In this segment, Dr. Mistry and Donna Lee are joined by Dr. Kerem Ozer of Texas Diabetes and Endocrinology. Dr. Ozer talks about the thyroid, an amazing organ responsible for producing your body's hormones and regulating its metabolism. If you're having unexplained symptoms and can't find an answer, your thyroid might be the culprit. Learn what to watch for and when to call your endocrinologist!
To reach Dr. Ozer at Texas Diabetes and Endocrinology, call (512) 458-8400 or visit www.texasdiabetes.com.
If you enjoyed this episode, don't forget to like, subscribe, and share us with a friend. As always, be well!
Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
We enjoy hearing from you. Email us at armormenshealth@gmail.com and we’ll answer your question in an upcoming episode!
Phone: (512) 238-0762
Email: Armormenshealth@gmail.com
Website: Armormenshealth.com
Our Locations:
Round Rock Office
970 Hester’s Crossing Road
Suite 101
Round Rock, TX 78681
South Austin Office
6501 South Congress
Suite 1-103
Austin, TX 78745
Lakeline Office
12505 Hymeadow Drive
Suite 2C
Austin, TX 78750
Dripping Springs Office
170 Benney Lane
Suite 202
Dripping Springs, TX 78620
In this segment, Dr. Mistry and Donna Lee are joined by Dr. Kerem Ozer of Texas Diabetes and Endocrinology. Dr. Ozer talks about the thyroid, an amazing organ responsible for producing your body's hormones and regulating its metabolism. If you're having unexplained symptoms and can't find an answer, your thyroid might be the culprit. Learn what to watch for and when to call your endocrinologist!
To reach Dr. Ozer at Texas Diabetes and Endocrinology, call (512) 458-8400 or visit www.texasdiabetes.com.
If you enjoyed this episode, don't forget to like, subscribe, and share us with a friend. As always, be well!
Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
We enjoy hearing from you. Email us at armormenshealth@gmail.com and we’ll answer your question in an upcoming episode!
Phone: (512) 238-0762
Email: Armormenshealth@gmail.com
Website: Armormenshealth.com
Our Locations:
Round Rock Office
970 Hester’s Crossing Road
Suite 101
Round Rock, TX 78681
South Austin Office
6501 South Congress
Suite 1-103
Austin, TX 78745
Lakeline Office
12505 Hymeadow Drive
Suite 2C
Austin, TX 78750
Dripping Springs Office
170 Benney Lane
Suite 202
Dripping Springs, TX 78620
Welcome back to the armor. Men's health hour with Dr. Mystery and Donna Lee.
Speaker 2:Hello, and welcome back to the armor. Men's health hour. I'm Dr. My reer host here with my co-host Donnel Lee. That's
Speaker 3:Right. Hello
Speaker 2:Everybody. And you know, Don, I got a big smile on my face today
Speaker 3:Because I'm sitting next to you.
Speaker 2:No,<laugh> because of our guest today.
Speaker 3:Oh, the other person sitting next to
Speaker 2:You. That's right. I am a board certified urologist and you are certifiable as a, uh, professional comedian.
Speaker 3:That's right. And a little
Speaker 2:Bit crazy. I cannot wait till we get those videos on YouTube.
Speaker 3:Sure.
Speaker 2:Mm-hmm<affirmative> eventually
Speaker 3:<laugh> yes.
Speaker 2:Yep. One of the partners here, Dr. Christopher Yang mm-hmm<affirmative> also thinks that he needs to upload some of his fun YouTube videos when he was a Chinese dragon dancer in high school. Really?
Speaker 3:Yes. I would love
Speaker 2:To see that I'm also excited. It'll probably be one of those that gets posted and then taken down quickly by him.
Speaker 3:I, we look forward to that. We look forward to that, that on the Facebook page
Speaker 2:And the website, you know, people ask me all the time, why I became a urologist mm-hmm<affirmative> and you and I tell them mm-hmm,<affirmative> the jokes. That's right. Really. There's a deeper reason as a urologist. I get to be a lot of things. I get to be a surgeon, which I love. I love that part. I get to deal with the most advanced technology on the planet, surgical robots, lasers. I mean, it's cool. And then I get to be a medical professional. I get to deal with hormone issues and chronic pain issues and all these great things like medical stone disease in the clinic. I get to be a counselor for patients with sexual dysfunction or difficulty with fertility.
Speaker 3:And you're holistic
Speaker 2:Love that part. That's right. And you get to be like this extra level of care. That's why I love being a urologist.
Speaker 3:We should give you a real last name. Yeah.
Speaker 2:Instead of this makeup, Dr. Mystery, last name<laugh>. And one of the things that I get to do a lot of is become an endocrinologist
Speaker 3:<laugh> stop
Speaker 2:Because we do so much hormone work. And for those of you that don't know, endocrinology is a field of medicine in which, uh,
Speaker 3:In which you were not specialized
Speaker 2:<laugh> that, that that's also correct. That, that, that would also, I am not board certified, no endocrinology. You just
Speaker 3:Know how to spell it. That's right. And it gives you a leg up.
Speaker 2:So we, uh, we have had a very strong relationship with Texas diabetes and endocrinology since I started practice 13 years ago. Mm-hmm<affirmative> and one of our really great friends and partners, Dr. Kara Ozer is here today. Right. You welcome. Hey, thank you so much for coming
Speaker 4:In. Thank you very much for having me. I'm a fan of the show. I'm excited to be here.
Speaker 2:Well, good. Uh, you are a board certified endocrinologist. What did that mean in terms of what kind of schooling and training you went through?
Speaker 4:So a board certified endocrinologist, like you said, basically specializes in endocrin endocrin endocrin endocrinology. I, I need to learn practice. My<laugh> pronunciation here too. So endocrinology basically looks at and deals with all issues related to hormones and hormones of course, are the little messengers in our body. In our system. There are several specific organs that produce hormones like thyroid glands, parathyroid glands. We are all familiar of course, with female hormones, estrogen, progesterone, male hor are the main male hormone, testosterone and endocrinology just by its nature of dealing with these mass messengers. One of the biggest things we also deal with is metabolism. That is of course, how our body processes feels, processes, carbs, fats, proteins, and the main hormones. The main messengers that regulate that aspect of endocrinology are hormones like insulin and glucagon. And now we have a whole slew of fancier, newer hormones, like growlin, which rein, which regulate things like appetite. So when you think of preventative approaches and wellbeing, endocrinology has a lot to do with how the body normally regulates its processes. And if you think of disease processes, we deal with thyroid problems, diabetes, um, osteoporosis, low testosterone is something I know we share and pituitary gland issues. And of course the pituitary gland is that little gland that sits under the brain and regulates all the other hormones in the body.
Speaker 2:So what's an interesting thing about endocrinology is that there's so much perceived overlap between what you would think a primary care doctor does and the kinds of medicine that an endocrinologist does your comment about them being little messengers, endocrinology. There are hormones that you can check levels of. So you have numbers on a piece of paper, but it really affects everything in your body, from how you're thinking and feeling to how your body looks to how your heart rate's working to, how strong you are. I mean, these little messengers are really what make us work, right?
Speaker 4:Absolutely. And that's what, that's what I love the most about endocrinology. It's really about how everything talks to each other and how we can optimize different things to help people achieve their best potential.
Speaker 2:Well, it's too bad. You can't cut on people because then, uh, that'd be the<laugh>
Speaker 4:That I'll leave
Speaker 2:To you. It would be the first best field of medicine to go into. Uh, what I wanted to talk to you today about were a thyroid issue. The thyroid, the thyroid has always been like a complex confusing organ to me. Why don't you tell us, what does the thyroid do? And what does it make?
Speaker 4:Of course. So the thyroid is a butterfly shaped gland. It's it's right in the middle of the neck, kind of it's right on top of the Atos apple, it makes two main hormones called T4 and T3. T4 and T3 are the key are key players in how our body regulates metabolism. They influence body temperature. They help regulate heart rate. They may influence things like blood pressure and especially T3, which is a smaller, more active type of thyroid hormone influences things that are a little less tangible, like energy levels, focus concentration through its effects on the brain.
Speaker 2:That's amazing when you have low levels or high levels, both of those extremes can cause symptoms. Right?
Speaker 4:Exactly. So you could think of the thyroid as the accelerator and the break. And you can think of if you're thyroid is overactive. If it's making too much of its hormones, you can think of your body as being on overdrive. So everything gets faster. Your temperature may go up. Heart rate goes up, you start seeing sort of nervous system related issues like tremors, tremors, P, and people experience, weight, loss, expectations, weight loss, then diarrhea, uh, not good.
Speaker 2:I was excited about the weight loss part of it.<laugh> and then you threw in the diarrhea
Speaker 4:Part. I know I had to spoil it And diarrhea, spoiled so many things. And then of course the other end of the spectrum is if you don't have enough thyroid hormone, which I actually personally have, I as an endocrinologist, I'm a proud hypothyroid, uh, patient as well. Um, if, if your thyroid levels are too low, then everything slows down. So people start feeling very sensitive to cold. Um, you start seeing a tendency to gain weight, um, dry skin constipation, sort of the, the body's now really on a, almost like a hibernation type, slower track.
Speaker 2:But when I have a patient with low testosterone, mm-hmm,<affirmative> sometimes their number may be on the low end of the normal range, but they still are very highly symptomatic. And so those are people that we, you know, so often will treat just to see if they feel better. Um, would you say that that sometimes happens with thy disease, that people could be kind of borderline, but, but, but still highly symptomatic.
Speaker 4:So there are a couple of different schools of thoughts here, and I I'm gonna tread lightly here. I wanna make sure I get out of here alive.<laugh> if my, any of my colleagues are listening. Oh, um, and some of this, oh boy, indeed. Uh, so, and some of this has to do with how the field evolved, um, and how the normal ranges, the standard ranges were developed. So the current TSS, so the, the other hormone I wanna talk about before we go into that is TSH, which is thyroid stimulating hormone, which is the hormone. The brain makes through the pituitary gland to regulate thyroid function. And this TSH is so sensitive to what the thyroid is doing, that it is traditionally used as a really good, sensitive marker of thyroid function. Sometimes the brain senses that the thyroid is working slower before the T4 and T3 the actual thyroid hormone levels go down. Now, if you think about, if we are defining thyroid function by using normal levels of TSH, we need to think about how the normal ranges for TSH were set. And a lot of these numbers came from studies in the sixties, seventies, um, mainly in Germany. And these were general population, average based studies,
Speaker 2:Which take taken, look out symptomatic and asymptomatic people,
Speaker 4:Asymptomatic and asymptomatic people. And, um, and these studies, the ironic thing about these studies is that the, um, incidence of thyroid disease, prevalence of thyroid disease in the general population is about five to 10%, depending on who you read, where you look. So these general population studies had quite a bit of patients, quite a large amount of patients who may be on the extremes of thyroid function. More recent studies show that, especially for someone who's younger, more active, um, you may actually need to define normal TSH ranges in a tighter range. Karen,
Speaker 2:How, how do people generally go about getting their thyroid checked? You
Speaker 4:Know, there are two ways. One is, it just comes up as a routine blood test as part of most annual visits. So it's more of on a screening basis. You're you're feeling well, you're good. You just do a blood test and a number pops up and says, Hey, you may have something going on with your thyroid. The second thing is people who present with symptoms that make us think of, Hey, is, is there something wrong with the thyroid? Let's run the thyroid tests again, these would be blood tests, and those could be signs and symptoms related to an overactive thyroid. These would be things like anxiety increase in temperature, heat, sensitivity, palpitations, heart racing, tremors, shakiness, or these could be potential signs or symptoms of an underactive thyroid things like feeling very cold all the time, feeling very tired all the time, constipation, dry skin, lack of concentration, focus,
Speaker 2:A lot of overlap with symptoms that people would classically attribute to low testosterone.
Speaker 4:Absolutely.
Speaker 2:If they're gonna get treated a hyperactive thyroid, you probably see a lot of it. I don't see that much of it because those people can sometimes be very obvious and sometimes a little less obvious. What, what is the general treatment for a hyperactive thyroid
Speaker 4:Hyperactive thyroid, which is general nice umbrella term for any condition where someone has too much of those thyroid hormones. There are three different ways of treating this it. And, and we pick the treatment method. We sit down with our patients and we say, Hey, here are three methods. Here are the pros and cons of each. And here's, you know, this may work better for you versus another one. So it really depends on what the cause of the overactive thyroid is. But basically we can use medications. We can use something called radioactive iodine treatment, which is a relatively low dose of radiation. That's delivered to go to the thyroid tissue in a focused way or surgery, especially in people where the overactive thyroid is due to nodules, lumps, or bumps in the thyroid. We usually, uh, refer our patients to our, uh, surgeon
Speaker 2:Friends. So I'm a big fan of questions that used to be on the MCAT or on tests. Wonderful. No. Okay. What, what is the most common cause of hyperthyroidism?
Speaker 4:<laugh> the most common, uh, cause of hyperthyroidism would be graves.
Speaker 2:It, it is a trick question. It is overuse of medication<laugh>
Speaker 5:Oh boy.<laugh>.
Speaker 2:And so it's a trick question because it is like one of those things where like, uh, what's the most common cause of bleeding after a prostate surgery, it's, uh, you know, an, an incomplete surgery, you know, like you, you should have been a better surgeon. Wow. And so, uh, when it comes to hypothyroid, which is probably the more commonly seen kind of condition, uh, we use lots of medicines, right? Mm-hmm<affirmative> what are the most common medicines? I I've also seen people use kind of natural versions of things mm-hmm<affirmative> and people want biodentical maybe just, you know, briefly talk about absolutely how we, how we do that.
Speaker 4:So the whole idea behind treating hypothyroidism is replacing or supplementing what the body is not making enough of. So we use thyroid hormone supplements, and these have been around for decades, just like you said, we either use levothyroxine, which is the equivalent of the main thyroid hormone. T4. Our listeners may have heard of different brand names like Synthroid Tein, Levoxyl, OID. These are all preparations, which have the exact same T4 hormone that the body normally makes in people who don't have quite enough of the T3 hormone. We may use, uh, another prescription, uh, medicine called Leo thyronine. And people may know of that as cyto.
Speaker 2:So cyto is for T3, which is the more metabolically active version. Correct. And something like Synthroid would be a T4, which is, I guess, more of a, a more chronic, more longer acting kind of thyroid hormone.
Speaker 4:Absolutely. And some people do perfectly fine on just using one. Some people may need both. And then just like you mentioned, there are other preparations which people refer to as natural thyroid supplements. And the reason for this is many of these, uh, medications, prescriptions are made by using dried up or desiccated, uh, animal thyroids, mostly pig thyroids. And some of the brands you may have heard there are armor and PTH, thyroid, or nature. Throid
Speaker 2:Do you need prescriptions for the natural ones too?
Speaker 4:You do need prescriptions for these natural ones as well.
Speaker 2:So they take a pig, thyroid mm-hmm<affirmative> and dry it mm-hmm<affirmative> and then crunch it up and put into a pill
Speaker 4:Uhhuh. That's a
Speaker 2:Boy, we have a new business.<laugh> you know what I've heard? Goat thyroids are amazing. Oh, That
Speaker 4:Would be more, You have little baby goats jumping around
Speaker 5:As you'll do some yoga.
Speaker 2:I don't even know if they have thyroids
Speaker 5:<laugh>.
Speaker 2:So, you know, in our practice because of the overlap between low T mm-hmm<affirmative> and your low T, right,<laugh> your low thyroid and my low testosterone issues, we frequently test it. Sometimes we'll get people who are borderline, but they are highly symptomatic and will still treat them. And sometimes people are low in testosterone and we still don't treat them because they're not symptomatic. Mm-hmm<affirmative> talk to me about that. What is the correlate and thyroid medicine,
Speaker 4:Exact same idea. And, and I'm really glad you're checking the thyroid levels as well. Because as you know, there's a ton of data showing that since most of these conditions are, have autoimmune backgrounds, you actually have an increased incidence of one, if you have the other one that's right. Um, so I'm, I'm really glad you're, you're doing that. You're doing, you're doing that screening as far as treatment goes, there are different classes of thoughts here. We do know that, um, some of the tests that we run to check thyroid function have quite a wide range of normal levels. When you think about the lab tests, Uhhuh for different people, different different people may feel different at different points in that spectrum.
Speaker 2:What's normal may not be normal for you.
Speaker 4:Exactly. That's a really way, a nice way of putting it. So in some people, if we have those typical symptoms and their levels are borderline there, there's plenty of, um, studies showing that you can do a brief trial, maybe three months, three to six months of a thyroid supplement. And we would usually start with a lower dose here and see if, if, if that supplement is addressing the symptoms, if it is then we're good. As long as we're not overtreating and making that person hyperthyroid, we, we can continue to monitor and adjust things as we go.
Speaker 2:How often do you check and then adjust the medicine dose.
Speaker 4:It depends on the patient, but mostly once you start something, it takes about four to eight weeks for those levels to balance out. So depending on how severe the symptoms are, depending on what dose we are starting, we, we would usually check the levels in about four to six
Speaker 2:Weeks. Now, when you give testosterone, it cuts down your normal feedback pathway. So if you abruptly stop the testosterone, you can get very low levels for a time. Does that also happen with the thyroid? That's
Speaker 4:Actually not true for thyroid. And that has to do with the feedback, the different kinds of feedback loop that the hormones use as you know, with testosterone is, uh, steroid hormone. Of course. So it very easily suppresses the feedback loop from the brain. So if you have an external source of testosterone, your brain through your pituitary glances, okay, we have enough of this. We don't need to make it anymore. The thyroid hormones are immuno acid based hormones. So they work through a different kind of feedback loop. Your thyroid continues to make its own hormone. And the thyroid that you're putting into the system ends up being a true supplement.
Speaker 2:So if you, uh, were to go through a little trial of thyroid hormone, you could stop it and not necessarily kind of cause a real decrease or detriment to your system,
Speaker 4:Correct. It would be very short, lived your TSH, the hormone that the brain makes to stimulate thyroid function would still go down when you're on a supplement. Uh, but thyroid hormone supplements have very short half lives.
Speaker 2:So you'll bounce back quick.
Speaker 4:So you'll bounce back very quickly.
Speaker 2:Well, that's wonderful. Um, briefly, can you tell people how to go to hold of you and make an appointment with you?
Speaker 4:Absolutely. So we're Texas diabetes and endocrinology. We have three offices, south Austin, central Austin and round drug. Um, our phone number is(512) 458-8400. Um, and our website is www do takes us diabetes.com.
Speaker 2:That's wonderful. And I, I would encourage our listeners. If you have a health condition that people just can't get their arms around. Mm-hmm,<affirmative> really take a deep dive into your hormones because it can affect you from the top of your head, to the tips of your toes. Donna, how do people get ahold of us?
Speaker 3:You can call us during the week at 5 1 2 2 3 8 0 7 6 2. Our website is armor men's health.com. You can send an email through the website or you can email us directly and we will answer your questions anonymously on armor men's health, gmail.com, and you can listen to our podcast wherever you listen to podcasts. Thank you guys. That was amazing.
Speaker 1:The armor men's health hour is brought to you by urology specialist for questions, or to schedule an appointment, please call 5 1 2 2 3 8 0 7 6 2 or online at armor men's health.com.