Top Doc 2012

The Thyroid

Hemorrhoids

Healthy Living - What Are You Eating?

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Medical Fact

We are happy to announce that Dr. Rubino has been recognized as "Top  Doc"  for the fifth consecutive year by NJ Monthly Magazine.

The Thyroid - Health, Disease and Nodules

The thyroid is found in the neck, below the "Adams's apple". It controls your body's metabolism - how quickly the body uses energy, makes proteins and reacts to hormones. The thyroid, in conjunction with the  pituitary gland in your brain, makes, stores and releases the T4 and T3 hormones. Thyroid disease occurs when the thyroid gland makes too much or too little of these hormones.

Thyroid disease can be diagnosed with a physical exam, blood tests, an ultrasound and a thyroid scan, which includes drinking iodine to detect the the activity of the thyroid.

Hypothyroidism occurs when the thyroid gland doesn't make enough of the thyroid hormones to maintain your body's normal metabolism. This is referred to as thyroiditis and can be caused by an inflammation of the thyroid gland.

Symptoms include:

Fatigue, weight gain, decreased appetite, change in menstrual periods, loss of sex drive, feeling cold, constipation, muscle aches, puffiness around the eyes, brittle nails and hair loss.

Hyperthyroidism is when the thyroid gland makes too much thyroid hormone, causing your metabolism to speed up. The most common disorder of hyperthyroidism is called Graves disease and affects women between the ages of 20 and 40. This condition might also result from medication or hot nodules (lumps in the thyroid) that produces excess thyroid hormone.

Symptoms include:

Fatigue, weight loss, nervousness, rapid heart beat, increased sweating, feeling hot, changes in menstrual period, more frequent bowel movements and tremors.

Medication can be prescribed to treat both hypo and hyper thyroidism and, in some cases, surgery might be recommended to remove the thyroid gland.

Thyroid nodules are lumps in the thyroid gland that can either be benign or malignant. Your doctor may use an ultrasound or biopsy to examine the nodule. If no cancer cells are found, medication may be used to reduce the size or surgery to remove it. If cancer is found, further treatment might be used. Thyroid cancer can usually be treated with success.

During pregnancy, some women might develop thyroid problems that are usually short-term and resolve quickly when hormone levels return to normal.

Regular screening for thyroid disease is recommended every 5 years beginning at age 50. Women at risk may need to be screened more often.

Hemorrhoids - Definition and Solutions 

Hemorrhoids, vascular structures in the anal canal that help with stool control, are a common condition, often found in 4 out of 5 adults at  some point in their lives. They become piles when swollen or inflamed and can be extremely painful, especially if not treated early and progress with time.

Hemorrhoids can occur as a result of:

• pregnancy
• aging
• chronic diarrhea
• low-fiber diets
• chronic constipation
• lack of exercise
• straining to move a stool
• sitting for long periods of time
• obesity
• genetics

Hemorrhoids can appear internally or externally. Painless rectal bleeding is typically indicative of internal hemorrhoids while external hemorrhoids may produce significant pain and swelling. 

Diagnosis

Hemorrhoids are typically diagnosed by a physical examination. A rectal examine might be necessary to diagnose rectal tumors, polyps, an enlarged prostate or abscesses.

Prevention

It is possible to take measures to prevent hemorrhoids including avoiding straining while trying to move a stool, eating a high fiber diet, drinking plenty of water to avoid constipation and diarrhea and getting sufficient exercise. Other suggestions are to spend less time on the toilet, losing weight if you are overweight and avoiding lifting heavy items. For women, avoid wearing a thong which can cause inflammation.

Treatment

Simple treatments can be used to alleviate the symptoms of a hemorrhoid. These include increasing your daily intake of water and fiber, anti-inflammatory drugs, sitz baths (using Epson salt has been a common remedy) and rest. Topical agents including Tucks soothing pads, witch hazel, external ointments such as Calmoseptine and other barrier creams such as petroleum jelly, zinc oxide or an analgesic agent such as lidocaine could alleviate symptoms. Steroids should not be used for more than 14 days as they may cause thinning of the skin.

If hemorrhoids progress and become serious, it may require an in-office procedure with a colo-rectal surgeon. Common procedures include a rubber band ligation to cut off the circulation of a hemorrhoid, causing it to fall off; sclerotherapy which involves the injection of a sclerosing agent to cause the vein walls to collapse and shrivel up; or cauterization to remove the hemorrhoid. In more severe cases, surgery might be required.

It is important not to try to remove the hemorrhoid with a home remedy or try to alleviate the swelling with a needle. You will cause even more damage and potential severe bleeding.

If you would like more information on hemorrhoid, please make an appointment with one of our doctors.

Food labels have been increasingly confusing to decipher. Marketing   companies focus their messaging on how to get people to buy their product, yet these messages can be deceiving when it comes to the  contents of the product and the nutritional value of the ingredients. 

Nutritional health experts recommend that you keep your intake of saturated fat, trans fat, sugars, sodium and cholesterol as low as possible to maintain a nutritionally balanced diet. However, marketing labels are often misleading when it comes to what you are buying.

It is important to take a look at the ingredient labels to really understand what you are consuming. For example, you may think 100% whole wheat bread or flavored Greek yogurt are  healthy choices. However, the food label may reveal it contains additives including high fructose corn syrup, guar gum, colored dyes or artificial sweeteners including aspartame, sucralose/sucrose or Splenda. And the yogurt often may have up to 24 grams of sugar, per serving.

A product's ingredients are listed in descending order of weight (from the most to the least). Typically, the less ingredients in a product, the less manufactured it is, which means the healthier it is to eat. Ingredients that are processed or manufactured are often difficult for our bodies to digest and use as fuel, or burn off as energy.

Some ingredients to avoid:

• High fructose corn syrup - a highly refined sweetener made from genetically modified corn
• Artificial sweeteners (acesulfame-K, aspertame, Equal, NutraSweet, Saccharin, Sweet'n Low, Sucralose, Splenda & Sorbitol) - they are chemically derived
• Hydrogenated oils (trans fat) - actually illegal in some countries
• "Enriched" and "bleached flour" (ie. "enriched" whole wheat flour is not healthy - all of the nutrients have been taken out and your body will have difficulty processing food with this ingredient, as carbs and empty calories are the only thing left- 100% whole wheat flour is the best option - or sprouted bread)
• Foods with 10 ingredients or more - typically, the more ingredients, the more a food is artificially manufactured
• Artificial colorings/flavorings  - found in everything from soda to snack cakes, they are chemical compounds made from coal-tar derivatives to enhance color and flavor
• Saturated fats - leading cause of high cholesterol
• High sugars - refined white sugar has no nutrients and can cause premature aging, digestive problems and obesity
• High sodium - can lead to high blood pressure and excessive bloating
• MSG (monosodium glutamate) - an artificial flavor enhancer added to many foods
• Sodium nitrate - chemicals used to preserve meat
• BPA - a hormone mimicking chemical found in nearly all food packaging plastics - known to be harmful to your health

Whenever you purchase a food item, remember to look at the Nutrition Facts label to understand the serving size and nutrients in a product and the ingredient label to avoid foods that are manufactured and may be hazardous to your health. A general rule is to keep your daily intake of fat to less than 65 grams, saturated fat to less than 20 grams, cholesterol to less than 300 mg, sodium to less than 2400 mg, total carbohydrate to 300g and dietary fiber to 25 g.

Dr. Robert Rubino was interviewed for his profile - following are his remarks: