Hormones are chemical messengers that travel through the body and coordinate complex processes like growth, metabolism and fertility.
With the power to change food into fuel and help you develop, these invisible influencers can also upset the function of the immune system, moods and behaviors, wreaking havoc on your mental and physical health.
Thankfully, there is a subspecialty of healthcare professionals who study the endocrine system, which is made up of all the body’s different hormones, and regulates all the biological processes in the body. Shruti Gandhi, MD, is an endocrinologist at the Washington DC VA Medical Center, where she treats Veterans who are referred to her with suspected hormonal issues.
“It can be challenging to pinpoint exactly what is causing symptoms because we are working with every system in the body that produces hormones,” said Gandhi. “We have the pituitary gland, which is responsible for producing hormones that regulate all other hormones in the body. We have overactive or underactive thyroid conditions that can impact energy levels or cause fluctuations in weight. We have adrenal glands that can overproduce or underproduce hormones that regulate blood pressure. We have a lot of interplay with a lot of different organ systems, so we really investigate what is causing each issue.”
Because endocrine glands and hormones are involved in most of the body’s functions, Veterans can be referred to endocrinology for a wide range of symptoms and conditions. Gandhi said the most common condition they see Veterans for is diabetes, which can be caused by hormone imbalances that lead to high glucose levels in the blood stream. Veterans are at a higher risk of diabetes than the general population with one in four Veterans in VA Healthcare being diagnosed.
When a Veteran is referred to the Endocrinology team, the team will examine their charts and may recommend certain labs to be done prior to the appointment, in order to speed up treatment options.
“When we have the results before their visit, we can work with them on the spot to create a plan to help them reach their health goals,” said Gandhi. “With regards to diabetes, we can use an A1C test to measure a Veteran’s blood glucose level over three months to determine if they are prediabetic or if they have advanced to type two diabetes.”
Catching it in the “silent” stage matters according to Gandhi because if caught early enough, diabetes can actually be reversed through lifestyle changes. The best way to catch it early is to know your risk factors and attend regular screenings with your provider.
“Diabetes is complex and the its development can stem from not only environmental stimulants but ethnicity and family history can play a role as well. If you have a family history of diabetes, regular screenings and A1C monitoring allows us to intervene earlier and minimize the negative effects of diabetes,” she said.
The VA offers specialized care for prediabetic, type two and type one diabetics. Gandhi said that the best thing any diabetic can do is to make healthy lifestyle changes like increasing activity and exercise and eating healthier. She also stressed the importance of routinely checking in with your doctor to monitor progress.
“We are just one part of a specialized team who works with their primary care doctor to treat diabetes,” said Gandhi. “We have diabetes nurse educators, nurse practitioners, clinical pharmacists, and a physician assistant who can help diabetic patients learn how to live with their diabetes and make healthier choices. We work with Whole Health to teach diabetics about proper nutrition and diet and offer opportunities to get more active.”
Diabetes is just one of several conditions that the endocrinologists at the Washington DC VA Medical Center treat. Gandhi said sometimes her team is a steppingstone in the elimination process for finding what ails Veterans.
“Often times Veterans come to us with a symptom like fatigue and they believe it is because of hormonal imbalances. There are so many conditions that have overlapping symptoms that include fatigue, so we have to look at each symptom to determine if it is originating from the endocrine system and if so, why,” said Gandhi. “Often times it may not be but we do our part to make sure we, as a healthcare team, get to the bottom of the issue to find the Veteran a treatment plan that will get them back to living life fully.”
To learn more about VA’s specialized diabetic healthcare program, visit: Diabetes Information - Nutrition and Food Services (va.gov)