hormone therapy for thyroid disease in seniors
Dr. Jean Chen on Over Treating the Thyroid and Cognitive Decline in Older Adults

The thyroid  is a small gland at the front of your neck that produces hormones which help control several different organ systems. If it’s either underactive (hypothyroidism), or overactive (hyperthyroidism), it could cause serious health issues such as weight changes, fatigue, anxiety/depression, or osteoporosis and may require medication to help better regulate it. 

New research shows though that some hormone medications used to treat thyroid conditions, if administered in excess, may contribute to cognitive disorders in older adults.

This particular study evaluating more than 65,000 patients appeared recently in the JAMA: Journal of the American Medical Association and showed that those 65 years and older who received thyroid hormone therapy were at an increased risk for developing dementia and other cognitive issues, especially those who were aggressively dosed. 

Our endocrinology experts at Texas Diabetes and Endocrinology treat many hormonal issues, including those affecting the thyroid. One of our board-certified endocrinology specialists, Dr. Jean Chen, shared her thoughts on this study for an article in Medscape.

The article stressed the importance of being vigilant when dosing hormone therapy for older adults to avoid the cognitive consequences of overtreatment. 

“Taking a cautious approach to prescribing thyroid hormone therapy for older patients is

paramount,” said Dr. Chen. “All medical providers need to be aware that the 65 and older population does not need to be treated as aggressively with their thyroid hormone.” 

“We are finding more and more complications from overtreatment rather than benefit in this (senior) population.”

Dr. Chen also explained that symptoms of hyperthyroidism can often mimic those of another condition, so it is important to obtain a thorough diagnosis from a primary care physician before automatically adopting any hormone therapies. Our endocrinologists frequently work in close collaboration with other care providers to arrive at the most accurate diagnosis and treatment plan to suit your personal needs. 

Thyroid Specialists in Austin

Our team of endocrinology specialists is experienced at diagnosing and treating all issues affecting the thyroid including hypothyroidism, hyperthyroidism, thyroid nodules, and thyroid cancer. We provide convenient thyroid ultrasound imaging and biopsy procedures on-site in our clinics and will work with you to formulate the most effective treatment plan possible.

Contact Us Today to Learn More about Managing Your Diabetes and Hormones 

If you’d like to schedule an appointment with Texas Diabetes and Endocrinology and discover how our comprehensive endocrinology services can help you, 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 with 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


  • 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.