Author Archives: Paul Fitzgerald

Addison Disease

The adequacy of glucocorticoid replacement (hydorcortisone, prednisone) must be assessed clinically. A WBC (white blood count) with differential (the percentage of lymphocytes and polymorphonuclear (PMN) leukocytes) can help, since patients whose replacement dose is too high tend to have a … Continue reading

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Background: Prolactin is a peptide hormone that is produced and released from the anterior pituitary. The pituitary is an autonomous prolactin factory. The pituitary will produce increased amounts of prolactin automatically unless it is inhibited from doing so by dopamine, … Continue reading

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Diabetes Caused By Protease Inhibitor Therapy for HIV/AIDS

Protease inhibitors refer to a group of medications used to stop replication of the HIV (human immunodeficiency virus) retrovirus. They are very effective medications and remain an essential element in the HIV/AIDS cocktail of drugs, also known as “HAART” (Highly … Continue reading

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Hypothyroidism The following discussion of hypothyroidism is intended to be understandable and practical.   I’ll first present a glossary of terms and then a description of hypothyroidism in adults: symptoms, causes, testing, and treatment.   Then I have sections on special groups … Continue reading

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Graves Disease Symptoms & Treatment

Graves disease is the most common cause of hyperthyroidism in the United States. Other causes of hyperthyroidism include multinodular goiter, toxic solitary nodules of the thyroid, and functioning thyroid cancer. Rare causes for hyperthyroidism include TSH-secreting pituitary tumors, struma ovarii, … Continue reading

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Menopause & Hormone Replacement Therapy

MENOPAUSE & HORMONE REPLACEMENT THERAPY (HRT) Attitudes towards post-menopausal HRT continue to change.  Oral HRT enjoyed widespread use through the 1990s, when it was thought to reduce cardiovascular disease.  Then came the Women’s Health Initiative (WHI), a prospective study of … Continue reading

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Hemoglobin A1c Testing

Hemoglobin A1c: Hemoglobin is composed of a tetramer of globin chains; two of the chains are alpha-globin (chromosome 16). Most adults have hemoglobin that is largely comprised of two alpha chains combined with two beta chains (chromosome 11) (alpha2beta2), called … Continue reading

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Acromegaly & Gigantism

Acromegaly refers to the clinical syndrome caused by excessive growth hormone (GH) in adulthood, after the closure of epiphyses (bone growth plates). GH produces many of its effects through the stimulation of insulin-like growth factor (IGF-I), produced in the liver … Continue reading

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Hyperparathyroidism therapy with cinacalcet

The tiny parathyroid glands are located in the neck and are usually located adjacent to the thyroid gland, hence the term “parathyroid”. There are usually four parathyroid glands, but there can be more, and they can sometimes lie in locations … Continue reading

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Introduction to Pheochromocytoma and Paraganglioma

Pheochromocytomas are uncommon tumors that arise from cells of the sympathetic nervous system and may secrete catecholamines (adrenalin). Such tumors are usually found within one or both adrenal glands (90%), but may arise in other areas of sympathetic nerve cells, … Continue reading

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5 Questions and Answers on Male Hypogonadism and Testosterone Deficiency

Male Hypogonadism (testosterone deficiency) is a hormone disorder in which the body does not produce enough testosterone. This condition affects 10% of all adult men and the majority of men over age 80 years. This post will review the symptoms, … Continue reading

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Hypothyroidism: Diagnosis & Treatment

Google and the UCSF Department of Medicine commissioned me to write a Google Knol entitled “Hypothyroidism.” I’ve included sections of it here.

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Due to the COVID-19 pandemic, I’ve been practicing telemedicine along with in-office appointments. Asymptomatic individuals frequently transmit the SARS-COV-2 virus to others, which can result in serious morbidity and mortality.  Therefore, our office is abiding by UCSF guidelines and practicing … Continue reading

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Journal of Clinical Oncology Paper

This paper was published in the Journal of Clinical Oncology in September, 2009. My colleagues and I describe our experience treating 50 patients with high-dose 131I-MIBG for their malignant pheochromocytoma or paraganglioma. Download: Phase II Study of High-Dose [131I]Metaiodobenzylguanidine Therapy … Continue reading

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Embolization of a large secretory paraganglioma

My colleagues and I presented two papers at the Second International Symposium on Pheochromocytoma at Queens College, Cambridge University in October 2008.  We describe the successful pre-operative embolization of a large secretory paraganglioma. Poster: Embolization of a large secretory paraganglioma (PDF)

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