Endocrinology, Diabetes & Thyroid Specialists of Colorado

Centura Health Physician Group

11700 W 2nd Pl
Ste 410
Lakewood, Colorado 80228-1704

39.7153323, -105.1301964

Latitude: 39.7153323, Longitude: -105.1301964

Endocrinology, Diabetes & Thyroid Specialists of Colorado

Centura Health Physician Group

Specialists in Endocrine Diseases & Disorders

At Endocrinology, Diabetes & Thyroid Specialists of Colorado we provide care and treatment for a variety of endocrine diseases and disorders including Type 1 and Type 2 Diabetes. Learn more about these conditions, treatment options and how we support you in managing your condition.

Diabetes Services

  • Diabetes Management

    The problem:

    Diabetes is a serious, costly and common condition in which one's blood sugar (blood glucose) is higher than normal. Nearly 8 percent of Americans have it. Without proper diagnosis and treatment, it can lead to kidney failure, vision loss, nerve damage, lower-extremity amputation and stroke/cardiovascular disease.

    There are two types of diabetes:

    • Type 1 generally affects younger people and accounts for about five percent of all cases of diabetes. It is not caused by lifestyle or diet.
    • Type 2 is more likely to occur in those age 40 and older and/or those who are overweight. Directly related to dietary and lifestyle choices, it accounts for between 90 and 95 percent of all cases.

    Genetics is believed to play a role in both, as well. Moreover, 79 million+ U.S. adults have pre-diabetes, placing them at greater risk for damage to multiple body systems.

    Diabetes Symptoms:

    Because its symptoms are often subtle or similar to those of other conditions, diabetes often goes undiagnosed.

    Persons with Type 1 diabetes often experience:

    • Extreme hunger
    • Frequent urination
    • Unusual thirst
    • Unexplained weight loss
    • Extreme irritability and/or fatigue
    • Nausea
    • Vomiting

    Individuals withType 2 diabetes often experience:

    • Some/many of the symptoms of type 1
    • Frequent infections
    • Slow to heal cuts/bruises
    • Blurred vision
    • Tingling/numbness in hands/feet
    • Recurring bladder, skin or gum infections

    To complicate matters, those with Type 2 often have no symptoms, as may women with gestational diabetes (diabetes related to pregnancy).

    Diabetes Treatment:

    There is no cure for diabetes. Immediate treatment goals are to enhance one's quality of life, reduce symptoms and prevent complications. This is accomplished through:

    • Education
    • Nutrition
    • Regular exercise
    • Weight control
    • Vigilant self-monitoring of high blood glucose levels
    • Blood pressure and cholesterol control
    • Foot and eye care
    • Oral medications, injectable medications, or insulin
    • Treatment of diabetic ketoacidosis (an often life-threatening complication resulting from a shortage of insulin)

Endocrinology Services

  • Hormone Replacement Therapy

    Hormone replacement therapy (HRT) - female hormone medication to replace those no longer produced by the body after menopause - was once standard treatment for women suffering with hot flashes and other symptoms of menopause. The prevention of heart disease, osteoporosis and dementia were thought to be part of its benefit.

    In 2002, findings from clinical trials by the Women's Health Initiative (WHI) showed otherwise, in fact demonstrating that long-term use of hormone therapy posed numerous risks outweighing the benefits and possibly increasing the chances of heart attack and stroke. As concerns grew, physicians became more cautious in prescribing it.

    Hormone Replacement Therapy Pros and Cons:

    HRT Pros:

    • Prevents bone loss that can lead to osteoporosis.
    • Relieves symptoms of menopause.
    • Lowers risk of macular degeneration, damage to / or breakdown of the macula of the eye, which allows us to see fine details clearly. Causes blurriness or darkness in the center of vision.
    • Lowers risk of diabetes.
    • Lowers risk of colon cancer.
    • Reduces hot flashes and night sweats.
    • Reduces mood swings.
    • May lower cardiovascular risks in healthy women.
    • Prevents vaginal atrophy.

    HRT Cons: 
    May increase:

    • Risk of stroke.
    • Risk of breast cancer, taken with progestin.
    • Risk of pulmonary embolism.
    • Risk of dementia after age 65.
    • Risk of heart disease in older women.
    • Breast tenderness.
    • Risk of endometrial cancer (for women who still have their uteruses and are not taking progesterone/with estrogen).
    • Risk of blood clots.
    • Risk of stroke.
    • Risk of gallbladder disease.
    • Risk of high blood pressure.

    The HRT Dilemma:

    Today, new evidence reveals that for some women, depending on their risk factors, certain types of HRT may be beneficial. The determination to use or not use hormone therapy after menopause is one that should be carefully considered by a woman and her healthcare provider, taking into account the personal risks.

    Those most commonly endorsed are:

    • Systemic estrogen (available in pill, skin patch, gel, cream or spray) to relieve menopausal hot flashes and night sweats, along with vaginal dryness, itching, burning and discomfort during intercourse.
    • Low-dose vaginal products (available in cream, tablet or ring form) to treat vaginal and some urinary symptoms, while curtailing absorption into the body. (Ineffective for hot flashes, night sweats or protection against osteoporosis.)

    If you are on Hormone Replacement Therapy:

    • Minimize amount of medication, using lowest effective dose for shortest possible of time to effectively treat symptoms.
    • Schedule regular checkups, pelvic exams and screenings such as mammograms.
    • Don't smoke. If you do, stop. 
  • Polycystic Ovary Syndrome

    Polycystic ovary syndrome (PCOS) is an imbalance of female sex hormones common among women of reproductive age. The exact cause is unknown. Enlarged ovaries containing numerous small cysts located along the outer edge characterize the appearance of the condition, though type and severity varies from woman to woman

    The disorder may result in changes in the menstrual cycle, infertility, cysts in the ovaries and other health-related issues.

    Symptoms:

    PCOS signs and symptoms often begin shortly following a woman's first menstrual cycles (menarche). In some instances, the condition appears later, during the reproductive years, often in response to substantial weight gain.

    PCOS Symptoms include:

    • Unexplained weight gain
    • Development of male-like characteristics (virilization)
    • Body hair on chest, belly, face and around nipples
    • Change in breast size
    • Deepening voice range
    • Enlarged clitoris
    • Thinning hair on head (male-pattern baldness)
    • Skin changes
    • Worsening of acne dark and/or thick skin markings/creases around breasts, armpits, groin or neck
    • Deviations in the menstrual cycle
    • Periods cease following one or more normal ones during puberty irregular periods ranging from very light to very heavy
    • Enlarged ovaries containing numerous small cysts
    • Difficulty becoming pregnant

    Treatment:

    Given early diagnosis and treatment, the risk of long-term complications such as Type 2 diabetes, heart disease and high blood pressure may be decreased. Treatment and management include:

    • Maintaining a healthy weight
    • Regular exercise
    • Medications
    • Birth control pills to help regulate periods and reduce abnormal hair growth
    • Diabetes medicine (metformin) to regulate menstrual cycles; prevent Type 2 diabetes; aid in weight loss
    • Clomiphene citrate to help ovaries grow and release eggs
    • Surgery
  • Lipid Disorders

    Lipid disorders are a group of medical conditions referring to excessive levels of fatty substances in the bloodstream, including cholesterol and triglycerides.

    • Cholesterol is produced naturally by the liver and a normal amount is necessary in producing hormones, developing new cells and insulating nerves.

    There are two types of cholesterol: the "good" high-density lipoproteins (HDL) work to clear unneeded cholesterol from the blood, while "bad" low-density lipoprotein (LDL) cause buildup of plaque on the walls of the arteries that pump blood to the heart.

    Excess LDL may be caused by an unhealthy diet, such as over-consumption of animal-based foods (dairy products, eggs and meat). Genetics may also be the culprit; high cholesterol often runs in families.

    A surplus of LDL greatly increases risk of heart disease and stroke.

    • Triglycerides are the major form of fat stored by the body. It is produced by the body and ingested from the food we eat. Elevated triglyceride levels are a risk factor for atherosclerosis (hardening of the arteries). Those with high cholesterol often have a raised level of triglycerides.

    Symptoms

    Lipid disorders are usually "silent, " detected by chance during screening or routine blood tests for other medical conditions. Often, they are diagnosed only when serious complications such as angina, heart attack or stroke occur.

    Treatment

    Lowering of abnormal LDL levels is most important in the prevention of the life-threatening conditions it produces. Since it is usually asymptomatic, the importance of regular screening (fasting lipid blood test at age 40 and every three years after) cannot be overstated.

    Should you have risk factors such as family history or diabetes, consult your physician to determine how often you should be screened,

    Follow these guidelines:

    • Know your target numbers.
    • Schedule regular checkups.
    • Lead a healthy lifestyle.
      • Limit intake of fats.
      • Increase intake of fiber (oats, oat bran, barley, vegetables, legumes, whole grains, fruit)
      • Replace saturated with unsaturated fats. (Read food labels.)
      • Limit alcohol intake to no more than two drinks or less per day.
      • Monitor cholesterol intake. (Squid, fish roe, shellfish, prawns, crabs, organ meats, egg yolk, animal fats.)
      • Exercise at least 30 minutes, five or more days per week.
      • Don't smoke. If you do, stop.
      • Maintain a healthy weight.
    • If your physician prescribes medication, be diligent in taking it.
    • Manage any other medical conditions you might have. (High blood pressure, diabetes, etc.)
  • Lipid Disorders

    This bean-sized pituitary gland at the base of the brain is known as the "master control." Pituitary tumors are responsible for a majority of the body's hormone abnormalities, causing excesses or deficiencies in glands that produce, regulate and control metabolism, growth and reproduction. These include:

    • Thyroid (regulates metabolism, growth, energy and nervous system activity)
    • Adrenal (influence body's responses to stress)
    • Sexual organs (influence sexual drive, growth and development, function and reproduction)
    • Antidiuretic hormone (regulates water balance)

    Symptoms

    Signs and symptoms may include:

    • Headache
    • Weakness
    • Vision loss, particularly of peripheral vision
    • Less frequent/no menstrual periods
    • Nausea and vomiting
    • Body hair loss
    • Sexual dysfunction
    • Increased frequency and quantity of urination
    • Unintended weight loss or gain

    Treatment

    The goal of treatment is to return hormone levels to normal. This may be accomplished by:

    • Reduction or complete removal of tumor
    • Regulation of abnormal hormone secretion
    • Elimination of most symptoms
    • Restoration of normal pituitary function

    Treatments may include one or more of the following:

    • Medication
    • Surgery
    • Radiation therapy
    • External beam radiation
    • Observation (careful monitoring of disorder's progression)
  • Thyroid Disorders

    Hyperthyroidism

    The butterfly-shaped thyroid is located low on the front of the neck. It produces hormones that help regulate metabolism. If the thyroid gland is overactive, the result is hyperthyroidism. A common cause of hyperthyroidism in the United States is Grave's Disease.

    Symptoms of Hyperthyroidism:

    • Increased appetite
    • Weight loss, even when no changes in eating habits
    • Tremor/ trembling in hands and fingers
    • Rapid heartbeat (tachycardia)
    • Irregular heartbeat (arrhythmia)
    • Pounding of heart (palpitations)
    • Anxiety, nervousness, irritability
    • Excessive perspiring
    • Altered menstrual patterns
    • Problems sleeping
    • Fatigue
    • Muscle weakness
    • Thinning of skin
    • Fine brittle hair
    • More frequent bowel movements
    • Increased heat sensitivity
    • Enlarged thyroid gland (goiter)

    Treatment of Hyperthyroidism:

    The treatment for hyperthyroidism depends on age, physical condition and severity of condition. All have some risks.

    • Medications 
      * Anti-thyroid medications (propylthiouracil and methimazole) gradually reduce symptoms by preventing production of excess amounts of hormones. 
      * Beta-blockers (such as propranolol ) do not reduce thyroid levels, but treat symptoms such as rapid heart rate, sweating and anxiety.
    • Radioactive iodine shrinks thyroid gland, halting excess production of hormones.
    • Surgical removal of thyroid (thyroidectomy)

    Hypothyroidism

    When the thyroid is underactive and produces an insufficient level of hormones, the condition is called hypothyroidism. The most common cause of hypothyroidism in the United States is Hashimoto's thyroiditis, which causes the body's immune system to attack thyroid tissue. 

    Symptoms of Hypothyroidism:

    • Dry brittle hair and /or nails
    • Dry, coarse skin
    • Patchy hair loss / thinning of eyebrows
    • Inability to tolerate cold
    • Yellowish tint to skin
    • Muscle cramps/weakness
    • Depression, mood swings
    • Fatigue or weakness
    • Puffy face
    • Hoarseness
    • Slowed heart rate
    • Heavier than normal or painful menstruation
    • Memory loss
    • Unexplained weight gain
    • Constipation
    • Bone and joint pain

    Treatment of Hypothyroidism:

    In most cases, hypothyroidism is treated quite effectively using a thyroid hormone replacement medication.

  • Parathyroid Disorders

    Located in the neck on the thyroid gland, the four oval, grain-of-rice-sized parathyroid glands (PTH) produce the hormone necessary to maintain the correct balance of calcium and phosphorous in body.

    When too much of this hormone is produced, the condition is called hyperparathyroidism.

    Symptoms of hyperparathyroidism include:

    • Osteoporosis (fragile bones that fracture easily)
    • Kidney stones
    • Abdominal pain
    • Fatigue
    • Depression or forgetfulness
    • Bone and joint pain
    • Excessive urination
    • Nausea, vomiting or loss of appetite

    The most common treatment for primary hyperparathyroidism is surgery, which provides a cure in at least 90 percent of cases.  Sometimes medications can also be used. 

    When the parathyroids produce too little hormone, the diagnosis is hypoparathyroidism.

    Symptoms of hypoparathyroidism are often subtle, but may include:

    • Hair loss
    • Muscle cramping or spasms, most frequently in the hands or feet 
    • Malformed nails or dry skin
    • Burning, numbness or tingling, most often around around the mouth or in the fingers
    • Depression and memory problems
    • Seizures

    Treatment of hypoparathyroidism usually involves calcium and Vitamin D supplements to restore the calcium/phosphorus ratio in the body.

  • Adrenal Disorders

    Adrenal (suprarenal) glands, located on the top of each kidney, produce hormones without which we can't survive. These small triangular glands consist of two parts: The outer region, called the adrenal cortex, produces cortisol, aldosterone and androgens. It regulates metabolism, blood pressure and maintenance of fluid and electrolyte balance in the body. The inner region, called the adrenal medulla, produces epinephrine and norepinephrine. These stimulate the heart, relax some smooth muscles and tighten blood vessels.

    Symptoms

    Those with adrenal disorders may experience:

    • Congestive heart failure
    • Renal disease
    • Muscle weakness
    • Fatigue
    • Weakness
    • Anorexia
    • Nausea
    • Vomiting
    • Weight loss
    • Abdominal pain
    • Hypotension
    • Hypoglycemia
    • Craving for salt

    Multiple causes may lead to improper functioning of the adrenal glands, producing a wide variety of conditions including:

    • Cushing's syndrome, related to overproduction of cortisol and occurring when the body is exposed to high levels for an extended period of time.
    • Hyperaldosteronism, resulting from overproduction of aldosterone, causing salt retention, which leads to high blood pressure.
    • Addison's disease, brought on from insufficient production of hormones.
    • Adrenal gland cancers, extremely rare, leading to high levels of any of the many adrenal hormones.
    • Adrenal insufficiency, manifesting in:
      • Inability to concentrate
      • Excessive fatigue
      • Insomnia
      • Nervousness and irritability
      • Intolerance to stress
      • Depression
      • Excessive weakness
      • Lightheadedness, especially upon standing up quickly
      • Faintness and fainting
      • Frequent infections
    • Pheochromocytoma, a rare tumor of adrenal gland tissue, the consequence of which is discharge of excess epinephrine and norepinephrine, hormones controlling metabolism, blood pressure and heart rate.

    Treatment

    Treatment depends on the specific problem caused by the adrenal disorder. Surgery, prescription medications, lifestyle changes, dietary modifications, radiation and surgery are used alone or in combination.

  • Hypogonadism

    Both men and women may suffer with hypogonadism, defined as a reduction or lack of hormone secretion or other physiological activity of testes or ovaries.

    In men, the condition is typified by low serum testosterone levels (low T). In older males, it is defined as late onset symptomatic hypogonadism or andropause. In those younger, it it is generally the result of a disorder of the testicles or neuroendocrine system. Causal factors may include abuse of heroin and cocaine, disease or other issues.

    In women, blood levels of estradiol are low. The condition causes ovarian suppression with irregular or absence of periods (amenorrhea). In older women, it is referred to as menopause. In younger women, it can be caused by poor or inadequate nutrition. In rare cases, for both men and women, hypogonadism appears when there is a brain tumor.

    Hypogonadism Symptoms in adult men:

    • Decrease in sexual desire
    • Erectile dysfunction
    • Reduction in bone density (osteoporosis)
    • Mood changes / depression
    • Infertility
    • Development of breast tissue (gynecomastia)
    • Decrease in facial and body hair growth
    • Decrease in muscle mass
    • Increase/redistribution of fat mass
    • Inability to concentrate
    • Hot flashes
    • Fatigue/loss of energy

    Hypogonadism Symptoms in adult women:

    • Absence of menstrual period (amenorrhea)
    • Abnormally short stature
    • Absent or stunted breast growth
    • Hot flashes
    • Abnormal amount of body hair
    • Lowered sex drive
    • Reduced bone density and mass
    • Infertility
    • Impotence (sexual dysfunction)
    • Reduced vaginal lubrication fluid
    • Discharge from breasts
    • Headache
    • Irrational behavior
    • Decreased levels of ovulation

    Treatment

    Treatment for adult men varies according to cause and concerns about fertility.

    • Low blood levels of testosterone increased through hormone replacement therapy (HRT) by injection, patch, gel or orally
    • Pituitary hormones to stimulate sperm production/restore fertility.
    • Human chorionic gonadotropin (hCG) or human menopausal gonadotropin (hMG) given intramuscularly to restore fertility.

    Treatment for adult women may include:

    • Combination of estrogen and progesterone for women who still have their uteruses, decreasing odds of developing endometrial cancer.
    • Low-dose testosterone to combat low sex drive (controversial).
    • Injections /pills to stimulate ovulation.
    • Human chorionic gonadotropin (hCG) or human menopausal gonadotropin (hMG) given intramuscularly to restore fertility.
    • Mandatory annual pap smears and mammograms.

    A pituitary tumor may require surgical removal, medication, radiation or the replacement of other hormones. 

  • Osteoporosis

    Osteoporosis - which literally means "porous bones" - is the loss of mineral density that causes bones to become thin, brittle and weak. Fractures may be caused by a simple misstep or something as minor as coughing or stooping over; they are most common in the wrist, hip or spine and can result in severe pain. Osteopenia is the term used when bone mineral density is lower than normal. Many doctors consider it to be a precursor to osteoporosis.

    Females are more prone to have the disease. Other osteoporosis risk factors include:

    • Aging
    • Low body weight
    • Menopause
    • Amoking
    • Certain medications
    • Being confined to bed
    • Certain medical conditions
    • Excessive alcohol consumption
    • Family history of osteoporosis

    Symptoms

    Although there are generally no symptoms of the disease until a fracture occurs, there may be certain signs such as:

    • Backache
    • Gradual loss of height
    • Stooped posture

    Treatment

    Osteoporosis treatment includes:

    • Diet rich in calcium and vitamin D
    • Calcium and vitamin D supplements
    • Weight-bearing exercise
    • Regular daily exercise
    • Fall prevention
    • Prescription medications specifically for the treatment of bone loss

    Check with your physician to determine which of these may be right for you.

    DXA (Dual Energy X-Ray Absorptiometry) screening is used to confirm and manage osteopenia and osteoporosis. This low-dose x-ray examination of the spine and hip is non-invasive and painless. you can schedule a DXA bone scan with St. Anthony Hospital.