FAQs

Glucagon-Like Peptide 1 (GLP-1) is released by specialized cells found throughout the intestines called L cells. GLP-1 release occurs in 2 phases within an hour of eating a meal. GLP-1 increases insulin release from the pancreas and lowers blood sugar levels. In the stomach, GLP-1 slows stomach emptying resulting in a feeling of satiety and fullness. It also acts directly on receptors in the hypothalamus signaling a similar feeling of fullness and satiety. This is where and how GLP-1 receptor agonists such as Wegovy (semaglutide) work!

GIP (glucose-dependent insulinotropic polypeptide formerly known as gastric inhibitory polypeptide) is released by K cells located primarily in the small intestine. Like GLP-1, it increases the release of insulin from the pancreas. like GLP-1, it also stimulates satiety and fullness in the brain and hypothalamus. Zepbound (Tirzepatide) works by activating both GLP-1 and GIP receptors.

Carrying excess weight or being obese heightens the likelihood of developing a wide range of medical conditions. Not maintaining a healthy body weight increases the risk of heart disease, endocrine disorders such as diabetes, joint problems, digestive tract issues such as gallbladder disease, respiratory problems such as sleep apnea and even increases the risk of certain cancers.

Insulin is a hormone produced by the beta cells of the pancreas. Its primary function is to regulate blood glucose (sugar) levels. Simplistically, when the body is not producing insulin, you have Type I Diabetes. When the body becomes resistant to insulin or produces less insulin than needed, you have Type II Diabetes.

Yes, there are several alternatives to Synthroid (levothyroxine) if you need thyroid hormone replacement. The goal is to find the medication that works best for you, which may depend on your individual needs, response to treatment, and any underlying conditions.

Here are some alternatives:

1. Other Levothyroxine Brands
   Levothyroxine is the synthetic form of thyroid hormone T4 (thyroxine). While Synthroid is the most well-known brand, other formulations of levothyroxine are available, including Euthyrox, Eltroxin, Levoxyl, and Unithyroid. These are essentially the same hormone but may vary slightly in their formulation and inactive ingredients, which can affect absorption or tolerance in some people.
2. Liothyronine (Cytomel)
   Liothyronine is the synthetic form of T3, the active thyroid hormone. Some people feel better when they take both T3 and T4 together. Liothyronine is typically prescribed when there's a need for faster absorption or more immediate thyroid hormone activity.
3. Desiccated Thyroid Extract (DTE)
   DTE is derived from the thyroid glands of pigs and contains both T3 and T4 hormones in a “natural” form. It’s available under brand names like Armour Thyroid or Nature-Throid. It is not typically the first-line treatment because it can have variable hormone levels and is not standardized.
4. Combination Therapy (T3 + T4)
   Some patients may benefit from a combination of both T4 (levothyroxine) and T3 (liothyronine).

In order to provide my patients with the time and follow up they need, we have opted not to participate with health insurance companies. Longer appointments are now able to be scheduled in a more timely fashion. Follow-up appointments are also easier to schedule. I never want you to feel rushed and I certainly do not want you to leave any visit without all of your questions being answered.

The short answer is yes. The longer answer is these studies should be covered to the extent of your insurance coverage. Any labs, radiology studies, and prescriptions ordered by Dr. Greenwald will be covered as per routine by Medicare or your private health insurance.

I am always reachable through the patient portal which I check daily. Myself or one of my endocrinology associates is always available by phone.

It is a very simple process that will be explained to you at your initial visit.