type 2 diabetes with a high degree of probability. One of its main causes is excess weight. The classic recommendation in this case is to normalize body weight, but, unfortunately, this sounds “uninteresting”, people want innovative approaches without restrictions and efforts.
Is it true? that stress can lead to disruptions in the hormonal system?
Stress is an important factor in the development of diseases. It is known, for example, that Obesity is more common in people who sleep less than eight hoursand lack of sleep is stress for the body. Accordingly, stress can indirectly predispose to diabetes: if a person is often nervous and eats sweets to cope with their worries, and also does not get enough sleep, they are highly likely to be overweight, which increases the risk of this disease.
Of course, you need to fight stress: get enough sleep, rest, exercise, maybe try meditation or breathing exercises. But you don’t need to monitor your cortisol levels.
in the blood. Alternative medicine doctors often prescribe such a test, and then attribute all problems to the deviation of the level of this hormone from the norm and “treat” it.
Taking a blood test for cortisol is pointless in most cases. It normally rises in the morning, and its level is also affected by any external factors – for example, stress from getting up early, fear of an injection, or worries about the test results.
You only need to check cortisol if adrenal insufficiency is suspected — autoimmune damage to the adrenal glands, when the organ does not work and secretes little or no hormones. If the diagnosis is confirmed, the disease is treated not with dietary supplements, but with hormone replacement therapy.
Is it necessary? check hormones if you feel weak, tired, or sleepy?
Many endocrine diseases are accompanied by complaints of decreased performance, fatigue, weakness, and lack of strength. It is worth visiting an endocrinologist to rule out these diseases, although you can start looking for the cause in this case with a consultation with a therapist. I emphasize that in most cases, two appointments will be enough: if, in response to such complaints, the doctor prescribes a bunch of tests and examinations, and then a bunch of jars with various dietary supplements and vitamins, it is better to look for another doctor.
Thyroid diseases, in particular, chronic autoimmune thyroiditis – when the organ functions worse and the body develops a deficiency of thyroid hormones – often manifests itself with these symptoms. The doctor will prescribe a blood test and, possibly, an ultrasound of the thyroid gland. Based on these examinations, a diagnosis can be made and treatment can be prescribed – it consists of taking one tablet daily L-thyroxine.
Vitamin D deficiency. It is called a “vitamin hormone”. Now the role is being questioned vitamin D in the development of weakness, hair loss or frequent acute respiratory viral infections. But if a deficiency of this substance is detected, it must be replenished.
Iron deficiency and iron deficiency anemia. Because of Regular iron loss during menstruation in women of reproductive age causes a deficiency of this microelement. If iron deficiency is confirmed by blood tests, it is necessary to replenish its supply.
Other reasons. Weakness is a non-specific symptom, meaning it can be a sign of various diseases. If a person does not have problems with the thyroid gland, deficiency vitamin D and iron, we continue the search or refer the patient to other specialists – for example, to a psychiatrist, to rule out depression.
Is it true? that if you are obese you need to see an endocrinologist?
Obesity is a chronic disease, not just an aesthetic problem
. It requires constant monitoring and adequate treatment, so you should not wait until other symptoms appear against the background of excess weight – it is better to consult a doctor.
Now some doctors and bloggers are promoting the idea that obesity is normal. From a medical point of view this is wrong. I like the concept of body positivity, I agree that you need to love yourself. But this does not mean that you should close your eyes to a real medical problem that can lead to serious consequences. As a doctor, I must gently convey to the patient that their weight directly affects their health and my recommendation to lose weight is not an assessment of appearance, but a medical prescription. This is not always easy.
Is it necessary? check hormones periodically if nothing bothers you?
There are recommendations for checkups
where it is described in detail what examinations and at what age you need to undergo in order to detect certain diseases in time.
In my opinion, it is necessary to adhere to generally accepted recommendations, and if necessary, add to them the tests that the doctor prescribed taking into account individual risk factors. For example, an overweight person should definitely check glucose and glycated hemoglobin
at least once a year to avoid the development of prediabetes
or diabetes.
Taking blood tests for all hormones just in case is a bad idea. I joke that in medicine the principle “who seeks will find” applies. It is very likely that out of 30 indicators, 10 will have minor deviations. Moreover, information about them will not affect the doctor’s tactics in any way if he adheres to an evidence-based approach, and does not seek to sell more dietary supplements and prescribe a proprietary treatment regimen. But this extra information will cause anxiety in a person.
Is it true? that taking testosterone is good for men, while taking estrogen prolongs youth in women?
Testosterone. Today, both men and women give themselves testosterone injections. Of course, life subjectively becomes better because it is an anabolic drug.
. It gives a surge of energy: mood, sex life, muscle strength improve. But is it useful such an improvement? I compare testosterone injections to drugs – once upon a time migraines and other pains were effectively treated with narcotic substances. Now we know that the harm of such treatments outweighs the benefit.
Improving the quality of human life is the goal of medicine, but we should not achieve her at any cost. There are no studies yet, which would have shown convincingly that testosterone injections can be used to become more sexually active and energetic without harming one’s health. This treatment has many side effects, such as increased blood pressure.
Of course, if a man is diagnosed with decreased testosterone – a condition called hypogonadism – treatment with this hormone is justified.
Estrogen used in women as menopausal hormone therapy. It can indeed be helpful, if it is used as indicatedthat is, in women in menopause, including premature menopause
.
Menopausal hormone therapy reduces the risk of osteoporosis and fractures, alleviates menopause symptoms, and improves metabolism. But it also has side effects, so estrogen can only be taken after consulting a doctor and eliminating contraindications.
- Endocrine diseases develop under the influence of many factors, it is impossible to take them all into account and eliminate them in advance. But you can significantly reduce the risk of developing type 2 diabetes: you need to maintain normal body weight.
- Obesity is a disease that requires monitoring by an endocrinologist and treatment, even if it is not accompanied by other symptoms.
- Stress is one of the most important risk factors for chronic diseases, but controlling blood cortisol levels will not help prevent these diseases.
- If you feel constant fatigue, weakness and drowsiness, you can start by visiting a therapist or endocrinologist. They will exclude the most common causes: thyroid disease, deficiencies vitamin D and iron.
- There is no need to check all hormones regularly just in case. This will not help prevent diseases, but will increase anxiety. It is better to perform scheduled checkups and ask your doctor about individual risk factors that require monitoring.
- Evidence-based medicine doctors do not recommend the use of testosterone or estrogen replacement therapy without indications. There is no convincing evidence that it can safely prolong youth.
