Feeling off-kilter? It could be hormonal


Out of all the systems of the human body, the hormone-producing glands of the endocrine system may be the least understood.

Patients don’t head to their doctor’s office complaining that their adrenal gland isn’t doing its job or because something is wrong with their pineal gland.

At the same time, the endocrine system helps determine so much of what it means to be human through the production of hormones. That influence ranges from testosterone or estradiol ushering in puberty to the basic control of our body’s metabolism.

By the time patients are referred to a surgeon like myself, they have often dealt with vague symptoms, such as fatigue or muscle weakness, for years, unable to pinpoint their cause.

These chronic ailments and the relief from surgery are part of what pulled me to perform as many endocrine surgeries as I could during my training. I have seen the dramatic improvement that treatment can effect on my patients’ quality of life, which is tremendously rewarding as a physician.

What is the endocrine system?

The endocrine system is comprised of glands — organs that produce chemicals with a specific function — spread over the body.

These chemicals, known as hormones, help communicate in our bodies by triggering changes in behavior and bodily functions. A well-known role of hormones is the onset of puberty, which is controlled by the sex hormones estrogen and testosterone.

Disruptions in the glands or the hormones they produce create endocrine disorders.

A common example is diabetes. It is caused when the pancreas, an endocrine gland in the abdomen, either can’t produce enough insulin or the body becomes resistant to insulin, a hormone that regulates blood sugar levels.

What questions to ask

Symptoms of endocrine system disorders can be vague and related to other medical problems.

Perhaps you have slow but steady weight gain or you feel consistently tired. Maybe you are dogged by aches and pains. Some patients can have intermittent sweating, heart palpitations or uncontrolled high blood pressure.

Rather than learning to live with your symptoms, keep asking questions and pursuing treatment. In most cases, the first stop for an endocrine system disorder is at a primary care office.

Simple lab tests or images can often localize a potential source and this may prompt referral to a surgeon. Fear not, this does not mean you will need an operation.

Because the endocrine glands make up an intertwined system that often requires various medical and surgical approaches, many patients can be managed without surgery. Your visit with me is vital to understand where best surgical practices are appropriate in your individual care.

What surgery might look like

 Among the more common reasons patients are referred to me for potential surgery is for thyroid nodules or to treat high blood calcium, or hypercalcemia, a condition usually involving the parathyroid glands.

In the case of hypercalcemia, symptoms can be nonspecific, including depression, constipation, muscle aches or seizures. There are actually four small parathyroid glands in the neck, which sit behind the thyroid gland. An “overactive parathyroid” is usually caused by a benign tumor forming on one of these glands.

Surgery to remove the gland is typically an effective treatment.

Though most growths spotted on the parathyroid gland are benign, some can be cancerous. But being referred to a surgeon for a growth on an endocrine gland does not mean you have cancer.

This can be the case for patients with thyroid nodules who are often best served with surveillance ultrasounds and observation. If the nodules become suspicious, they may need a biopsy, or ultimately require removal of some or all of the thyroid gland.

Beebe is proud to offer genetic testing of thyroid nodules, a new therapy designed to stratify the risk of malignancy in thyroid nodules, which can help determine whether or not surgery is the best option.

A big part of a surgeon’s role is to be involved in the care team outside the operating room. I work with family doctors and endocrinology specialists to investigate whether surgery is the right approach. Our multidisciplinary team is complemented by radiologists, pathologists and oncologists whose job is to help identify those patients at risk for serious disease and decide on the best course of therapy.

In those cases when evidence suggests surgery will help, procedures can be completed right here in Lewes, as Beebe has the expertise and technology to perform endocrine surgery successfully.

Dr. Mark Facciolo, DO, is a general surgeon with a special interest in endocrine surgery who said he believes in care guided by friendly relationships with patients combined with up-to-date medical knowledge. For more information on Facciolo and General Surgery at Beebe, go to www.beebemedicalgroup.org/services/general-surgery.

By Dr. Mark Facciolo
Beebe Healthcare