Forewarning, I am no scientist, doctor, nutritionist. Please don't take my knowledge here as any recommendation.

I felt like writing this post as both a summary of what i've learned, public verification, and hopefully even learn something new! I've been pretty obsessed about keto, fats, and fasting over the last year. Let's talk about chemicals:

• insulin - a chemical often referred to as the "key" for letting energy into our cells and is produced by pancreas in reaction to carbs
• lipase - the chemical that burns our fat into energy
• leptin - a chemical that decreases your appetite
• grehlin - a chemical that increases your appetite
• glucose - a form of carbohydrate in the blood stream that can be turned into energy
• fructose - a form of carbohydrate in the blood stream that can be turned into energy but only processed by the liver
• lipids - fat that can be turned into energy
• glycogen - glucose storages in the liver
• human growth hormone (HGH)- a chemical primarily for protection and repair of protein (muscle) in the body
• insulin like growth factor (IGF) - a chemical that helps our body grow very fast
• cortisol - a chemical that breaks down proteins in our body, release glucose from liver
• HDL cholesterol - cholesterol that moves fat to the liver
• LDL cholesterol - cholesterol that moves fat to the organs of the body

From my understanding these are all the important chemicals at play that go on during fasting and keto that I've wanted to know about to really balance my health. Let's talk about the interplay of these chemicals.

Hunger

• normally fats generate leptin that decrease our appetite
• insulin interferes with the ability of leptin to notify us that we are satisfied (what causes endless carb craving)
• eating low carb means fat is far more satisfying because leptin can fully do it's job
• the feeling of hunger is caused by grehlin, but only spikes and then lasts for 2 hours (max you will ever feel hungry is 2 hours)
• fasting for long periods of time does not make you hungrier, grehlin levels are not any higher when going through a fast, and in fact get less

Burning Fat

• insulin is a response to carbohydrates in the blood
• insulin is a signaler to make store fat, and does this by disrupting lipase from burning fat into energy
• the liver also stores glucuse in glyocogen like a battery which released and is used up when we execise and hit rock bottom amounts of carbs in our system
• human growth hormone increases in hyp

https://www.ncbi.nlm.nih.gov/pubmed/31111407 ; https://sci-hub.tw/10.1007/s40618-019-01061-2

Authors: Caprio M, Infante M, Moriconi E, Armani A, Fabbri A, Mantovani G, Mariani S, Lubrano C, Poggiogalle E, Migliaccio S, Donini LM, Basciani S, Cignarelli A, Conte E, Ceccarini G, Bogazzi F Cimino L, Condorelli RA, [La Vignera S](https://www.ncbi.nlm.nih.gov/pubmed/?term=La%20Vignera%20S%5B

I know you’re going to say it’s all in my head like my family always tells me. I finally did get surgery but it didn’t help and now my endocrinology labs are all relatively normal (except for high FSH).

AAPA salary report didn't offer a lot in pediatric subspecialties so I just want to make sure I don't get a horribly low ball offer.

https://twitter.com/igbutt/status/1221751889185759232?s=20

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Hello fellow T1Ds! I am a current ICU nurse, and was diagnosed with T1D as a child. I am finishing my last year of nurse practitioner school this year, and looking to specialize in endocrinology.

As I prepare for this role transition, I am curious as to what has been the most/least helpful to you as a T1D. that your provider (MD or NP) has or hasn’t done for you. Thank you in advance for sharing your wisdom.

I'm currently a second year student studying History and Japanese (more on this in a second) and am considering doing a degree shift.

I am interested in medicine and in particular, in endocrinology. I am somewhat interested in sexual health and general practice as well but mostly in endocrinology. I'm a trans person and the medical services available in New Zealand for us are... fucking stone age. Like it's so far behind it's a joke. I'd want to go into endocrinology and specialize in helping and working with transgender patients and (hopefully) make some form of difference the treatment options in NZ. (Whether that be by starting my own clinic or working with Auckland Sexual Health Services or just some way I can help.) I am completely uninterested in taking surgery (I'm not squeamish, but my hands are a little shaky and I'm not too good with finicky work so it would be a bit out of my reach).

My issue is I have no idea what path I would follow to get into this field and if it would even be possible at this point. Like I said, second year student at the moment and am majoring in arts at the moment. (Also, I have no idea how long a degree to get me to a career in endocrinology would take me. I'm 20 at the moment so I know it'll be before I turn 30 but it's still a long time if I remember correctly.)

I do absolutely love Japanese and History (Japanese history and the 2 World Wars because I'm basic as fuck...) but I feel like the degree may be slightly umm... not useful in the slightest. (Something I took mainly cause I was just interested in it and wasn't planning for future. :/)

Is it too late to change? What would the process be like? Is it worth changing? What career paths do I have in my current path?

One other one I have had in mind is going into Computer Sciences although I've heard from some people in the industry that a degree in this isn't particularly helpful? How accurate is this?

I had a laparoscopy 6 days ago with confirmation of endo, some excision (I think) and some adhesions on my bowel released. GYN wants to see me this week (1 week after), when before he told me the standard was 4-6 weeks after. So I'm trying not to think too much about what that might mean.

Anyway, this diagnosis was a long time coming...meaning that I had severe symptoms when I was 13 and now I'm 35. For some reason the pain was less severe between when I was 21 and 33. My sister and mother also had severe pain symptoms, my mother had a hysterectomy at 40 but didn't get diagnosed with endo (not that that means she didn't have it). My sister has bipolar and my mother probably does as well. I have depression and anxiety which I feel are directly correlated to my menstrual cycle...I have been given a diagnosis of PMDD a couple of times. Both my sister and have chronic insomnia and take quetiapine to sleep.

I suppose my issue is how to manage my care in the face of there not being any coordination whatsoever between professionals. I want all the knowledge, across specialties to be applied to my case. My Gyno is supposedly a specialist in Endo but hadn't heard of PMDD. I don't know if there is a validated link between the two but mood issues are listed as a symptom of endo on many lists I've seen. I've been put on a number of BCPs over the years (of course without any proper diagnosis) in attempt to manage a number of theorised hormone related issues (acne, pain, severe pms). Most of them made me suicidal or hallucinate (awesome!), Yaz was great for a few years but then my hair started falling out...which one Gyn said can happen as your natural hormone profile changes with age.

My main concern up until 2 yrs ago were my moods and insomnia. I definitely saw some improvement in mood symptoms after I ended a very difficult relationship, ate better, Exercised regularly etc. but the insomnia has persisted, masked now by the medication. My own theory was, if this is all hormonal like I suspect, if I can get an accurate diagnosis of that and get treatment, then I could finally get off the sleep meds and have a clear head. I always feel like I am not firing on all cylinders and I would really like to have experienced my brain at full capacity.

So I went to see an Endocrinologist 8 months ago because I thought SURELY there is a way to take hormone levels accurately and supplement them specifically for my body. I was done with being a guinea pig...give me some SCIENCE

Endocrinology appointment is on Friday and I have no idea what the process is beyond that. I gave them my blood, I started with my therapist, I want my testosterone.

It has been a while since I reviewed endocrinology, and it seems that I have forgetten some stuff . So, sorry if this too stupid.

One card say that thyroid hormones cross BBB and the other says that brain tissue actually have 5' deiodinase and it converts T4 to T3 even in times of starvation. Of course brain tissue needs thyroid hormones for upregualtion of metablism. So does the card which says that Thyroid hormone don't cross BBB is wrong? Someone clear the confusion plz

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Little background. Im 19. Recently diagnosed after having a miscarriage and not being able to get pregnant since (almost 10 months) My main doctor is a family doctor who said I had PCOS and put me on Sprionolactone because of my high testosterone. I just had my first Endocrinology appointment and she took me off the sprionolactone but didn't put me on anything else for fertility wise. She said she doesn't recommend metformin as it doesn't work or something??? My insurance doesn't cover reproductive endocrinology which she said I would need to get the other fertility drugs. She also doesn't seem to think my hormonal imbalances are causing infertility?????? Since I got pregnant originally 4 months after stopping birth control. She also said she wasn't going to test for insulin resistance because she "can tell by looking at my weight" quote on quote. She also wanted to see my stretch marks? Not sure if that's normal for an endocrinologist to do. I just don't know what to do anymore. She said the only thing that will help me and my PCOS is weight loss but its so hard to loose weight. Even if i starve myself I don't loose weight. She also told me to look into weight loss surgery as apparently that's the only option. I just don't know what to do anymore. Every doctor keeps trying to push me off to a different doctor.

Physeo and Pathoma haven't been helpful

Endocrine vignettes are more integrated b/c they present as more "multi-system"... so, i'm having trouble picking out relevant clues in the vignettes

Hello! I’m a trans college student pre-HRT. I’ve been talking with my college’s health center and, while they can’t prescribe me Hormone Treatments, they were able to give me a referral to an Endocrinologist semi-nearby. The only problem with that is that the earliest appointment they can get me is February 17th.

I really don’t want to wait that long, and I noticed the pinned post on this sub discusses Planned Parenthood clinics. While there’s not one too close to me, there is one in my hometown where I’ll be over Thanksgiving break. I just don’t know how good of an idea it is to go that route when I already have an outside appointment set up.

What should I do here? Cancel my appointment and contact PP? Grit my teeth and stick it out? I’m willing to elaborate on anything further if I need to; I just could really use some advice right now. Thank you!