FAQ & Resources

Not exactly. Currently available insulin pumps utilize automated insulin delivery technology that adapts the flow of insulin delivery based on real time feedback from your continuous glucose monitor (CGM) to correct blood glucose back to a target value and to minimize risk of hypoglycemia. They still require input from the patient about nutrition intake and timing. A true closed-loop insulin pump that manages blood glucose only based on CGM feedback is coming in the future, but not available as of today.

There can be a wide variability between different generic Levothyroxine formulations in terms of achieved concentration in your circulation despite being considered therapeutically equivalent. Most practicing Endocrinologists strongly prefer name brand thyroid hormone, where you will receive exactly the same formulation, no matter what pharmacy you use. Thyroid hormone is well known for being affected by impaired gastric absorption. You will have the most consistent absorption by taking your thyroid hormone each morning on an empty stomach with water only, separate from food or other medication by at least 1 hour.

Testosterone in males is important for energy levels, libido and erectile function, but also important for maintenance of lean body mass and bone density. Many male patients find out about testosterone deficiency (hypogonadism) when they experience a fragility fracture. Testosterone replacement is available by topical transdermal gel, intramuscular or subcutaneous injection and there are currently oral testosterone formulations available.

Osteoporosis refers to diminished bone mineral density, which can predispose to abnormal vertebral deformation or fracture. In female patients, bone mineral density can decrease rapidly in the years following menopause and reduction in circulating Estrogen levels. Current medical management options include anti-resorptive agents, which at best are capable of maintaining current bone density and preventing future losses as well as anabolic agents that are capable of increasing bone density. The best outcomes with improvement in bone density are achieved by a course of anabolic therapy followed by anti-resorptive maintenance therapy.

Growth hormone replacement can be beneficial with regard to improving the full adult height in pediatric patients with documented growth hormone deficiency, who have growth plates (epiphyses) that have not yet closed. Pediatric growth hormone deficiency requires specific lab testing with two provocative stimuli to confirm the diagnosis.

Hypercortisolism (Cushing's Syndrome) is difficult to diagnose as cortisol, the body's primary stress hormone, varies physiologically at different times during the day and testing of random blood levels of cortisol are not helpful in establishing the diagnosis. Diagnosis is critical in Cushing's as the preferred therapy may be surgical resection. Other options in mild cases or in patients who are not surgical candidates include medical management. The optimal diagnosis and management plan must be tailored to the individual patient to achieve an effective clinical outcome.