Natalia Mikhailova – endocrinologist
photo: Elena Vakhrusheva / 76.RU
Lack of sleep, stress, an irresistible desire to always something to chew on … It's Spring mocks? Play, a hormone – shirsya, butt and waist? Or our body is arranged differently? For information on how excess weight is associated with hormones, what problems can arise with shitovidkoy and how to understand it's time to run to the doctor, we talked to the endocrinologist Natalia Mikhailova.
– There is a belief that our weight, weight gain is highly dependent on hormones. Is it true or is it a myth?
– Of course, it is a myth. Now the epidemic of obesity in the world, and in Russia as well. We have almost 50% of the population are overweight.
– And with diabetes? Most people suffering from this disease, complete.
– Thus, about 80% of our patients with diabetes Type II diabetes are overweight. In general, obesity – a risk factor for diabetes.
– That is, on the contrary it turns out? Excess weight causes the development of diabetes?
– More often than not the case. There are, of course, and endocrine diseases accompanied by weight gain and high blood sugar, but the majority of patients they are absent. Initially, overweight plus ran some more circumstances. What? Poor diet, sedentary lifestyle, heredity, stress – all of which can lead to the development of diabetes. But obesity is probably the most powerful risk factor. And besides, it is – a risk factor for many other diseases.
– Ischemic heart disease, circulatory insufficiency, hypertension, osteoarthritis (joint disease), malignant tumors of individual locations, cholelithiasis.
– Chronic fatigue may be associated with disturbances in hormones?
– This complaint, which to us is very often patients come. They say: "I woke up in the morning and have no strength to do anything." This indication for verification. But, to be honest, in a very small percentage of cases we find some kind of pathology. Because now, in fact, a complex life: stress, irregular working hours, irregular work and rest, a lot of people are depressed. The reasons may be different: one of life's problems, who have other health problems. But this is the evidence for thyroid examination.
– Increased hair growth – a reason to run to you?
– We must start with the gynecologist. Often this involves a problem – and gynecology, and endocrinology. And depending on what else there is a problem: the menstrual cycle, pregnancy bad conduct examination and gynecologist and endocrinologist, and ideally – a gynecologist-endocrinologist.
– How do you know it was time to the endocrinologist? There are some external signs that the body is not going smoothly?
– Everyone can see at a weight problem. Not everyone is able to calculate body mass index, although the Internet is all formula, but waist circumference be measured very simply. So a woman is more than 80 centimeters in men over 94 – all, forward to the endocrinologist. Although, of course, obesity is difficult to treat. After all, this is a departure from the usual human life: change your habits are formed in childhood. And we say to him: "Do not eat, move" Patients, of course, look at us blankly..
There are drugs that treat obesity. They can be divided into three groups: those that prevent the absorption of fat in the gastrointestinal tract, those that affect the mind by blocking the hunger center, and others more complex, which is also used in the treatment of diabetes. Naturally, the patient can not receive, whatever the drug, all of them are selected and prescribed only by doctors. Treatment of obesity is quite expensive, so it is best not to bring to this.
– How often you need to visit an endocrinologist, to hand over analyzes on hormones?
– This is not a routine examination, ie not over the whole once a year to go to the endocrinologist. Overweight people may itself apply to the endocrinologist, bypassing the therapist. If you are overweight it is clear everything is visible, thyroid complaints are not very specific. In case of violation of the thyroid gland may be a weakness, drowsiness, impaired memory, attention, dry skin, edema, insomnia, palpitations, sweating.
Such complaints may be with other problems in the body, so the person can not diagnose yourself problems with the thyroid gland. Refers to the therapist, he has sent to us, if it deems it necessary. And if the standard annual survey includes analysis of sugar, cholesterol, complete blood count, the study on thyroid hormones is indicated. Although after 40 years to check the thyroid hormones, namely, thyroid-stimulating hormone is necessary.
It is important to check blood thyroid hormone when planning a pregnancy, to know that everything is in order and prepare properly, taking iodine in sufficient dosage. Check the hormones needed in the menstrual cycle, when it is impossible to conceive. But these problems to our patients direct gynecologists.
– What are the biggest fears and mistakes come patients?
– The most common problem that patients come to us, – the nodes in the thyroid gland. Many people go to check them every year. It should be understood that the components – it is usually benign, which do not affect the quality and duration of life. Thyroid cancer is somewhere in the 5% of all the nodes, and the nodes after 50 years found 50% of women and 20% men. And the older the person, the more this percentage. All units are subject to a 1 centimeter puncture. If they are benign, even in monitoring once a year, patients do not need, because the benign to malignant nodes do not move. Dynamic observation is carried out in order to attend, not to & # 39, new units, and the growth of cash, since even benign nodes grow, but grow relatively slowly, and in the absence of complaints, ultrasound is sufficient to make 1 time in 1.5 2 years.
Proved: good knot (the result of fine-needle aspiration biopsy) never in the cancer does not go, and people are afraid to believe that he can be reborn in malignant. When the thyroid gland nodes, its function as a rule, does not suffer, and hormones remain normal. Violations may be in cases where the units are compared with other thyroid diseases (autoimmune thyroiditis, diffuse nodular toxic goiter).