Sunday, April 20, 2014

Choosing Wisely - A Guide for Patients Five Medical Facts You Need to Know About Hormone ( Endocrine) Disorders


We are seeing  a major epidemic of avoidable care today. Unnecessary tests and expensive treatments have become a major health hazard. What can  you do to protect yourself ?


An initiative of the ABIM Foundation, Choosing Wisely is focused on encouraging physicians and patients to talk about medical tests and procedures that may be unnecessary, and in some instances can cause harm.

Adapted from the Endocrine Society and American Association of Clinical Endocrinologists (www.endo-society.org and www.aace.com)

1. Adults with Type 2 diabetes do not need to perform multiple daily self-glucose checks . Once target blood sugar control has been achieved, there is little to be gained from repeated daily testing . Self-monitoring is beneficial only when you are learning and adjusting to a new form of therapy.

2. Doctors sometimes over-order a vitamin D (1,25-hydroxyvitamin D) blood test. It should not be done unless your doctor finds you have a high level of calcium (hypercalcemia) or decreased kidney function.

3. Another test doctors commonly over order is thyroid ultrasound. If there are no signs and symptoms of thyroid gland abnormality, thyroid ultrasound is a costly procedure and should not form part of a routine evaluation.

4. Thyroid profiling (a panel of blood tests, including total and free T3 levels, ordered to help diagnose thyroid disorders ), is not needed for prescribing the correct dose of levothyroxine ( T4) in hypothyroid patients . In most of these patients, a normal TSH ( Thyroid-Stimulating Hormone ) level is enough to confirm the correct dose of T4.

5. Don’t go for testosterone (male hormone) therapy unless there is evidence of testosterone deficiency in your body. Testosterone therapy has the potential to cause serious side effects. It is important to confirm the diagnosis of hormonal deficiency (hypogonadism) by doing blood tests before going in for hormonal replacement therapy.

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