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Luo Juan
Endocrinology
About me
Associate Chief Physician, Department of Endocrinology, Hunan People's Hospital, Master's degree. Youth Committee Member of the Hunan Diabetes Professional Committee. Member of the Women's Endocrine Disease Prevention and Treatment Professional Committee of the Hunan Female Physician Association.
Proficient in diseases
Diagnosis and treatment of diabetes, thyroid disease, and adrenal gland diseases.
Voices
Can obesity be treated?
Obesity is treatable. Generally, the treatment of obesity mainly includes several aspects: First, dietary intervention; second, increased physical activity; third, correcting bad behavioral habits; some cases may require medication and surgery. Dietary treatment mainly involves reducing calorie intake and recommending a low-sugar diet. Physical exercise generally requires three to five days of activity per week, with 30-40 minutes each day being appropriate. It also includes correcting some poor dietary habits and enhancing self-monitoring, including records of food intake and daily physical activity. Medication treatment is an option for individuals with a body mass index (BMI) of 30 or higher, or a BMI of 27 or higher who also have obesity-related comorbidities. This treatment can be combined with exercise and dietary behavioral corrections. Furthermore, for those with a BMI of 40 or higher, or a BMI between 35-39.9 with one or more severe obesity-related complications such as hypertension, heart failure, type 2 diabetes, or sleep apnea, surgical treatment may be considered.
What are the symptoms of acute thyroiditis?
Acute thyroiditis generally refers to acute suppurative thyroiditis, a type of pyogenic infectious disease. For instance, many patients may exhibit symptoms of an upper respiratory tract infection or experience swelling, pain, or difficulty swallowing in the lateral aspect of the thyroid in the anterior neck following a fine needle aspiration biopsy of a thyroid nodule. The local skin over the thyroid may display erythema or heat, and some may also have systemic symptoms of a febrile disease, such as increased body temperature, generalized body aches, and fatigue, along with swelling and pain in the cervical lymph nodes. Thus, the primary symptoms of acute thyroiditis are infectious, accompanied by symptoms of compression pain due to thyroid enlargement.
Causes of Acute Thyroiditis
We generally refer to acute thyroiditis as an acute suppurative thyroiditis, which is a type of purulent infectious disease, often caused by a mixed bacterial infection, such as staphylococcus, streptococcus, gram-negative bacilli, and anaerobes, etc. Patients with compromised or deficient immune functions, such as those with AIDS, leukemia, diabetes, can also have infections like fungi and pneumocystis. Some thyroid nodules, due to events like necrosis or cystic changes from punctures, can also cause a suppurative infection, and this condition is generally common among middle-aged and elderly patients. Therefore, the main cause of acute thyroiditis is mostly due to infections.
Symptoms of thyroid cysts
Regarding the symptoms of thyroid cysts, typically, patients with thyroid cysts do not experience any discomfort in the early stages. Often, a neck mass is incidentally discovered during a physical examination, and usually, there are no systemic clinical symptoms. Some patients may experience slight pain. Of course, if the cyst is large or there is bleeding within the cyst, it may lead to symptoms of compression, such as pain, difficulty swallowing, difficulty breathing, or hoarseness. Additionally, some thyroid cysts can affect thyroid function. For instance, if there is hyperthyroidism, symptoms may include heat intolerance, excessive sweating, and weight loss. Conversely, in long-term cases, patients may experience symptoms of hypothyroidism, such as cold intolerance, fatigue, constipation, and poor appetite.
How to deal with fatty liver with elevated transaminases?
First, it is necessary to determine whether the fatty liver is alcoholic or non-alcoholic. If it is non-alcoholic fatty liver with elevated transaminases, lifestyle interventions should be implemented first. Weight loss and exercise can treat fat-associated fatty liver. Generally, it is necessary to control the intake of calories and fats, especially saturated fatty acids, maintain an ideal weight, and exercise sufficiently and consistently. Similarly, if there is a significant increase in blood lipids, lipid-lowering drugs can also be used. Additionally, some liver-protective drugs can be incorporated into treatment. If it is alcoholic fatty liver, abstaining from alcohol is a key treatment, as well as appropriate nutritional support. For long-term alcoholics, since alcohol replaces the calories provided by food, there is generally an insufficient intake of protein and vitamins. Therefore, a diet high in protein and low in fat should be provided, along with appropriate vitamin supplementation, and liver-protective drugs can also be used. (Please use medications under the guidance of a doctor.)
What should I do about a thyroid cyst?
What should I do if I have a thyroid cyst? First, we need to understand what a thyroid cyst is. A thyroid cyst refers to a fluid-filled sac found in the thyroid gland. Generally, patients with thyroid cysts do not show any clinical symptoms in the early stages. Some discover a lump accidentally, usually without systemic symptoms. Individual patients may exhibit symptoms such as hyperthyroidism, and some with a longer disease course can also experience hypothyroidism, such as fatigue, poor appetite, constipation, and edema. Therefore, when diagnosed with a thyroid cyst, it is crucial to determine whether the cyst is benign or malignant and whether it affects thyroid function. If it does impact function, symptomatic treatment is necessary. Of course, most thyroid cysts are benign and can be monitored over time.
Are thyroid cysts contagious?
Thyroid cysts are not contagious. They are fluid-filled sacs within the thyroid gland, usually presenting as a single nodule, although in some cases multiple nodules can occur. Typically, thyroid cysts are asymptomatic unless the cyst becomes large or bleeds internally. In such cases, symptoms such as pain, difficulty swallowing, breathing difficulties, and a hoarse voice may occur. Thyroid cysts are considered a local endemic disease primarily caused by iodine deficiency, leading to thyroid hyperplasia and enlargement. Thyroid cysts represent a degenerative change. Therefore, thyroid cysts are not contagious.
How is obesity treated?
Regarding the treatment of obesity, the cause of obesity must first be identified. For patients with simple obesity, the primary approach involves lifestyle interventions, including exercise and diet. The diet should involve a calculation of caloric intake based on activity levels, generally focusing on a low-calorie or very low-calorie intake. Additionally, it is recommended to engage in suitable aerobic exercises. Currently, there are products available such as fat enzyme inhibitors that reduce weight by inhibiting the absorption of fats in the intestines. Also, in the United States, GLP-1 agonists are available for the treatment of simple obesity. If obesity is caused by certain medical conditions, such as an endocrine disorder known as Cushing's syndrome, which can also lead to obesity, treatment should first address the primary disease, which would also resolve the obesity.
What department should I register for obesity?
For obesity, one should register for an appointment in the endocrinology department. Obesity is a chronic metabolic disease caused by excessive accumulation or abnormal distribution of body fat. Obesity often occurs due to a higher calorie intake than expenditure in the body, resulting in excessive fat accumulation and thus overweight and bulky physique. An actual weight measurement exceeding 20% of the standard weight, and a fat percentage exceeding 30% can be classified as obesity. In endocrinology, obesity is generally divided into primary and secondary types. Some secondary factors, such as hypothalamic-pituitary disorders, hypercortisolism, hypothyroidism, hypogonadism, insulinomas, etc., can cause secondary obesity, therefore, it is appropriate to consult the endocrinology department for obesity.
Which department to see for thyroid cysts?
For which department to consult for thyroid cysts, firstly if it is just a routine physical examination and a thyroid ultrasound reveals a thyroid cyst, it is recommended to first consult the endocrinology department. An assessment of thyroid function should be conducted to see if the thyroid is functioning normally or abnormally. If it is confirmed to be simply a thyroid cyst, then the size of the cyst should be considered in deciding the next steps for treatment. If the cyst is not large and thyroid function is normal, it might be advisable to observe it for some time. If the cyst causes symptoms due to compression, surgical treatment in the department of surgery might be necessary, or dealing with the thyroid cyst using techniques such as radiofrequency ablation could be considered. Therefore, it is advised to first visit the endocrinology department and, based on the opinion of the endocrinologist, if surgical intervention is needed, then consult the breast and thyroid surgery department.