Park Avenue Endocrinology & Nutrition, PLLC

Products And Services

• Diabetes Treatment

  What Is Diabetes? Diabetes is the inability to use or create insulin in the body. Insulin is a hormone secreted by the pancreas that allows glucose or sugar to enter the cells. It is a chronic metabolic disorder in which the body either doesn’t produce enough insulin or doesn’t respond to the produced insulin. Typically, the body breaks down most of our food into glucose, the body’s main source of energy. Glucose requires the help of insulin in order to move into the cells of the body. A person without diabetes naturally produces enough insulin to do this which obviously isn’t the case for someone with diabetes. This causes glucose to build up in the blood instead of moving into the cells. Serious health problems can occur if too much glucose builds up in the blood. Although diabetes can lead to serious complications, it can be successfully managed through diet, lifestyle modifications or medication. Diabetes Symptoms While type 1 diabetes usually develops throughout childhood or adolescence, it can also occur during adulthood. Unlike type 1 diabetes, type 2 diabetes may not require insulin. Type 1 and type 2 diabetes symptoms may consist of: Increased thirst HungerDiabetes Treatment | Diabetes Symptoms NYC Unusual weight loss Fatigue Irritability Frequent urination Frequent infections Blurry vision Tingling or numbness in the hands or feet Cuts of bruises that heal slowly Recurring skin, mouth, vaginal or bladder infections Diabetes Risk Factors The exact cause of diabetes is not clear but there are risk factors leading to increased chances of developing diabetes. Type 1 diabetes risk factors include; the presence of autoantibodies (damaging immune system cells), family history of diabetes, as well as environmental factors. Risks for developing type 2 diabetes increase with age and may consist of: Lack of exercise Being overweight Polycystic ovary syndrome High blood pressure Low level of HDL cholesterol Diabetes Test We offer a full range of diagnostic testing at our office including: RMR Sudoscan ANS Monitoring Nerve Conduction CV Profiler Digital Fundoscopy Lab Services Diabetes Treatment At Park Avenue Endocrinology and Nutrition, we are expert diabetologists. We use state-of-the-art equipment to diagnose and manage patients with diabetes, Type 1 and 2. Guided by initial history and physical exam, our team performs a panel of comprehensive tests including Hemoglobin A1c, insulin, and C-peptide levels to properly diagnose diabetes. We are able to closely monitor patients by downloading blood sugar monitoring device measurements onto our computers.

• Weight Management

  What Is Weight Management? The Permanens™ Lifestyle Change Program (PLC) and Permanens™ Weight Management System (WMS) were created by Dr. Gage to induce PERMANENT weight maintenance. The PLC Program provides twelve weeks of educational instruction (using behavior modification techniques with the option of meal replacement food and/or medications). Our licensed nurse practitioner and our board-certified endocrinologists provide ongoing weekly 1-hour group or individual meetings conducted in-person or online. We offer a full range of diagnostic testing at our office including: Body Composition RMR Lab Services CV Profiler Spirometry Body Composition Testing At Park Avenue Endocrinology & Nutrition, we highly recommend the Body Composition Analysis. This test only takes 2 minutes to complete and can provide you with valuable insight based on medically relevant results. The Body Composition Analyzer allows us to better understand a patient’s fat distribution as well as their total cardiovascular risk factors. Weight Loss Program Weight Loss Programs | Weight Management | NYCThe PLC Program uses the behavioral and defensive eating techniques discussed in Dr. Gage’s book, The Thinderella Syndrome. The WMS is the key component in aiding and achieving PERMANENT, SUCCESSFUL weight loss with our PLC Program. It is an innovative, computer-driven, secure, internet-enabled weight tracking device. This educational tool allows communication between the health care provider and client. We offer a “turn-key” program that is user-friendly and practitioner-friendly and can easily be integrated into a busy medical practice. Weight Loss Solution The Permanens™ Lifestyle Change Program seeks to change this “yo-yo” syndrome by initiating a novel approach to the dieters’ lifestyle. The PLC Program will show you how to avoid falling into this precarious situation and will eventually define what permanent weight maintenance is all about. This includes the “Three R’s of Behavior Modification” plus the “Permanens™ Weight Monitoring System” for permanent weight maintenance. In weekly group meetings, clients learn defensive eating techniques. Meanwhile the Red Alert System helps to achieve and maintain weight loss goals. The Problem With Other Diets Striving for permanent weight maintenance has always been the elusive factor in the dieting arena. Numerous studies demonstrate the ability of patients to lose weight using various combinations of restrictive eating with exercise. The vast majority of patients regain their weight within two years. Patients lack an inventory of “defensive eating style” techniques. They fail to sound a “Red Alert” when they are at only five percent regain in body weight. They continue to “yo-yo” upward toward their original weight. Weight Loss Topics Slowing down technique Place of eating technique Physical activity in everyday lifestyle Shopping and storing Visual cues: modular food (liquid bars/shakes) banking, plate, and utensil size Restaurant eating Cardinal rules of nutrition Cognitive techniques Alternate activities Assertive techniques for sabotage Realization Phase This comes in two forms. Clients seeking help due to an awareness of their obesity or the physician/health care practitioner becomes aware of their obesity. Awareness is key! Clients are referred to our program by physicians or health care practitioners where we customize a weight loss plan that works best for them.

• Pituitary/Adrenal Disease

  Pituitary And Adrenal Disorders The pituitary and adrenal glands are small, but powerful glands in the human body that control many bodily processes, everything from metabolism to blood pressure to sexuality. Various problems can affect these glands leading to all kinds of health conditions, many of which go undiagnosed by primary care physicians. As endocrinologists, the team at Park Avenue Endocrinology & Nutrition has extensive experience in diagnosing problems originating with the pituitary and adrenal glands, and then regulating your hormone levels to get your health back on track. What Is The Pituitary Gland? The pituitary gland is a pea-sized body attached to the base of the brain, just below the hypothalamus. The pituitary is part of the endocrine system and produces critical hormones, the chemical substances that control various bodily functions. Because the pituitary controls the secretion of the body’s hormones it is often referred to as the “master gland.” Release of these substances by the pituitary into the bloodstream has a dramatic impact on all kinds of body processes and a person’s overall quality of life. What Hormones Are Produced By The Pituitary Gland? These are some of the major hormones produced by the pituitary gland, along with what health problems caused by deficiencies: Growth hormone (GH) — The body’s principal hormone. Regulates body and brain development, bone maturation, metabolism, and is essential for muscle health. Deficiency causes decreased muscle mass, increased body fat, elevated cholesterol, low bone density, and other life-impacting problems. Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) — These hormones control the production of sex hormones (estrogen and testosterone), as well as sperm and egg production and release. Deficiency causes decreased libido, erectile dysfunction, irregular menses, decreased body hair, mood swings, hot flashes, and decreased muscle strength. Thyroid stimulating hormone (TSH) — This hormone stimulates the thyroid gland to release thyroid hormones that control metabolic rate, are critical for growth and maturation, and affect just about every organ in the body. Deficiency causes fatigue, weakness, weight gain, memory loss, mood swings, dry skin, and other issues. Adrenocorticotropic hormone (ACTH) — This hormone triggers the adrenal glands to release cortisol, the hormone that regulates carbohydrate, fat, and protein metabolism. Deficiency causes nausea, weakness, low blood sugar, low blood pressure, dizziness, body aches, vomiting, and other digestive problems.

• Alternative & Holistic Medicine

  Our philosophy is to integrate wellness into your lifestyle. By combining traditional evidence-based medicine with a host of preventative techniques, each patient is offered an individualized plan to optimize wellness. The individual is treated as a whole, not as a series of patchwork diagnoses with separate treatments. Patients are instead educated about the various causes of their underlying illnesses. They are taught to use lifestyle pattern changes, nutritional remedies, and foods to alleviate symptoms and disease. For example, a healthy diet with appropriate fiber may be a remedy for a patient suffering from irritable bowel syndrome, instead of just “the laxative pill.” In addition, thyroid patients may benefit from a diet focused on autoimmune disease.

• Osteoporosis

  At Park Avenue Endocrinology & Nutrition, we have extensive experience in the diagnosis and treatment of osteoporosis. We help manage calcium levels and vitamin D metabolism, and can prescribe medications to reverse or at least slow the patient’s bone loss. What Is Osteoporosis? Osteoporosis is thinning of the bones, which usually occurs in women and men as they age. At Park Avenue Endocrinology & Nutrition, we have a vast experience in all treatments of osteoporosis, managing calcium and vitamin D metabolism, as well as the ability to prescribe medications that can help reverse or slow the progression of bone loss. Osteoporosis is characterized by a decrease in the bone density. When a patient has osteoporosis the bones become abnormally porous; they can become compressible, like a sponge. Bones that are affected by osteoporosis can break with relatively minor injuries or even movements that would never cause a fracture in a healthy person. In an area such as the hips, osteoporosis can lead to cracking of the hipbone — a hip fracture. In the spine, the bone can collapse, such as in a compression fraction of a vertebra. Osteoporosis-related fractures can occur in almost any bone in the body, but they are most common in the spine, hips, ribs, and wrists. We also treat parathyroid disease, which is the gland that controls calcium and bone homeostasis in the body. What Causes Osteoporosis? Our bones are in a constant state of renewal, building new bone and breaking down old bone. This keeps the bones strong. With this ongoing cell turnover, we rebuild most of our skeleton every 10 years. When we’re young, we make more bone than we break down, contributing to our growth and filling out our frame. This process peaks somewhere in our 20s, and then the body loses bone mass faster than it is created. Here are some common causes of osteoporosis: Low estrogen levels in women — Bone loss accelerates after menopause, a time when estrogen levels drop quickly. Women in this stage of life have the highest risk of developing osteoporosis. This can also happen in young women who stop menstruating, such as overly thin athletes or girls with anorexia. Low testosterone in men — Men convert testosterone into estrogen, which preserves bone mass. As men age, their testosterone levels drop. Lack of calcium — The bones need calcium to rebuild, but many organs need a constant level of calcium, too. If they don’t have it, the body will steal calcium from the bones. Lack of vitamin D — Vitamin D helps your body absorb and use calcium. Too little leads to weak bones and bone loss. Sedentary lifestyle — Use them or lose them. Bones weaken if they aren’t used. Astronauts in weightless space have been shown to suffer bone mass loss. Weight-bearing exercise, however, helps keep your bone cells turning over. Other causes — Hormone imbalances, thyroid conditions, smoking, taking certain medications, various medical conditions, and too much alcohol consumption can also lead to osteoporosis.

  Link: Osteoporosis

• Thyroid Treatment

  As Board Certified Endocrinologists, our team has particular expertise in the treatment of thyroid disease. Individuals may present different symptoms, including thyroid nodules and/or signs of underactive or overactive function. It is our job to do the investigative work necessary to understand each person’s thyroid function. Thyroid disease is a category of conditions that occur due to abnormal function of the thyroid gland. The thyroid gland sits just below the Adam’s apple on the neck. It is small but integral to several physiological processes, including metabolism and heartbeat. People diagnosed with some form of thyroid disease either make too much or too little thyroid hormone. As a result, they may experience symptoms such as poor heat regulation in the body, weight gain or difficulty gaining weight, and irregular heartbeat. Nodules may also develop on or around the thyroid gland. In many cases, the presence of nodules does not indicate thyroid cancer. However, it is necessary to consult with an experienced endocrinologist to have nodules evaluated to rule this out. Our treatment of thyroid disease is individualized. Some patients with fatigue, weight gain, dry skin, or other signs may still have normal thyroid function testing but already test positive for Hashimoto’s antibodies. We use specific diet and nutritional recommendations and thyroid medications in our treatments, depending on the clinical situation. As thyroid disease is often nuanced, we take the time and care to listen closely to the concerns of our patients to find an underlying reason and treatment of the condition.

  Link: Thyroid Treatment

• Polycystic Ovarian Syndrome (PCOS)

  Polycystic Ovarian Syndrome, or PCOS, is a constellation of symptoms that include irregular periods and symptoms of high male hormone levels such as scalp hair loss, acne, and increased body hair growth. Women with Polycystic Ovarian Syndrome may also have difficulty with weight loss and show signs and symptoms of high insulin levels. PCOS affects as many as eight percents of women. We do not have a good understanding of what causes PCOS and scientists continue to work to improve our understanding of this common syndrome. Researchers have discovered a link between PCOS and obesity. Such patients frequently have severe insulin resistance, with diabetes occurring in up to fifty percent of PCOS patients. They develop upper body obesity and accelerated heart disease risk. Dr. Gage describes the ill effects of insulin in his book, The Thinderella Syndrome: A Practical Guide to Individualized Permanent Weight Loss. “The higher the insulin, the more illness we see.” Insulin resistance in women with PCOS seems to resemble what which occurs in the obese type 2 diabetic. Per Dr. Gage, the difference is that the insulin resistance of PCOS occurs first, with the obesity and carbohydrate cravings becoming a secondary phenomenon.