Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.
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. We learn what an endocrinologist does, how the thyroid acts as the thermostat for our bodies, and what are some of the most common thyroid conditions endocrinologists treat. Our hormones play a huge role in the regulation of our bodies, so it's wise to rule out hormonal imbalance if you're experiencing unexplained symptoms. Indications that you may have an overactive thyroid include anxiety, increase in temperature, heat sensitivity, heart palpitations, heart racing, tremors, shakiness. An underactive thyroid often manifests symptoms like feeling very cold or tired all the time, constipation, dry skin, and lack of concentration or focus. Simple blood tests can help diagnose these and other hormonal abnormalities.
To reach Dr. Moser at Texas Diabetes and Endocrinology, call (512) 458-8400 or visit www.texasdiabetes.com.
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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!
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Speaker 1:
Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.
Dr. Mistry:
Hello, and welcome back to the Armor Men's Health Hour. I'm Dr. Mistry, your host here with my cohost Donna Lee.
Donna Lee:
That's right. Hello everybody.
Dr. Mistry:
And you know, Donna, I got a big smile on my face today.
Donna Lee:
Because I'm sitting next to you?
Dr. Mistry:
No. Because of our guest today.
Donna Lee:
Oh, the other person sitting next to you.
Dr. Mistry:
That's right. I am a board certified urologist. You are certifiable as a professional comedian.
Donna Lee:
That's right. And a little bit crazy.
Dr. Mistry:
I cannot wait until we get those videos on YouTube. Eventually. One of my, one of the partners here, dr. Christopher Yang also thinks that he needs to upload some of his fun YouTube videos when he was a Chinese dragon dancer in high school.
Donna Lee:
Really?
Dr. Mistry:
Yes.
Donna Lee:
I would love to see that.
Dr. Mistry:
I am also excited. It'll probably one of those that gets posted and then taken down quickly by him.
Donna Lee:
Well, we look forward to that. We're going to put that on the FaceBook page and the website.
Dr. Mistry:
We look forward to that too. You know, people ask me all the time, why I became a urologist and you want to tell them? The jokes.
Donna Lee:
That's right.
Dr. Mistry:
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. You know what I'm saying? 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.
Donna Lee:
And you're holistic. Love that part.
Dr. Mistry:
And, and, that's right. And you get to be like this extra, extra level of care. So that's why I love being a urologist.
Donna Lee:
We should give you a real last name instead of using your fake...
Dr. Mistry:
Yeah. Instead of this makeup,"Dr. Mistry" last name. And one of the things that I get to do a lot of is become an endocrinologist...Because we do so much hormone work. And for those of you that don't know, endocrinology is a field of medicine in which...
Donna Lee:
In which you are not specialized.
Dr. Mistry:
That's also correct, that, that would also, I am not board certified endocrinology.
Donna Lee:
No, you're not. You just know how to spell it and that gives you a leg up.
Dr. Mistry:
That's right. We have had a very strong relationship with Texas diabetes and endocrinology since I started practice 13 years ago. And one of our really great friends and partners, Dr. Kerem Ozer is here today.
Donna Lee:
Hi. Welcome!
Dr. Mistry:
Hey, thank you so much for coming in.
Dr. Ozer:
Thank you very much for having me. I'm a fan of the show so I'm excited to be here.
Dr. Mistry:
Well, good. Well, good. You are a board certified endocrinologist. What does that mean in terms of what kind of schooling and training you went through?
Dr. Ozer:
So a board certified endocrinologist, like you said, basically specializes in endocrine endocrine, endocrine endocrinology. I need to practice my 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: thyroid glands, parathyroid glands. We're all familiar of course with female hormones, estrogen, progesterone; male hormones are, the main male hormone, testosterone. And endocrinology just by its nature of dealing with these massive 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 ghrelin, 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, 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.
Dr. Mistry:
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?
Dr. Ozer:
Absolutely. And 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 selves.
Dr. Mistry:
Well, it's too bad you can't cut on people because then that'd be, that would be the first best field of medicine to go into. What I wanted to talk to you today about were thyroid issues. The thyroid has always been like a complex, confusing organ. Why don't you tell us, what does the thyroid do, and what does it make?
Dr. Ozer:
So the thyroid is a butterfly shaped gland. It's it's right in the middle of the neck, kind of sits right on top of the Adam's Apple. And it makes two main hormones called T4 and T3. And T4 and T3 are the key, our 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.
Dr. Mistry:
That's amazing when you have low levels or high levels, both of those extremes can cause symptoms, right?
Dr. Ozer:
Exactly. So you could think of the thyroid as the accelerator and the brake. And you can think of if your 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, people experience palpitations...
Dr. Mistry:
Tremors, weight loss.
Dr. Ozer:
...weight loss, then diarrhea. Not good.
Dr. Mistry:
I was excited about the weight loss part of it. Then you throw in the diarrhea part.
Dr. Ozer:
I know, had to spoil it.
Dr. Mistry:
Diarrhea spoils so many things.
Dr. Ozer:
And then of course the other end of the spectrum is you don't have enough thyroid hormone, which I actually personally have--I as an endocrinologist, I'm a proud thyroid patient as well--if, if your thyroid levels are too low, then everything slows down. So people start feeling very sensitive to cold, you start seeing a tendency to gain weight, dry skin, constipation, sort of the, the body's now really on a, almost like a hibernation type slower track.
Dr. Mistry:
And so like when I have a patient with low testosterone, 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, often we'll treat just to see if they feel better. Would you say that that sometimes happens with our disease, that people could be kind of borderline, but, but, but still highly symptomatic?
Dr. Ozer:
So there are a couple of different schools of thoughts here, and I, I'm going to tread lightly here. I want to make sure I get out of here alive if my, any of my colleagues are listening. And so--Oh boy, indeed--and some of this has to do with how the field evolved and how the normal ranges, the standard ranges were developed. So the current TSH--so the, the other hormone I want to 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, mainly in Germany. And these were general population, average-based studies.
Dr. Mistry:
Which take into account symptomatic and asymptomatic people.
Dr. Ozer:
Symptomatic and asymptomatic people. And, and these studies, the ironic thing about these studies is that the incidence of thyroid disease, prevalence of thyroid disease in the general population is about 5% 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, you may actually need to define normal TSH ranges in a tighter range.
Dr. Mistry:
Just like the testosterone.
Dr. Ozer:
Just like the testosterone.
Dr. Mistry:
I, you know, I think these hormone debates are something that are going to be a similar theme. Donna, how do people get ahold of us?
Donna Lee:
You can call us during the week, and this reminds me though, when I meet a friend who's gained a lot of weight and I'm like,"Why'd you gain all this weight?" And she says,"I have a thyroid condition." And I'm like,"Did you ever get it checked?""No." So they just gained weight, basically what it is.
Dr. Mistry:
Well there you are.
Dr. Ozer:
You do need to get your thyroid checked.
Donna Lee:
You can call us at(512) 238-0762. Our email address is armormenshealth@gmail.com and our website is armormenshealth.com. You can also listen to our podcasts wherever you listen to podcasts for free, because it is award winning. We'll be right back.
Speaker 2:
The Armor Men's Health Hour will be right back. If you have questions for Dr. Mistry, email him at Armour men's health, ed gmail.com.