Body in Balance

Gunjan Tykodi, M.D., Kaiser Permanente
FROM THE PRINT EDITION |
 
 
Genetic profiling is allowing for prevention and earlier treatment of some endoctrine disorders, says Dr. Gunjan Tykodi of Kaiser Permanente

Why did you choose this specialty?
My fascination of how the human body and its different systems work together led me to medicine and specifically to endocrinology. Sometimes I feel more like a detective than a doctor. Many of my patients have troubling symptoms: unexplained weight gain or loss, fatigue, depression, forgetfulness, nervousness, poor sleep, eye problems. These could have any number of causes. It’s like a puzzle, and figuring out the cause to these varied symptoms can help my patients heal.

Many patients with diabetes see an endocrinologist. What are patients newly diagnosed with this disease most concerned about?
A new diagnosis of diabetes comes with varied emotions. Sadness is common, which can lead to depression from the enormous lifestyle adjustment and can greatly affect treatment outcomes. This requires an entire health care team to help patients manage their physical and psychosocial well-being.

What are the biggest developments in diabetes treatment or prevention?
A better understanding of genetic and environmental risks, as well as the physiology of the disease at the molecular level, has led to the development of exciting novel medications and targeted earlier interventions in those individuals at risk. Particularly exciting are newer medications which, in addition to insulin, also target other specific hormones to achieve tighter blood sugar control. These therapies are leading us closer than ever to artificial pancreas functionality or a closed loop system for optimal blood sugar control by which medication delivery will be automatically synced to blood sugar levels using a computer algorithm.

What are your areas of special interest?
Thyroid disease and thyroid cancer are a major focus of my practice. Thyroid disease, which is quite common, can put patients at risk for major medical problems, like heart disease, bone loss, infertility or miscarriage. While thyroid cancer has increased in incidence at a faster rate than any other cancer over recent years, it remains one of the most curable. Educating patients about prevention, the physical and psychological impact of their diagnosis, and helping them choose the best treatment available is an important and rewarding aspect of caring for patients with thyroid cancer and other endocrine disorders.

Is there a recent development in your field that you’re especially excited about?
The genetics of endocrinology is advancing rapidly and is both exciting and challenging. With genetic profiling, we are now able to offer prevention and earlier treatment for some high-risk diseases, while in lower-risk diseases, close observation may be most appropriate. As an example, we can offer thyroid surgery for pediatric patients at a very young age who are at high risk for developing aggressive thyroid cancer. We are not far from being able to gather an exact genetic endocrine profile and risk assessment across the entire genome for every patient at a very young age.

What qualities should a patient look for when choosing a doctor?
Do they make good eye contact, are they a good listener, do they have a warm personality or a sense of humor? Are they caring, are they interested in the psychosocial aspects of your health, do they have the knowledge, experience and confidence to provide a comprehensive care plan that is individualized to your needs? Do they communicate with your other health care team, and will they continue to provide compassionate care for you throughout your entire journey with them? Ideally, the doctor you choose would epitomize all of these qualities.

Related Content

The spinal surgeon at Northwest Neurosurgery says the back surgery he performs now requires only short hospital stays and results in quick recoveries

Horowitch is an internal medicine specialist at Virginia Mason who sees patients throughout their lifetime

With kids spending more and more time staring up close at screens, cases of severe myopia are on the rise. Here's what these University of Washington scientists are doing about it.