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Endocrinology, Diabetes + Metabolism

The endocrine system uses glands and organs to create powerful chemical messengers called hormones. These hormones carry signals that influence how the body functions, like metabolizing food for energy. Imbalanced hormones can lead to endocrine conditions, like diabetes, that can take a toll on the body’s natural rhythm.

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Exploring the endocrine system

Hormones are chemical messengers that are essential to our health because they tell our organs, skin, tissues and muscles how to function. The endocrine system alone is the conductor for many major bodily processes, including:

  • Emotions and mood
  • Growth and development
  • Metabolism
  • Sexual function
  • Sleep

Through research, we can better understand the roots of endocrine conditions and develop more effective treatments. We work hard so you can live a full life that isn’t defined by your endocrine condition.

Anastassios Pittas, MD, MS, endocrinologist and Co-Director of the Diabetes Center at Tufts Medical Center consults with patient in clinic appointment.
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Conditions

Caring for your endocrine system takes a village, and you deserve a village of experts. When you turn to Tufts Medicine, you can trust that we'll all work together to fast-track your path to wellness. Because the endocrine system touches so many key bodily processes, your care team may include specialists from:

Together, we specialize in the management of:

Addisons disease
Adrenal disorders
Conn’s syndrome
Cushing's syndrome
Diabetes insipidus
Diabetes mellitus
Diseases of the pituitary gland
Excessive hair growth conditions
Gestational diabetes
Goiter
Grave's disease
High/low calcium
Hyperthyroidism
Hypoglycemia
Hypothyroidism
Impaired fasting glucose
Impaired glucose tolerance
Islet cell tumors
Lipid disorders
Low testosterone
Metabolic bone diseases
Metabolic syndrome
Neuroendocrine and endocrine neoplasia
Obesity
Osteoporosis
Pituitary and hypothalamus diseases
Polycystic ovary syndrome (PCOS)
Pre-diabetes
Sex hormone disorders
Thyroid diseases
Turner syndrome
Type 1 diabetes
Type 2 diabetes

Diabetes

Diabetes is a condition where the body’s blood glucose (sugar) levels are too high. There are different types of diabetes, including:

  • Type 1 diabetes: A condition where the pancreas produces too little or no insulin at all. People with type 1 diabetes require insulin injections to control their glucose levels. 
  • Type 2 diabetes: As the most common form of diabetes, Type 2 diabetes occurs when the body is resistant to insulin. 
  • Diabetes insipidus: Defined as the kidneys being unable to conserve water.
  • Gestational diabetes: Diabetes developed during pregnancy. 
  • Pre-diabetes: When a person has higher glucose levels than normal, but not quite within the diabetic range.

Metabolic bone diseases

Metabolic bone diseases, like osteoporosis, occur when you lack important vitamins, hormones and minerals that are essential for strong, healthy bones.

Neuroendocrine + pituitary disorders

The pituitary gland, commonly referred to as the master gland, has the very important job of controlling how most other endocrine glands work to release hormones.

For the most part, the pituitary gland is made up of neuroendocrine cells. These cells receive signals from your nervous system and spring into action by making and releasing hormones that influence key bodily functions like growth and development, metabolism and sexual reproduction.

Neuroendocrine and pituitary disorders can affect your hormonal harmony, and ultimately take a toll on your body's natural processes.

Neuroendocrine + endocrine neoplasia

The endocrine system is made of of nerves and gland cells that make and send hormones throughout the body. Neuroendocrine and endocrine neoplasia occurs when those cells grow out of control, and can lead to rare conditions.

Thyroid disease

The thyroid gland is a butterfly-shaped organ in your neck that releases hormones to regulate many of your body’s functions, like your metabolism. So when your thyroid isn’t working properly, it can lead to a domino effect of thyroid diseases like hypothyroidism, hyperthyroidism or even forms of thyroid cancer.

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Testing

Most adults should have a regular physical with their primary care doctor, where they'll receive a fasting blood sugar test or an oral glucose tolerance test — especially if they're at high risk for developing diabetes.

To better understand what your hormone levels say about your healthcare story, we may perform the following tests:

  • 24-hour urine collection test
  • ACTH stimulation test
  • Bone density test
  • Cortrosyn stimulation
  • CRH stimulation test
  • Dexamethasone suppression test
  • Dynamic endocrine testing
  • Fine-needle aspiration biopsy
  • 5-day glucose sensor test
  • Glucagon stimulation
  • Glucose suppression of growth hormone
  • Mixed meal tolerance test
  • Oral glucose tolerance test
  • Semen analysis
  • Thyroid nodule fine needle aspiration biopsies
  • Thyroid ultrasonography
  • TSH blood test

Dynamic endocrine testing

Dynamic endocrine testing measures your hormonal and physical response to a specific agent. These agents could be in the form of an injection or drinkable solution. There are a variety of tests that can shed important light on how your endocrine system functions, including:

  • ACTH (Cortrosyn) stimulation
  • Glucose suppression of growth hormone
  • Glucagon stimulation
  • Oral glucose tolerance test
  • Mixed meal tolerance test

By watching how your body responds to these agents, we can rule out or determine what condition may be causing your symptoms.

To prepare for the test, we may ask you to fast overnight or refrain from certain medications the day before. Your doctor will prepare you with instructions so you know what to expect.

Thyroid ultrasound + fine needle aspiration

When it comes to your thyroid health, you deserve the most accurate and safest testing available to biopsy nodules or growths in your thyroid.

A fine needle aspiration (FNA) for diagnosing thyroid disease is a non-invasive procedure that's a smart alternative to surgery. This procedure lets us quickly determine whether the thyroid growth or nodule is benign (noncancerous) or malignant (cancerous).

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Treatments

Many endocrine disorders require lifelong care but rest assured, you don’t have to navigate yours alone. We’ll work with you to better manage symptoms so you can live your healthiest life.

We can approach your condition with lifestyle changes, medications, surgery and support groups, including:

Insulin pumps for diabetes 

Everyone living with type 1 diabetes and some people with type 2 diabetes will need insulin injections to manage their blood sugar. Giving yourself daily insulin injections can be a time-consuming routine, and missing an injection can have a serious impact on your health.

To help manage your diabetes, an insulin pump may be recommended to continuously release insulin into your body so you don’t have to give injections a second thought.

Lifestyle Coaching Program for Diabetes + Weight Loss

Our Lifestyle Coaching Program for Diabetes + Weight Loss will teach you how to make key diet and exercise changes that can halt the progression of type 2 diabetes and prevent health-related complications. As part of this program, we'll explore diabetes self-management education and medical nutrition therapy.

Diabetes self-management education

You understand your lifestyle goals better than anyone else, so we're here to help you achieve them. We're committed to helping people with diabetes learn how to manage their condition so they can live their healthiest lives possible. It zooms in on 7 self-care behaviors, from being active to knowing how to reduce your risks of complications from diabetes.

Medical nutrition therapy

Medical nutrition therapy focuses on helping you manage your condition through nutritional testing, therapy and counseling.

A registered dietitian will map a wellness plan around your:

  • Activity level
  • Food preferences
  • Glucose control
  • Lifestyle
  • Nutritional needs

Gamma Knife surgery

When pituitary tumors are recurrent or difficult to reach with minimally invasive surgery, conventional radiation therapy or Gamma Knife surgery are smart options.

Gamma Knife surgery is an effective, non-invasive alternative to traditional brain surgery. Gamma Knife treatment pinpoints problematic areas with high doses of radiation while sparing healthy tissue.

Anasuya Gunturi MD, PhD talks with patient at Lowell General Hospital's Women's Wellness Center clinic appointment.
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Family physician Sarwada Tuladhar Jha, MD talking to patient during exam at a clinic appointment and inputting health information at the computer.
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Grave's disease, Multinodular goiter, Rheumatoid arthritis, Subacute thyroiditis, Systemic lupus erythematosus, Thyroid cancer, Thyroid nodules, Type I diabetes
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