By Robert Aden, MD

When left untreated, thyroid disorders can have a profound impact on a person's health and life. The thyroid gland is much like a traffic controller, guiding nearly all of the body’s metabolic processes. When the thyroid gland overproduces thyroid hormone, the result is hyperthyroidism; hypothyroidism is the condition that results from too little thyroid hormone production. 

The thyroid is small butterfly-shaped gland located in the neck just below the Adam’s apple, and above the voice box. The gland can sometimes enlarge, causing a goiter. Medications that treat thyroid disorder can keep the gland from enlarging to the point at which it must be removed; in some cases, they can actually cause the gland to shrink.

Your physician will diagnose thyroid disorder through blood tests and symptoms. Sometimes an ultrasound of the neck is ordered, and if nodules are found, a fine needle aspiration biopsy may be performed. Although the cause of thyroid disorder may be transient, as in the case of postpartum thyroiditis, the majority of people who suffer from thyroid disease will be on medication for their entire lives. 

About the Author: Robert Aden, MD, is board certified in endocrinology and internal medicine, and he has received procedural certification in Thyroid Ultrasound and Ultrasound Guided Fine Needle Aspiration. Dr. Aden treats patients in and around Miami, Florida. 

Type 2 diabetes is a genetic and lifestyle-related condition often attributed to years of unhealthy diet, coupled with lack of regular exercise. Although onset is gradual, once the condition develops it cannot simply be eliminated through changing habits that led to its development. Successful treatment requires a multi-level effort on the part of the patient, under supervision of a qualified endocrinologist.

The initial goal of diabetes treatment is to lower blood glucose levels to safe levels through undertaking sufficient regular exercise and altering diet around low-carbohydrate principles. It often takes patients several months to fully learn diabetes management skills as they involve a complex combination of food portion management; medication self-administration; recognizing and treating high glucose levels; handling and storing diabetes medical supplies; and coping techniques for sick days.

A critical aspect of successful diabetes management is self-monitoring of blood glucose (SMBG). This involves utilizing a glucose meter to take an accurate blood sugar reading. Although there are several types of glucose meters, they generally involve pricking the finger with a lancet, or small needle. The tiny resultant blood drop is placed on a test strip, which the glucose meter reads and processes digitally. Results of SMBG tests are usually available in a few seconds. The frequency with which blood testing must be undertaken depends on whether the patient has diabetes under control. Individuals just starting out on a SMBG regimen should utilize the glucose meter once or twice a day, while those with blood glucose levels that are under control can check a few times a week.

In addition to eating healthy foods, eating at roughly the same time each day is an important part of diabetes control. Consistency with foods eaten and portion sizes helps lessen blood glucose level ranges. Consult regularly with an experienced physician or nurse to determine the correct combination of proteins, carbohydrates, and fat intake for your particular situation. If you are obese, and diabetic conditions persist despite improved diet and medication regimens, consult with a physician about the possibility of bariatric, or gastric bypass surgery.

Physicians who specialize in the field of internal medicine possess the background to treat many of the health conditions related to the endocrine system, but only endocrinologists have the specific skills necessary to address complicated endocrine diseases. In this article, I describe the typical educational background and professional certifications of a qualified endocrinologist.

As physicians, endocrinologists must earn their medical degrees before pursuing further specialization. Depending on their chosen subspecialty, endocrinologists complete their residency training in one of three fields: internal medicine for adult endocrinology, pediatrics for pediatric endocrinology, or obstetrics and gynecology for reproductive endocrinology and infertility. After three years of residency, physicians who plan to become adult endocrinologists embark on advanced postgraduate fellowships in endocrinology, diabetes, and metabolism. These generally take an additional two years and qualify endocrinologists for board certification by the American Board of Internal Medicine (ABIM). 

Although board certification is voluntary, the ABIM currently certifies a quarter of practicing physicians in the United States. All candidates for subspecialty certification in endocrinology, diabetes, and metabolism must first earn certification in internal medicine; the board then evaluates qualified practitioners according to rigorous standards of education, training, and clinical competence. Once certified, endocrinologists regularly maintain certification through a process that includes continuing education, self-evaluation, and a comprehensive recertification exam. 

In addition to board certification, endocrinologists may choose to join professional membership associations such as the Endocrine Society and the American Association of Clinical Endocrinology. Dedicated to promoting excellence within the profession, these organizations also provide endocrinologists with valuable resources to address the wide and varied range of hormonal disorders.

About the author: A graduate of the Sackler School of Medicine at Tel Aviv University, Dr. Robert Aden completed his fellowship in endocrinology, diabetes, and metabolism at the New York University Medical Center. He earned board certification in 1999 and maintains affiliations with the American Association of Clinical Endocrinology, the Endocrine Society, and the American Diabetes Association.