Endocrinology Aims to Understand How Hormones Work in Our Bodies

“I think of it as a puzzle, finding the needle in the haystack.” Shannon Haggerty, M.D., on the challenges of studying hormones—and how that affects our bones.

Illustration by Paul Ryding

Shannon Haggerty, M.D.
The Christ Hospital – Diabetes & Endocrine Center—As told to Amy Brownlee

A lot of people think endocrinology is purely about diabetes, but it’s so much more. It’s the study of the hormones in the body. The pancreas secretes insulin, so we are often treating type 1 and 2 diabetes. But we also look at the pituitary gland, the thyroid gland, the adrenal gland, and the pancreas. And then there are the reproductive organs: the testicles and the ovaries. There are, unfortunately, with all of these organs in the body, several things that can go wrong. Within just the pituitary, there are many diseases that can occur—things that can be crucial to our daily functioning and how we feel every day.

In our outpatient clinic [at The Christ Hospital], we work on managing more chronic problems. For patients who have certain hormone deficiencies, it’s about long-term management. Initially when I see patients, I spend the majority of the time educating. A lot of them will read the internet, and we have to take what we read with a grain of salt; it’s not exactly scientifically based. A lot of times that’s eye-opening to patients. I try to steer them to where they can find better forms of information.

A lot people come to me and ask, “Is there a thyroid diet?” Unfortunately, the answer is “No.” We promote a healthy lifestyle. It’s more about having that balance. All of those things can help with general well-being, which supports the endocrine system.

I originally thought I wanted to do hematology and oncology, but it was quite an emotional rotation. And endocrinology was exciting. I think of it as a puzzle, finding the needle in the haystack.

I really like treating patients who have osteoporosis. When you think about osteoporosis, you don’t typically think about hormones. But vitamin D is metabolized as a hormone in our body, and it’s important for the absorption of calcium.

The hard thing with osteoporosis is that it’s not diagnosed until people experience fractures. There are bone density screening protocols, but most people are diagnosed after a fall. A hip fracture has a significant amount of morbidity and mortality associated with it. You have this immobility, [and] it’s a vicious cycle. You’re more at risk for other infections and blood clots. Depression and apathy start to take over. It’s really hard on those patients. After screening, we look at the thyroid, the parathyroid, vitamin D, and calcium levels. We try to treat both the causes and the symptoms: Why is there a deficiency, and how can we build new bone density?

There are several classes of drugs and several new groups of drugs that are helping to build new bone. A new one called Evenity was recently approved.

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