Clinical Trial Offers HypoPARA Patient New Lease on Life

Life with hypoparathyroidism has been a challenging journey for a Texas Diabetes patient,
who for the purposes of this blog will be referred to as “the patient”. Diagnosed at the age of
23 after their parathyroid glands were removed during thyroid cancer surgery, the 54-year old
Frisco resident has lived with the condition for over three decades.

Hypoparathyroidism is a rare condition where the parathyroid glands, located near the
thyroid in the neck, produce insufficient amounts of parathyroid hormone (PTH). PTH plays
a critical role in regulating calcium, phosphorus, and vitamin D levels in the blood and
bones.

“When I was diagnosed, there was no treatment for the disease, just medications to
manage the symptoms,” the patient recalls. Over the years, they relied on an exhausting
regimen of medications—up to 64 pills a day, taken every three hours—to keep their
calcium levels stable and avoid severe symptoms. Despite their best efforts, they faced
over 200 hospitalizations due to low calcium levels.

In 2019, the patient learned about a clinical trial for TransCon PTH, a new hormone
replacement therapy designed to restore physiologic levels of PTH. After speaking with
their endocrinologist, they applied to participate in the trial the day it went live on
ClinicalTrials.gov.

Within a week, they were contacted by Texas Diabetes & Endocrinology Research team to
begin the screening process. “The first four weeks were spent getting my blood levels
optimized for the trial,” they explain. The staff at Texas Diabetes played a critical role in
guiding them through this phase. “They communicated frequently and really walked me
through the process. It felt like I was the only patient they were working with.”

After successfully completing the optimization phase, the patient began the daily
injections, not knowing at the time if they were receiving the actual drug or a placebo.
Although the treatment regimen wasn’t easy at first, the team at Texas Diabetes was there
to support them.

Seeing Results

Soon, the patient experienced results beyond what they could have imagined – confirming
in their mind that they were receiving the actual drug. For the first time in decades, their
calcium levels stabilized, allowing themto gradually reduce and ultimately stop taking
daily pills.

“In less than six months of starting the trial, I was able to come off all my medications,”
they said. “I hadn’t been in range in over 30 years, and suddenly, I was.”

As their body adjusted to the new treatment, the symptoms that had plagued them for
years—numbness, tingling,muscle cramps, heart palpitations, fatigue and brain fog—
began to disappear.

“I didn’t realize how much brain fog I was living with until it lifted. I couldn’t remember the
names of everyday objects, and I would struggle to getmy thoughts out. But now, I feel like I
can think clearly again.”

Advocating for Change

With their newfound energy, the patient began volunteering for the HypoPARAthyroidism
Association
, a nonprofit dedicated to raising awareness and support for those living with
the condition. Passionate about helping others, their volunteer work quickly turned into
accepting a position on the board and eventually a full-time role with the organization.

One of their proudest accomplishments is spearheading an Externally Led – Patient
Focused Drug Development meeting with the FDA for PTH.

“You can read about symptoms on a page, but that doesn’t tell you how it impacts
someone’s daily life,” they explain. “I wanted the FDA to understand how
hypoparathyroidism affects real people.”

The meeting brought together patients and experts to share their experiences with the FDA.

Looking Forward

The FDA approved TransCon PTH and it is expected to come to market in early 2025. The
patient is grateful to Texas Diabetes for applying to be an early access provider so they can
continue to take the medication while waiting for it to become available.

Reflecting on their decades long journey, the patient emphasizes the importance of clinical
trials in advancing treatment options for rare conditions. “There’s a misnomer that you only
do a clinical trial when it’s your last hope, but that’s not the case” they say. “The drug has
given me a chance at life again, and I can’t thank Texas Diabetes enough for giving me the
opportunity to feel like a new human being.”

The patient hopes their story will inspire others to consider participating in clinical trials
and raise awareness of the transformative power they hold. “If I had to do it all over again, I
would, in a heartbeat. It has been life changing.”

You can learn more about our research department and currently enrolling clinical trials here. Please feel free to contact us at (512) 334-3505, option 4, to speak to a recruiter about our enrolling studies.

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menopause and diabetes
What should you know about menopause and diabetes?

There’s no doubt that cases of diabetes are on the rise. In fact, experts predict that by the year 2050, one in every three adults in the United States could suffer from this chronic disease that disrupts hormones, affects how the body reacts to food and sugars (glucose), and can lead to obesity, heart disease and stroke if not managed properly.  

At Texas Diabetes & Endocrinology (TD&E), our board-certified endocrinology experts treat diabetes, along with other endocrinology disorders like osteoporosis, every day. 

One group in particular that is experiencing an uptick in diabetes diagnoses is menopausal women.  During menopause, estrogen levels decrease (because of diminishing ovarian reserves) which can cause weight gain leading to potential insulin resistance and difficulty metabolizing glucose. 

New research now shows that Type 2 Diabetes (T2D) is one of the most common health risks associated with postmenopausal women (up to age 55 years). 

This particular study evaluated 2,295 postmenopausal women and surveyed them and their propensity towards diabetes via blood tests, physical exams and measurements, and in-person interviews. 

Here’s what was found:

  • Lower levels of the hormones estrogen and progesterone are key factors in contributing to more cases of T2D in women over the age of 40
  • The prevalence of T2D increased in women with a greater BMI (Body Mass Index) and also elevated cholesterol levels 
  • Mood swings and hot flashes associated with menopause can cause poor sleep which is also a contributing factor to obesity, and therefore diabetes 

One of the most important things women can do to prevent diabetes brought on by menopause is to get screened.

“In support of recommendations by the American Diabetes Association, we suggest getting tested for diabetes every three years after the age of 45 if you are overweight or have a family history of the disease,”  says TD&E board-certified endocrinologist and diabetes expert Dr.  Jean Chen.

“Additionally, adopting a healthy lifestyle including eating a well-balanced, low fat and low cholesterol diet, and exercising regularly incorporating weight-bearing workouts can go a long way in helping to prevent diabetes as women approach menopause and this transitional phase in life.”

Diabetes Treatment for Women in Menopause 

Hormone Therapy (HT), or hormone replacement therapy and estrogen supplements, is the standard treatment for women experiencing severe menopausal symptoms. HT can help balance and regulate hormones which are depleted and improve symptoms like hot flashes, help with insulin function, and decrease the potential for developing diabetes. 

HT has also been shown to reduce the risk of osteoporosis (weakened bones), another common condition as women reach menopause. 

At TD&E, we offer individualized treatment plans to help effectively manage your diabetes through tools like weight management and insulin pumps.  We also provide extensive treatment options for osteoporosis and fracture prevention.  

Contact Us to Help Manage your Diabetes, Osteoporosis and Thyroid Conditions 

If you’d like to schedule an appointment with one of our specialists at Texas Diabetes & Endocrinology and discover how our diabetes services  and other endocrinology therapies can help you lead a full and active life, please contact us at (512) 458-8400 or request an appointment online.  

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

hyperparathyroidism
What is Hyperparathyroidism?

At Texas Diabetes & Endocrinology, our board-certified endocrinology experts treat a number of endocrinological conditions including diabetes and thyroid disease. We also treat some less common hormone-related conditions such as hyperparathyroidism causing hypercalcemia.

What is hypercalcemia?

Hypercalcemia is caused by above normal calcium levels in your blood. Excess calcium in the blood can lead to weakened bones or osteoporosis, kidney stones or kidney failure, and even heart issues such as arrhythmia.  

What are some common symptoms of hypercalcemia?

Hypercalcemia is typically caught early as part of a routine blood test. However, long-term hypercalcemia can cause issues in the body near the region where the blood is most concentrated with calcium. Examples of some common hypercalcemia symptoms and associated areas include: 

  • Frequent urination or excessive thirst (kidneys)
  • Upset stomach, nausea, vomiting or constipation (digestive system)
  • Sore bones and muscles (skeletal and muscular systems)
  • Confusion, depression or fatigue (the brain)
  • Palpitations or arrhythmia/irregular heartbeat (the heart and circulatory system)

What causes hypercalcemia? 

Hypercalcemia can be caused by overactive parathyroid glands (hyperparathyroidism) or a parathyroid tumor. Other contributing factors that may potentially lead to hypercalcemia are:

  • Certain cancers like lung or breast cancer, or any cancer that has spread to the bones
  • Genetics and a family history of hypercalcemia 
  • Diseases such as tuberculosis that can elevate vitamin D levels in the blood and lead to more calcium absorption in the body
  • Dehydration
  • Certain medications or overuse of  calcium or vitamin D supplements 
  • A sedentary lifestyle causing bones to weaken, break down, and secrete calcium into the bloodstream

After a confirmed hypercalcemia diagnosis, your provider may recommend additional imaging tests to examine your parathyroid glands to determine if hyperparathyroidism is causing hypercalcemia. 

How is hyperparathyroidism treated? 

For mild cases of hyperparathyroidism,  our endocrinologists may recommend close monitoring and limiting supplemental calcium. 

For more advanced cases, surgical removal of the parathyroid glands may be necessary. Typically, only one of the four parathyroid glands are affected but all four could be involved.

Contact Us to Help Manage your Hyperparathyroidism 

If you’d like to schedule an appointment with Texas Diabetes & Endocrinology and discover how our diabetes services  and other endocrinology therapies can help you lead a full and active life, please contact us at (512) 458-8400 or request an appointment online.  

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

nder affirming hormone therapy
Texas Diabetes Offers Gender Affirming Hormone Therapy

Texas Diabetes and Endocrinology’s team of board-certified endocrinology experts treat common endocrinology issues which are closely associated with the body’s hormonal system. 

One of the services we offer patients is gender affirming hormone therapy. In this blog, Dr. Valerie Espinosa explains everything you need to know about the gender affirming hormone therapy we offer in Austin, TX. 

What is gender affirming hormone therapy? 

This form of treatment is used in transgender and non-binary patients in order to help better align the body with a person’s gender identity, whether it be feminizing or masculinizing therapy. 

Feminizing therapy is mainly achieved with the administration of the hormone estradiol in transgender women and non-binary individuals. 

While estradiol is the mainstay of treatment, other medications may sometimes be

added (such as progestins and anti-androgens). Treatment with these medications induces several physical changes that are more consistent with a feminine appearance. These changes

include:

  • Breast development
  • Less facial and body hair
  • Softer skin
  • More body fat and a decline in muscle mass
  • Smaller testicles
  • Lower libido and fewer erections

Masculinizing therapy which uses testosterone in transgender men and non-binary individuals will also bring about several physical changes which include:

  • Cessation of the menstrual cycle
  • Deepening of the voice
  • Growth of facial and body hair
  • Clitoral enlargement
  • Increase in strength and muscle mass

How long does it take to see changes with gender affirming hormone therapy?

Changes generally start to occur within a few months, but full effects may not become apparent

until two to five years after starting hormone therapy.

What are the possible risks and side effects? 

Gender affirming hormone therapy does not come without serious risks/side effects. 

Estrogen-related side effects are: 

  • Blood clots
  • Higher cholesterol
  • Elevated prolactin
  • Weight gain
  • Hypertension
  • Potential for stroke
  • Mood changes, anxiety or depression 

Testosterone-related side effects are:  

  • Weight gain
  • Acne
  • Male pattern baldness
  • Higher cholesterol
  • Hypertension
  • Sleep apnea
  • High red blood cell counts
  • Blood clots

Both hormones will cause the transgender individual to develop infertility, which may or may

not be permanent.

What is the process to begin gender affirming hormone therapy?

Prior to starting therapy, we require a physician referral. Then, we will provide patient education including the risks and benefits of treatment to ensure that you are well informed enough to consent to treatment. Following this initial step, you will:

1.         Undergo a complete medical evaluation, including physical exam and laboratory diagnostics, to determine any treatment risks.

2.         Learn about and discuss options for fertility preservation. 

3.         Seek a mental health evaluation in order to confirm a gender dysphoria diagnosis and to rule out any co-existing mental health issues.

Once you have begun your hormone therapy, you will visit with our providers on a regular basis so that we can track your response to treatment and check for any signs of complications. 

We are ready to facilitate your journey through this process.

If you’d like to learn more about our gender affirming hormone therapy services, please call Texas Diabetes and Endocrinology at (512) 458-8400 or request an appointment online.  

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

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