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• Addison’s disease (adrenal insufficiency)

• Cushing’s syndrome

• Adrenal nodules

• Pheochromocytoma

• Hyperaldosteronism

• Congenital Adrenal Hyperplasia

Evaluating a person for possible adrenal disease, or managing known adrenal disease is quite complex and time consuming. The tiny adrenal glands that sit on top of our kidneys like little “hats” are some of the most vital glands in the body. They secrete cortisol (our main “stress hormone”), aldosterone (maintains normal blood pressure), and epinephrine (often referred to as “adrenaline”) among other things. When there is too much or too little of any adrenal hormones, we can become pretty ill. Evaluation often includes extensive blood or urine testing, and imaging studies like CT and MRI.

The advantage of working with our practice if you have adrenal disease, is that we have the time it takes to collect all your history and records, explain everything thoroughly, and create a plan that you can feel confident about.

• Osteoporosis and Low Bone Mass (Osteopenia)

• Hypercalcemia

• Hyperparathyroidism

• Vitamin D deficiency

What is osteoporosis?

Osteoporosis is a common chronic disease that causes weak, brittle bones and increases your risk of fractures. Common places for osteoporosis-related fractures are your spine, wrists, and hips. To measure your bone density and diagnose osteopenia or osteoporosis, a DEXA or “bone density exam” is performed- which is like having an xray of your spine, hips and wrist. Dr. Costello has many years of experience interpreting bone density exams, conducts very thorough evaluations, and is up to date on all the latest treatments available. She will also counsel you on lifestyle measures including exercise and nutrition, as they relate to bone health.

How are calcium, parathyroid hormone and vitamin D related to bone health?

Our tiny parathyroid glands (located in the neck) control the level of calcium in our blood. Sometimes they can become overactive and cause an elevated calcium, which can cause kidney stones, bone thinning and issues with muscle function. Vitamin D also plays a role in our calcium level, and is extremely important for bone health and optimal function of many other tissues in the body. Vitamin D deficiency is extremely common, and is best treated under the care of a physician with experience in nutrition and gut health. It is important to be guided toward the right formulation of vitamin D, and to ensure your body is absorbing nutrients properly.

• Type 1

• Type 2

• Gestational

• Prediabetes

• Insulin pump management

• Continuous glucose monitoring

How does our practice stand out when it comes to taking care of our patients with diabetes?

Aside from many years of experience diagnosing and managing all forms of diabetes, Dr. Costello has a unique approach that many of her patients find truly reassuring and refreshing. Diabetes affects all organ systems, and more health care resources are spent on diabetes than any other condition. Prevention, early diagnosis, and aggressive treatment are key factors in managing this disease effectively.

In today’s world of medicine, large practice size and time constraints have had an increasingly negative impact on the quality of care being delivered. Our patients benefit from the extra time and attention that a small practice can provide. Dr. Costello will meet with her patients as long and often as is necessary to ensure all concerns are addressed- from optimizing blood sugars, blood pressure, and cholesterol, to discussing lifestyle and diet. She also works closely with her team to get the best medication pricing possible for her patients.

“Diabetes is often time consuming and expensive. I do everything I can to reduce the burden of diabetes for my patients.”

• Obesity

• Overweight

• Post bariatric surgery care

• Medical weight loss

• Gut health/Microbiome

• Metabolic liver disease

• Polycystic Ovarian Disease

• General Nutrition Education

• Functional Nutrition/Microbiome Health

• Anti-Inflammatory and Clean Eating

• The Mediterranean Diet

• Weight Loss/Maintenance

• Intermittent Fasting

• Carb Cycling

• Prolactinoma

• Hyperprolactinemia

• Hypopituitarism

• Cushing’s Disease

The pituitary gland is located just beneath the brain, and uses hormones to control your endocrine glands. It is often called “The Master Gland”. If a person has certain symptoms, we can conduct blood and urine testing, as well as imaging such as CT or MRI to evaluate for an abnormality in the pituitary.

• Hypothyroidism

• Hyperthyroidism

• Thyroid nodules

• Thyroid cancer

• Thyroid disease during pregnancy