Diabetes and Other Endocrinology Disorders

Assessing Thyroid and Parathyroid Function

An accurate evaluation of the way your thyroid or parathyroid glands are functioning is essential to determine the most appropriate therapy. We use a number of noninvasive procedures to accomplish this, including lab tests, ultrasound, thyroid scans, function stimulation tests, bone x-rays, and biopsy. You can receive any procedures you need in our hospital.

Graves' Disease and Overactive Thyroid Care

In people with hyperthyroidism, the thyroid gland produces high levels of thyroid hormones, increasing metabolism and causing symptoms such as rapid heartbeat, nervousness, high blood pressure, and weight loss. Graves' disease is a type of hyperthyroidism that can also cause a goiter (bulge in the neck from an enlarged thyroid gland), bulging eyes, and thickened skin. Our team tests thyroid hormone levels in the blood and performs a thyroid scan to diagnose Graves' disease and other types of hyperthyroidism. Treatments may include one or more of these approaches:

• Medication to block or change how the thyroid gland uses iodine. These drugs may be used as long-term treatment, or to control an overactive thyroid gland before surgery or radioiodine therapy.
• Radioiodine therapy, in which radioactive iodine is given by mouth. It concentrates in overactive thyroid tissue and destroys it. Thyroid hormone replacement therapy is prescribed for the rest of your life after this treatment to provide the hormones that your thyroid used to make.
• Surgery to remove the thyroid. We perform thyroidectomy using small incisions. Thyroid hormone replacement therapy is also prescribed after thyroid surgery.

Hypothyroidism Treatment

Hypothyroidism (under-active thyroid) is the most common thyroid disorder. It most often results from an autoimmune disorder or the treatment of hyperthyroidism. You may have hoarseness, weight gain, a puffy face, coarse skin and hair, and a reduced heart rate. Our doctors will treat you with thyroid hormone replacement therapy.

Care for Thyroiditis

Thyroiditis is inflammation of the thyroid gland. Hashimoto's thyroiditis is the most common form of thyroiditis and can cause goiter, fatigue, muscle weakness, and weight gain. It is often associated with other endocrine disorders, such as diabetes, under-active parathyroid or adrenal glands, or autoimmune disorders. Hashimoto's thyroiditis can cause under-active thyroid activity and is typically treated with thyroid hormone replacement therapy.

Thyroid Cancer

Benign thyroid tumors (adenomas) may over-produce thyroid hormone and require treatment, or become very large and cause symptoms. For patients with "indeterminate" thyroid nodules—growths for which it is hard to tell if they are benign or malignant, using standard pathology techniques—we can perform molecular testing. Thyroid cancers are frequently curable through surgery and/or hormone and radioactive iodine therapy. The endocrine cancer specialists at NewYork-Presbyterian Brooklyn Methodist Hospital treat thyroid cancer using a multidisciplinary approach. Learn more.

Genetic Endocrine Disorders

Some people have a hereditary predisposition to endocrine disorders, such as multiple endocrine neoplasia (MEN). People with MEN I have a defect in a gene that carries the code for a protein called menin. The condition causes tumors of the pancreas, parathyroid, or pituitary glands to appear in the same person, but not necessarily at the same time. People with MEN II have a defect in the RET gene and may develop overactivity or tumors in the thyroid gland as well as the adrenal or parathyroid glands. Treatment for MEN may include medication or surgery. At NewYork-Presbyterian Brooklyn Methodist, we provide genetic counseling and screening for families with MEN and other hereditary endocrine syndromes to detect problems and complications early, when they may be treated most effectively.

Parathyroid Disorders

Our doctors are experienced treating disorders of the parathyroid glands.

• Parathyroid tumors may cause high levels of calcium in the blood, increasing the risk of osteoporosis and possibly damage to organs such as the kidneys, bones, heart, and blood vessels. They rarely affect more than one of the four glands. Typically only the affected gland needs to be surgically removed—resulting in a cure in more than 95 percent of patients
• Hyperparathyroidism (overactive parathyroid) may result from another problem in the body, such a kidney failure, which leads to low blood levels of calcium and triggers an increase in parathyroid activity to compensate. We treat hyperparathyroidism using medication, and surgery to remove some or all four of the parathyroid glands if medication is not sufficient. Our surgeons perform minimally invasive parathyroidectomy as well as conventional surgery to remove all four glands. Your doctor will discuss the most appropriate treatment for you.
• Hypoparathyroidism (under-active thyroid) can lead to blood low calcium levels, which can result in seizures or uncontrollable spasms of the face, hands, arms, and feet. Your doctor may prescribe calcium and vitamin D supplements to correct blood calcium levels and treat your symptoms.

Adrenal Tumors

Adrenal tumors may produce excess hormones that can adversely affect your quality of life. They are best treated through surgical removal of the affected adrenal gland, which we typically do in a minimally invasive manner ("laparoscopic adrenalectomy").