Endocrinology Division

Bone Density Exams 

On the day of the test, x-rays will be taken of the lower spine, hip, & forearm. It is preferable that your bone density should be tested.

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Osteoporosis & Osteopenia 

There are now several medications on the market for treatment. These include estrogen, bisphosphonates & newer drugs such as, Forteo and Prolia.

Osteoporosis Q&A

Radioactive Iodine 

Thyroid Uptake/Scan is a diagnostic test used to determine the cause of hyperthyroidism (overactive thyroid).

Non-Healing Bone Fractures 

Call to schedule an appointment with one of our specialists.

Vitamin D Deficiency 

Vitamin D is an essential vitamin that is important in regulation of blood calcium levels & bone development.

Małe Hypogonadism 

The diagnosis of low testosterone, or low T, is increasingly common. As men age, they often experience fatigue, weakness, and a loss of sex drive — all symptoms of low testosterone. If you believe you might be experiencing any of these symptoms, don’t hesitate to schedule an appointment with Ashkan Zand, MD, and the team at Endocrinology and Osteoporosis Centers of Texas. Call the office in Houston, Pearland, or Pasadena, Texas, or request an appointment online today.
Male hypogonadism is a condition in which the body does not produce enough testosterone, the hormone that plays a key role in masculine growth and development during puberty or has an impaired ability to produce sperm or both.

Low Testosterone Q&A

Diabetes

Type I (any patient over 18 years old): Type I diabetes or insulin-dependent diabetes mellitus (IDDM) occurs in patients that make little to no insulin, and require daily insulin injections to control their blood sugar values. Type II (poorly controlled, frequent hypoglycemia): Type II diabetes refers to patients that are resistant to insulin, and most of the time occurs in adulthood. Some patients can develop diabetes due to medications such as steroids, mental health medications, and weight gain. Pre-diabetes: Pre-diabetes is a term used for persons with either high fasting sugars (greater than 126) or blood sugars going into 140-199 range 2 hours after a sugar load. Gestational diabetes / pregnant patients with diabetes: Gestational diabetes refers to diabetes that occurs during pregnancy and often can have many causes. High blood sugars during pregnancy can cause larger babies, increase complications during pregnancy, and create other concerns for mom and baby. The goal is to normalize blood sugars during pregnancy so these do not happen. Diabetic patients (both type I and type II) that become pregnant or patients that become diabetic during pregnancy have stricter blood sugar targets than non-pregnant patients, and need closer monitoring to prevent complications. Starting and managing insulin pump therapy (most pump brands supported): Many diabetic patients are eligible for an insulin pump, which is an external pump device worn by patients. Insulin pumps are proving to be better at delivering insulin and lowering blood sugars more safely in certain type I and type II diabetic patients.

Diabetes Q&A

Continuous Glucose Monitoring (CGM technology)

A continuous glucose monitor sensor is a small device the size of a quarter that provides blood sugar readings every 5 minutes. There are two types of sensors: a personal unit which a person can wear continuously and have access to sensor values and blood sugar trends. Or patients can wear a sensor short term 3-5 days to help evaluate their insulin doses or pump settings. Both types of sensors can be downloaded by your doctor and create great reports with graphs indicating possible periods of low and high blood sugars. CGM is one of the best ways to optimize insulin doses and pump settings.

CGM testing helps to determine your blood glucose pattern with an effort to better manage your blood sugar.

Osteoporosis Q&A

3 HR Oral Glucose Tolerance Test 

Patients are given a sugar-containing solution to drink. Blood sugar is measured hourly to monitor the body's response to sugar.

Thyroid Problems

Hypothyroidism (low thyroid) and hyperthyroidism (high thyroid):
Thyroid hormone is an essential hormone that controls almost every organ in the body, including heart, digestive system, skin/hair, nervous system, metabolism, and reproduction. Hypothyroidism is a term used to refer to low thyroid hormone levels, and hyperthyroidism refers to an overactive thyroid gland or increased thyroid hormone levels.
Thyroid nodules:
A thyroid nodule is a lump or an irregular area of the thyroid gland, and very common, with some studies showing 20% of the population has a thyroid nodule. That's 1 in 5 people! Although they are usually benign, unfortunately, thyroid nodules are often how thyroid cancer is initially diagnosed. Your endocrinologist can help you determine if a nodule is worrisome or not, ways to determine this and help you determine if a thyroid biopsy is needed. They can also explain this procedure to you in detail as they routinely perform these biopsies in our office.
Thyroid Cancer:
Whether newly diagnosed or have a history of thyroid cancer, we guide patients from diagnosis to surgical options and follow patients for cancer surveillance. In addition, some patients might need radioactive treatment. Thyroid cancer is a malignancy of the thyroid gland, and there are different kinds of thyroid cancer with different treatment strategies. Our physicians focus on helping patients from initial diagnosis to treatment. Also, we manage patients who have had thyroid cancer removed, monitor for potential regrowth and help prevent cancer from returning.

Thyroid Disorders Q&A

Abnormal Calcium Levels

High calcium levels evaluation/ hyperparathyroidism:
Calcium levels are closely regulated by the body via the parathyroid glands. There are four glands that reside behind the thyroid gland, and sometimes one or more glands become overactive. When this happens, patients can develop very high calcium levels, which can make them significantly ill, including causing severe fatigue, frequent urination, dehydration, and even hospitalization.
Low calcium levels evaluation/ hypoparathryoidism management:
Calcium levels are closely regulated by the body via the parathyroid glands. There are four glands that reside behind the thyroid gland, and sometimes these glands stop working. Low calcium levels can make patients significantly ill, including causing severe cramping and muscle spasms, numbness and tingling, fatigue, and severe muscle weakness, and even require hospitalization.

Parathyroid Disorders

High calcium levels evaluation/ hyperparathyroidism:
Adrenal insufficiency refers to low or underactive adrenal gland function. The adrenal glands make hormones that help maintain blood pressure among other things, and low adrenal function can be a medical emergency. Luckily adrenal insufficiency is rare and can be safely evaluated and treated by an endocrinologist.

Low calcium levels evaluation/ hypoparathryoidism management:
An adrenal nodule refers to a lump, growth, or abnormalities in the adrenal glands. Sometimes these nodules are benign, but often they can produce hormones or even be how adrenal cancer is initially diagnosed.

Adrenal disorders 

Adrenal insufficiency evaluation/ management:
Cortisol is a stress hormone made by the adrenal glands that has many effects throughout the body. Too much cortisol can cause significant weight gain, acne, fatigue, muscle weakness, high blood pressure, high blood sugars/diabetes, and many other symptoms.

Adrenal nodules:
High blood pressure is very common as people age. If high blood pressure was diagnosed at an early age (20s to 30s) or is difficult to control on many blood pressure agents then it may be caused by a hormonal problem and require further evaluation.

Elevated cortisol (Cushing’s syndrome) evaluation:
Prolactin is a hormone produced by the pituitary gland. It controls breast milk production during pregnancy, but in some patients may be elevated when they are not pregnant and cause breast discharge and irregular periods. Pituitary tumors can sometimes cause elevations in prolactin.

Severe high blood pressure/hyperaldosteronism:
The pituitary gland is a small gland attached at the base of the brain also called the master gland because it controls many endocrine hormones. Abnormal growths or irregular areas of the pituitary gland often are caused by both benign and malignant tumors. The pituitary gland makes many hormones, so it is important to evaluate these hormones in addition to determine if tumors are benign or malignant.

Adrenal Glands Disorders Q&A

ACTH Stimulation Test 

Monitor your adrenal glands’ response to ACTH.

Pituitary Disorders

Prolactinomas:
Diabetes insipidus is a medical condition that causes frequent urination regardless of how much water a patient drinks and can often cause significant dehydration and elevated sodium levels.
Pituitary tumors:
The pituitary gland makes growth hormone, and patients can suffer from a deficiency of this hormone (often due to a history of head trauma, concussions, or surgery or radiation to the brain). Other patients have too high growth hormone levels, which can cause abnormal growth and significant body changes.
Diabetes insipidus/excess urination:
Cushing syndrome refers to too much cortisol production by the body. It is a complicated medical condition that can arise from problems in the pituitary gland or adrenal glands. It can also be caused by medications such as steroid use.
Growth hormone deficiency or excess:
The pituitary gland makes growth hormone, and patients can suffer from a deficiency of this hormone (often due to a history of head trauma, concussions, or surgery or radiation to the brain). Other patients have too high growth hormone levels, which can cause abnormal growth and significant body changes.
Cushing's Syndrome:
Cushing syndrome refers to too much cortisol production by the body. It is a complicated medical condition that can either arise from problems in the pituitary gland or adrenal glands. It can also be caused by medications such as steroid use.

Pituitary Disorders Q&A

Thyroid Disease During Pregnancy 

Thyroid hormone doses often need to be increased during pregnancy, so your doctor will most likely recommend repeating your labs several times during pregnancy.

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High Cholesterol, Triglycerides

In some situations very high cholesterol or triglycerides levels are more challenging to treat and warrant evaluation by an endocrinologist. Certain patients, like diabetics or patients with history of a heart attack or stents often have more aggressive targets for LDL cholesterol and triglycerides.

High Cholesterol Q&A

Obesity 

Abnormal weight gain evaluation:
Weight gain is considered abnormal if a patient is obese based on BMI (BMI greater than 30). A BMI greater than 40 is considered severe obesity with many medical problems that can develop from this weight. Abnormal weight gain may also refer to a significant amount of weight gain in a short time span (6 months for example).

Difficulty with weight loss treatments (medical and surgical options):
There are currently many dietary, lifestyle modifications, medical and surgical options for management of weight gain and difficulty with weight loss.

Osteoporosis Q&A

Women’s Hormonal Health

Irregular menstrual periods/heavy periods:
A woman should have a menstrual period once a month, every 28 days or so depending on her body. Skipping of menstrual periods, absence of periods, or periods that are much heavier or lighter than usual may be caused by a number of hormonal abnormalities.

Menopause and hormone replacement therapy:
Menopause refers to the absence of periods for a woman for over 12 months from last menstrual period. Normally it occurs to women in their 40s-50s. If menstrual periods stop for a woman in her 20-30s this is considered abnormal and requires evaluation.

Hot flashes:
Hot flashes refers to a sudden feeling of hot, flushing and even redness that occurs to women during menopause likely as a result of sudden decreased hormone levels. The exact cause is still under investigation. Symptoms tend to occur in the face, neck, upper chest and seem to be caused by dilation of blood vessels trying to cool off the skin. There are a number of ways to treat these symptoms particularly if they affect sleep, quality of life, work, or are just too disruptive to everyday life for a woman.

Infertility / PCOS / abnormal hair growth:
A woman should have a menstrual period once per month about every 28 days with duration of actual period varying. If a woman has irregular periods there may be a cause such as polycystic ovarian syndrome (PCOS). PCOS presents with abnormal periods, sometimes abnormal hair growth, and other metabolic problems like higher cholesterol, blood sugars and blood pressure. PCOS can be treated effectively in women who go on to have regular periods and may even be able to get pregnant and have children.

Bone health/osteoporosis: Our bones are the foundation to the body. Unfortunately as men and women age, they often suffer from bone loss. Women lose bone faster than men particularly after menopause. Evaluation of bone health and early detection of osteoporosis can prevent fractures and even reverse some bone loss.

Low energy/fatigue: Although we all lead very active and demanding lives, there are some patients with significant fatigue caused by hormonal abnormalities. It is best to discuss these symptoms with your physician to determine if there is an endocrine cause requiring evaluation.

Osteoporosis Q&A

Men’s Hormonal Health

Low testosterone (hypogonadism) evaluation:
Low testosterone can cause significant fatigue, weight gain, decreased sex drive/interest in sexual activity, erectile disorder, and even mood changes in men. It is very important to establish a cause for low testosterone before treatment, as most men in their 20s to 50s should not suffer from testosterone deficiency. Also, treating the cause of low testosterone is key, as this can often raise a man's ability to produce adequate testosterone on his own. If testosterone therapy is indicated, then appropriate dosing and monitoring of levels is key to prevent complications.
Testosterone therapy/management:
Testosterone therapy can be both successfully and safely done in the hands of an experienced provider. Many patients can feel much better on testosterone replacement, but it is also important to honestly assess if therapy is helping or not. In certain cases, the risks of testosterone therapy may outweigh the benefits.
Erectile dysfunction:
Erectile dysfunction refers to either decreased or absent early morning erections or the inability to get or maintain an erection, which interferes with the ability to have sexual intercourse. In addition to low testosterone, medications and a number of health problems, such as poorly controlled high blood pressure, heart disease, and diabetes, can cause erectile dysfunction.
Bone health: Our bones are the foundation of the body. Unfortunately, as men and women age, they often suffer from bone loss. Women lose bone faster than men, particularly after menopause. However, more and more men are developing osteoporosis or hip and spine fractures due to the aging of the population. Evaluation of bone health and early detection of osteoporosis can prevent fractures and even reverse some bone loss.
Weight problems:
Weight gain is considered abnormal if a patient is obese based on BMI (BMI greater than 30). A BMI greater than 40 is considered severe obesity, with many medical problems that can develop from this weight. Abnormal weight gain may also refer to a significant amount of weight gain in a short time span (6 months, for example).
Low energy/fatigue:
Although we all lead very active and demanding lives, there are some patients with significant fatigue caused by hormonal abnormalities. It is best to discuss these symptoms with your physician to determine if there is an endocrine cause.

Osteoporosis Q&A

Abnormal Calcium Levels

High calcium levels evaluation/ hyperparathyroidism:
Calcium levels are closely regulated by the body via the parathyroid glands. There are four glands that reside behind the thyroid gland, and sometimes one or more glands become overactive. When this happens, patients can develop very high calcium levels, which can make them significantly ill, including causing severe fatigue, frequent urination, dehydration, and even hospitalization.
Low calcium levels evaluation/ hypoparathryoidism management:
Calcium levels are closely regulated by the body via the parathyroid glands. There are four glands that reside behind the thyroid gland, and sometimes these glands stop working. Low calcium levels can make patients significantly ill, including causing severe cramping and muscle spasms, numbness and tingling, fatigue, and severe muscle weakness and even require hospitalization.

Osteoporosis Q&A

High Blood Pressure 

Although high blood pressure is often just due to genetics and sometimes due to aging, in some patients there may be a hormonal cause. For example, patients diagnosed with high blood pressure in their 20s or 30s, and patients on multiple blood pressure medications may have hormonal causes for high blood pressure and need evaluation.

Osteoporosis Q&A

Nutrition/Healthy Living

Diet and endocrinology are closely linked and integral to patients' overall well-being. Endocrinologists are experts in metabolism and also knowledgeable on balanced nutrition dietary supplementation with vitamins/minerals and can help you find the right diet to meet your weight, energy, and healthy lifestyle goals.

Osteoporosis Q&A