3125 Bailey Dr · Bldg 6, Unit 120 · Fort Worth, TX 76177
Clarity · Compassion · Connection
Rooted in expertise. Centered on you.
✓ Board-certified specialists
✓ Rheumatology & endocrinology expertise
✓ Care shaped around the individual
Our specialties
Expertise that sees the whole picture.
Health concerns can overlap. ArthritisPlus and ThyroidPlus bring rheumatology and endocrinology together at one convenient Fort Worth location.
+01 / JOINT & IMMUNE HEALTH
ArthritisPlus
Rheumatology & Osteoporosis Center
Arthritis is only part of the picture. We consider joint pain and swelling alongside rashes, dry eyes or mouth, finger color changes, and other symptoms to guide a careful diagnosis and individualized management.
Dr. Swamy's clinical interests include systemic autoimmune disease, inflammatory myopathy, and autoimmune conditions that affect multiple organ systems. His approach emphasizes diagnostic reasoning, patient understanding, and individualized management.
+02 / HORMONAL & METABOLIC HEALTH
ThyroidPlus
Endocrinology & Diabetes Center
ThyroidPlus means comprehensive endocrine care: thyroid health plus all types of diabetes mellitus and the hormonal conditions that affect metabolism, bones, and overall health.
Dr. Saiprasad has extensive experience with continuous glucose monitoring, insulin pumps, and automated insulin delivery systems. Her clinical expertise also includes thyroid cancer follow-up, obesity, metabolic bone disease, and women's endocrine health.
Our approach to care
You deserve to feel heard.And to understand what comes next.
Your symptoms, concerns, and goals guide the conversation. We listen to understand how your health affects daily life, explain what we find in language you can understand, and discuss the next steps together. Our aim is a thoughtful care plan that fits your medical needs and personal priorities.
01
Clear explanations
We explain findings, diagnoses, and treatment options, including benefits and risks, and welcome your questions so you can take part in decisions about your care.
02
Attentive listening
We make understanding your story a priority: what you are experiencing, what concerns you most, and what you hope to achieve through treatment.
03
Individualized care plans
We consider your medical history, other health conditions, daily routine, and preferences when planning evaluation and treatment. Follow-up provides an opportunity to discuss progress and adjust the plan.
Meet your physicians
Experienced specialists. Personal connections.
Clinical expertise, a commitment to education, and a shared belief in care that treats you as a person.
Rheumatology
Narayana Swamy, MD
MRCP (UK)Board-certified rheumatologist
Dr. Swamy is a board-certified rheumatologist, clinician, and educator with more than a decade of medical practice and international training and clinical experience in India, the Caribbean (Jamaica), and the United States. His background includes rheumatology training in India, internal medicine training in Jamaica and at Creighton University, and a U.S. rheumatology fellowship at the University of Virginia. He cares for patients with inflammatory arthritis, lupus, vasculitis, other autoimmune conditions, and osteoporosis. His approach emphasizes careful listening, thorough evaluation, clear explanations, and individualized treatment plans that consider the whole person, alongside a commitment to patient education and clinical teaching.
Training & professional background
Rheumatology fellowship, University of Virginia
Internal medicine residency, Creighton University
ABIM board certification in rheumatology and internal medicine
Member of the Royal College of Physicians, United Kingdom
Clinical teaching and mentorship of internal medicine residents
His academic and clinical interests include lupus, Sjögren disease, vasculitis, inflammatory myopathy, osteoporosis, and autoimmune endocrine overlap disorders.
Dr. Saiprasad is a board-certified endocrinologist, clinician-scientist, and educator with more than a decade of U.S. endocrine practice and international training and clinical experience in India, the United Kingdom, and the United States. Her background includes medical training in India, internal medicine training in Leeds, UK, and internal medicine residency and endocrinology fellowship at Creighton University. She cares for patients with all types of diabetes mellitus, thyroid disease, osteoporosis, and complex hormonal conditions. Her approach emphasizes careful listening, clear explanations, patient education, and individualized treatment plans, with experience in continuous glucose monitoring, insulin pumps, and automated insulin delivery.
Training, fellowships & academic background
Endocrinology fellowship, Creighton University Medical Center, 2013–2015
Internal medicine residency, Creighton University Medical Center, 2010–2013
ABIM board certification in endocrinology, diabetes and metabolism, and internal medicine
Fellow of the Royal College of Physicians of London — elected August 2026
Fellow of the Royal College of Physicians and Surgeons of Glasgow — elected June 2026
Assistant Professor, Department of Medical Education, Texas Christian University Burnett School of Medicine
Scholarly Pursuit and Thesis Mentor, TCU Burnett School of Medicine
Endocrine Research Mentor, Baylor Scott & White All Saints internal medicine residency program
The FRCP fellowships recognize professional distinction and contributions to medicine through peer nomination and election.
Clinical interests, leadership & recognition
Diabetes, including latent autoimmune diabetes in adults (LADA)
Thyroid, adrenal, pituitary, calcium, and parathyroid disorders
Osteoporosis, metabolic bone disease, obesity medicine, and endocrine hypertension
Advanced diabetes technology and individualized glycemic care
Editorial Review Board Member, Clinical Medicine Insights: Endocrinology and Diabetes (SAGE); Guest Editor, Cureus
Voting Delegate, Texas Medical Association House of Delegates
Top Doctor — Endocrinology, Fort Worth Magazine, 2024
Endocrine Society Clinical Fellows Abstract Award, 2015
Peer Reviewer of the Month, Quantitative Imaging in Medicine and Surgery, June 2026
Full Member, Sigma Xi — elected April 2026
Volunteer endocrinologist at health camps serving underserved Dallas–Fort Worth communities
Her research focuses on autoimmune diabetes, insulin pump therapy, automated insulin delivery, and glycemic outcomes. She also contributes to public education through televised interviews and clinical teaching.
Bring the information that helps your physician understand your health history and the questions that matter most to you.
1
Gather your health information
Prepare a current medication list, relevant laboratory results and imaging reports, and notes from previous specialists if available.
2
Write down your questions
Consider your symptoms, when they began, and how they affect your day. Bring questions and your priorities for the visit.
3
Check appointment details
Call 817-674-2983 for appointment information. Confirm referral requirements and insurance participation before your visit.
A few questions you may have
How can I get appointment information?
Please call our shared office number at 817-674-2983 for updates on our anticipated opening around December 2026 and appointment information. Online scheduling is not available through this website.
What is the status of insurance credentialing?
Insurance credentialing is ongoing through TIOPA and with Medicare and Blue Cross Blue Shield. Participation is pending and has not yet been confirmed. Please call 817-674-2983 to verify your specific plan before scheduling.
Verify your benefits and any referral requirements with your insurance plan.
Will I need a referral?
Referral requirements depend on your insurance plan and the practice's scheduling process. Please call the office for guidance before arranging your visit.
Where will the office be located?
Both practices are located at 3125 Bailey Dr, Bldg 6, Unit 120, Fort Worth, TX 76177. Open directions.
Will there be a patient portal or online visits?
Please call the office to ask about patient portal access and telemedicine availability.
Patient education by specialty
Explore your patient education guides.
Rheumatology
Arthritis, autoimmune conditions, and related care.
Explore 11 journal articles by our physicians and collaborators. Case reports describe individual experiences and help raise clinical questions; they do not establish that a treatment will work for every patient.
Published online · In press
Apparent Refractory Type 2 Diabetes in Extreme Obesity: Marked Improvement Following Automated Insulin Delivery.
Saiprasad S, Swamy N. AACE Endocrinology and Diabetes. Published online August 27, 2026; journal pre-proof.
Saiprasad S, Swamy N, et al. Automated Insulin Delivery in Two Octogenarians With Type 2 Diabetes: Improved Glycemic Control and Reduced Treatment Burden. Submitted to AACE Endocrinology and Diabetes. Under review as listed in the October 2026 CV; not a published article.
Conference presentations & invited teaching
Conference work is listed separately from journal publications. November 2026 presentations below are upcoming as listed in the CV.
Synchronous Warthin-Like Variant Papillary Thyroid Carcinoma and Hürthle Cell Adenoma in the Setting of Chronic Lymphocytic Thyroiditis. Upcoming: ATA annual meeting, Philadelphia, November 2026.
Synchronous Large Hürthle Cell Carcinoma and Papillary Thyroid Microcarcinoma Within the Same Lobe: Diagnostic and Management Implications. Upcoming: ATA annual meeting, Philadelphia, November 2026.
Antibody-Negative Thyrotoxicosis Treated With Methimazole: A Diagnostic Pitfall of Destructive Thyroiditis. Upcoming: ATA annual meeting, Philadelphia, November 2026.
Autoimmune Clustering: Dysglycemia in Hashimoto’s Thyroiditis as an Early Indicator of Latent Autoimmune Diabetes in Adults. Upcoming: ATA annual meeting, Philadelphia, November 2026.
Infection-Associated Transient Neutropenia Mimicking Methimazole-Induced Agranulocytosis. Upcoming: ATA annual meeting, Philadelphia, November 2026.
Late Recurrence of Graves Disease Five Decades After Radioactive Iodine Ablation With Persistent Thyrotoxicosis and Thyroid Eye Disease. Upcoming: ATA annual meeting, Philadelphia, November 2026.
Transient Neutropenia Resembling Methimazole-Induced Agranulocytosis in Graves’ Disease. Baylor Scott & White All Saints Scholars Day, April 2026.
Late Recurrence of Graves’ Hyperthyroidism With Thyroid Eye Disease Approximately Five Decades After Radioiodine Ablation. Baylor Scott & White All Saints Scholars Day, April 2026.
Missed Autoimmune Diabetes: Latent Autoimmune Diabetes in Adults in the Setting of Autoimmune Clustering. Baylor Scott & White All Saints Scholars Day, April 2026.
When Type 2 Diabetes Isn’t Type 2: A Case Report. Baylor Scott & White All Saints Scholars Day, April 2026.
Risk of alopecia areata among rheumatoid arthritis and psoriasis patients treated with TNF inhibitors. Society for Investigative Dermatology, 2026; Poster 0550.
Assessing the relationship between vitamin D levels and risk of major adverse cardiovascular and thromboembolic events in patients with hidradenitis suppurativa. Society for Investigative Dermatology, 2026.
Transient Osteoporosis in Pregnancy. AACE, 2014.
Disseminated Histoplasmosis with Bilateral Adrenal Gland Enlargement in an Immunocompetent Host. AACE, Philadelphia, May 2012.
Life-Saving Interventions in Group B Streptococcal Toxic Shock Syndrome. ACP, Omaha, October 2011.
Stressful life events and onset of rheumatoid arthritis. Scientific conference presentation.
Vasculitis and Sjögren’s Syndrome. Scientific conference presentation.
A Case of Diffuse Idiopathic Skeletal Hyperostosis. Scientific conference presentation.
Overview of Biologic Agents in Rheumatology. Invited Grand Rounds, Riverside Regional Medical Center, 2018.
Painlessly Percolating: A Feverish First. Saiprasad S. ACP, Omaha, October 2010.
Treatment-Responsive Autoimmune Encephalitis. Saiprasad S. ACP, Omaha, October 2011.
Anti-NMDA Receptor Encephalitis: An Emerging Autoimmune Brain Disease. Saiprasad S. AMA Research Symposium, New Orleans, November 2011; also an oral presentation at SGIM, Chicago, September 2011.
Rare Case of Clostridium butyricum Sepsis in an Immunocompromised Adult. Saiprasad S. Oral presentation, SGIM, Chicago, September 2011.
Identification of Endocrine Disorders and Appropriate Referral Pathways in Primary Care. Saiprasad S. Invited educational lecture, West Fort Worth, 2022–2023.
Statin Use in Clinical Practice. Saiprasad S. Invited Grand Rounds, Riverside Medical Group, September 2016.
Extramedullary Hemophagocytosis Complicating a Case of Primary Mediastinal Germ Cell Tumor. Saiprasad S. Grand Rounds, St James’s University Hospital, Leeds, November 2006.
Treadmill Training and Its Effectiveness in Stroke Rehabilitation. Saiprasad S. Grand Rounds, Chapel Allerton Hospital, Leeds, October 2003.
Invited book contribution
Saiprasad S. “Disruptive Physician: Hostility Toward Learners, Nurses, and Other Healthcare Professionals in High-Stress Clinical Environments.” Section 13.4.13, Professionalism in Global Health Education Within the Rapidly Evolving AI Landscape (2026). Invited contribution authored and submitted; publication status not yet confirmed.
Research in preparation
Short- and Long-Term Glycemic Outcomes Following Closed-Loop Automated Insulin Delivery in Adults With Type 2 Diabetes and LADA. Manuscript in preparation.
Improving Detection of LADA Among Patients Referred With Type 2 Diabetes. Quality improvement; manuscript in preparation.
Improving Glycemic Outcomes Following Initiation of Insulin Pump Therapy in Adults With Diabetes. Quality improvement; manuscript in preparation.
Patient education
Understand your condition. Prepare for your care.
Practical guides to questions patients bring to rheumatology and endocrinology visits. Several topics connect with our physicians’ publications; recommendations also draw on established professional patient resources.
General education does not replace an individual evaluation. Your clinician’s personalized instructions take priority. For a medical emergency, call 911.
Rheumatology patient education
Rheumatology
Arthritis plus other symptoms: seeing the whole picture
Joint pain may be one part of a broader condition. Tell your rheumatologist about symptoms elsewhere in your body—even when they seem unrelated.
Read the guide
What the “Plus” means
ArthritisPlus means looking beyond arthritis to understand your whole health. Joint pain or swelling may occur alongside a rash, dry eyes or mouth, finger color changes, muscle weakness, or symptoms involving other organs. Understanding how these symptoms fit together helps your rheumatologist identify the cause and plan care for the joints and any other affected parts of the body. The “Plus” also includes care for autoimmune conditions and osteoporosis, with attention to mobility, independence, and quality of life.
Symptoms that help guide the evaluation
Joint swelling and prolonged stiffness
Persistent swelling, warmth, and morning stiffness may suggest inflammatory arthritis, including rheumatoid arthritis. Examination, selected blood tests such as rheumatoid factor and anti-CCP, and sometimes imaging help clarify the cause. Some people with rheumatoid arthritis have negative antibody tests.
Joint symptoms plus a sun-sensitive rash or mouth sores
Lupus is one possibility, especially when symptoms include hair loss, unexplained fever, or other organ involvement. When appropriate, evaluation may include ANA, anti-dsDNA or anti-Sm, blood counts, complement levels, kidney function, and urine testing. A rash or antibody result alone does not establish lupus; kidney involvement requires assessment beyond antibodies.
Joint symptoms plus dry eyes or dry mouth
Persistent dryness may prompt evaluation for Sjögren’s disease, but medications and other conditions can also cause dryness. Eye or saliva testing and selected antibodies, including SSA/Ro and SSB/La, may support the evaluation. Management can include eye and mouth care, dental protection, and treatment for other affected organs when needed.
Finger color changes, skin tightening, or muscle weakness
Fingers turning white or blue with cold or stress are called Raynaud’s phenomenon. Raynaud’s can occur on its own or alongside autoimmune disease. Puffy fingers, skin tightening, swallowing difficulties, breathlessness, or weakness may prompt evaluation for systemic sclerosis or an overlap connective-tissue condition. Selected antibodies may include anti-Scl-70, anticentromere, or anti-U1-RNP. The symptom pattern and organ assessment determine what these results mean.
Symptoms developing while taking a medication
Some medicines can trigger lupus-like illness. Bring a complete medication list and the dates you started each medicine. Anti-histone antibodies may help the evaluation but do not prove a drug reaction. If a medicine is responsible, the prescribing clinician will plan a safe change and any additional treatment. Do not stop prescribed medicines on your own.
How we work toward an accurate diagnosis
We review the timing and pattern of symptoms, examine joints and other relevant areas, consider medication effects and alternative causes, and choose tests that answer a specific clinical question. A positive ANA can occur in healthy people, particularly older adults; it does not automatically mean an autoimmune disease or a need for treatment. Symptoms can overlap, and follow-up may be needed before a diagnosis is clear.
How the diagnosis guides management
The plan depends on the condition, its activity, affected organs, your other health problems, and your priorities. For confirmed inflammatory arthritis, disease-modifying treatment may help control inflammation and protect joints. Lupus care is tailored to the organs involved. Dryness needs targeted eye, mouth, and dental care; systemic sclerosis or overlap disease may need circulation treatment and assessment of internal organs. Exercise or therapy, preventive care, medication safety checks, and follow-up can support the plan.
Prepare for your visit
Bring your medication list, prior laboratory results, symptom timeline, and photographs of intermittent rashes or finger color changes. Mention psoriasis, painful red eyes, cough, weakness, swelling, urine changes, and symptoms that affect daily activities.
When to seek urgent care A suddenly hot, very painful swollen joint with fever needs urgent assessment. A painful red eye or new vision change also needs prompt evaluation. Severe chest pain, difficulty breathing, or sudden weakness requires emergency care; call 911.
Scleritis is inflammation of the eye’s outer wall. It can cause deep pain, redness, light sensitivity, and sometimes reduced vision. It differs from ordinary surface irritation.
Read the guide
Why specialist assessment matters
Scleritis may occur with an autoimmune disease, an infection, or without an identified systemic cause. Blood tests can be negative even when eye inflammation needs treatment. An ophthalmologist evaluates the eye; a rheumatologist may help assess associated systemic conditions.
How to prepare
Bring your eye treatment records, medication list, and any history of arthritis, sinus or lung problems, rashes, or autoimmune disease. Tell the eye team about immune-suppressing medicines.
When to act A painful red eye, new blurred vision, or light sensitivity warrants urgent eye assessment. Sudden major vision loss needs emergency care. Do not self-treat with leftover steroid eye drops; some infections can worsen.
General patient education · Updated October 7, 2026.
Rheumatology
Lupus: why follow-up matters even when you feel well
Systemic lupus erythematosus can affect the skin, joints, kidneys, and other organs. Symptoms vary, and some organ involvement may develop with few early symptoms.
Read the guide
Keep monitoring on schedule
Your team may follow blood counts, kidney function, urine protein, and markers of disease activity. Feeling better does not automatically mean treatment or monitoring can stop. Report side effects and complete any medicine-specific safety checks.
Daily care and planning
Use sun protection, stay active as appropriate, and discuss vaccinations and infection prevention. Bring pregnancy plans to your team early because disease activity and medication choices affect pregnancy care.
When to act Report new swelling, blood or unusual foam in urine, fever, or worsening symptoms promptly. Chest pain, severe shortness of breath, seizures, or stroke-like symptoms need emergency care.
General patient education · Updated October 7, 2026.
Rheumatology
Vasculitis: care for blood vessels and the organs they supply
Vasculitis means inflammation of blood vessels. Different types can affect the kidneys, lungs, skin, eyes, nerves, or other organs.
Read the guide
Symptoms and testing
A rash, sinus problems, numbness, weakness, or persistent respiratory symptoms may require evaluation. Kidney involvement may be quiet, which is why blood and urine tests can matter. Diagnosis may include imaging or a biopsy depending on the situation.
Follow a coordinated plan
Treatment depends on the type and severity. Ask what symptoms to report, how medicines are monitored, and whether you need other specialists. Discuss infection precautions if you take immune-suppressing medicines.
When to act Coughing blood, severe breathlessness, sudden vision loss, or new major weakness requires emergency assessment. New vision symptoms with a severe headache also need urgent care.
General patient education · Updated October 7, 2026.
Endocrinology patient education
What the “Plus” means at ThyroidPlus
ThyroidPlus means looking at the full picture of your endocrine health. Hormones are chemical messengers that help regulate blood glucose, energy use, and many other body functions. Our care covers thyroid disorders, all types of diabetes mellitus, adrenal and pituitary conditions, calcium and parathyroid disorders, osteoporosis, and other endocrine and metabolic concerns.
Understand our approach to endocrine and diabetes care
Care for all types of diabetes mellitus
Diabetes care includes type 1 and type 2 diabetes, adult-onset autoimmune diabetes (often called LADA), gestational diabetes, and less common forms related to pancreatic disease, genetic changes, medications, or other conditions. Identifying the type matters because treatment needs differ. Gestational diabetes care is coordinated with your pregnancy care team.
Symptoms in context
Thirst, frequent urination, weight changes, tiredness, heat or cold intolerance, and changes in bone health may prompt an endocrine evaluation. These symptoms can also have other causes. We consider your history, examination, medications, and selected tests before deciding what they mean.
A plan that fits your life
We explain the diagnosis and build a plan around your needs and goals. Diabetes care may include nutrition support, medicines or insulin, glucose monitoring, and diabetes technology when appropriate, together with steps to reduce complications. Other endocrine conditions need treatment tailored to the hormone imbalance and its effects. Follow-up helps assess progress and adjust care.
Adult-onset autoimmune diabetes: could the diagnosis need another look?
Autoimmune diabetes can begin at any age. LADA is a slowly developing form in adults that may initially resemble type 2 diabetes.
Read the guide
What to understand
Body size and age alone do not determine diabetes type. Unexpected worsening, weight loss, or another autoimmune condition may prompt your clinician to reconsider the diagnosis. Antibody testing can help identify autoimmune diabetes; C-peptide can help assess insulin production. Not everyone needs these tests.
What to discuss
Ask whether your current diagnosis explains your glucose pattern, whether additional testing would change treatment, and how to recognize insulin deficiency. Bring your glucose records, medication list, and history of autoimmune disease.
When to act Get urgent medical help for vomiting with very high glucose, abdominal pain, deep or rapid breathing, or confusion. These can indicate diabetic ketoacidosis. Do not stop prescribed insulin on your own.
General patient education · Updated October 7, 2026.
Endocrinology
CGM, insulin pumps, and automated insulin delivery
Continuous glucose monitoring (CGM) shows glucose trends. Automated insulin delivery combines a compatible CGM, pump, and algorithm to adjust some insulin delivery.
Read the guide
What to understand
These systems may reduce the daily burden of diabetes management, but they still need training and attention. Many systems require meal announcements or carbohydrate entry. Suitability depends on diabetes type, the particular device, your needs, and coverage.
Prepare for a technology visit
Bring your device names, download or sharing details, insulin doses, and concerns about low glucose or missed doses. Ask about alarms, infusion-site care, when to confirm readings with a fingerstick, and a written backup plan if a device fails.
When to act A pump problem can interrupt insulin delivery. Follow your own backup and sick-day plan, including ketone testing when directed. Seek urgent care for vomiting, breathing changes, or confusion with high glucose.
General patient education · Updated October 7, 2026.
Endocrinology
Low blood sugar: recognize it and have a plan
Low glucose can cause shaking, sweating, hunger, dizziness, or confusion. Insulin and certain diabetes medicines increase the risk.
Read the guide
If you are awake and can swallow safely
For glucose below 70 mg/dL, take 15–20 grams of fast-acting glucose or carbohydrate, such as glucose tablets according to the label or 4 ounces of regular juice. Recheck after 15 minutes and repeat if still low. Follow any device-specific instructions your team has given you.
Prevent another episode
Report recurring lows so your team can review medication timing, meals, activity, and kidney function. Ask about a glucagon prescription and teach someone close to you how to use it. Keep fast-acting glucose accessible.
When to act If someone cannot swallow safely, has a seizure, or is unconscious, do not give food or drink. Use prescribed glucagon if available and call 911.
General patient education · Updated October 7, 2026.
Endocrinology
Graves’ disease, thyroid eye symptoms, and long-term follow-up
Graves’ disease is an autoimmune cause of an overactive thyroid. Eye disease can occur even when thyroid hormone levels are normal.
Read the guide
Symptoms worth reporting
Palpitations, tremor, heat intolerance, unexplained weight loss, and new eye irritation or double vision deserve evaluation. Report changes even if thyroid treatment was years ago. A rare recurrence described in a case report does not mean everyone will experience it.
Make follow-up useful
Ask which thyroid blood tests you need and when. Bring past radioactive iodine, surgery, and medication records. Discuss smoking cessation, pregnancy plans, and whether you need an eye specialist. Do not change thyroid medicines without guidance.
When to act Seek urgent assessment for reduced vision, new significant double vision, or severe eye pain. Chest pain, severe breathlessness, or fainting warrants emergency care.
General patient education · Updated October 7, 2026.
Medication safety
Methimazole or PTU: fever and a severe sore throat matter
Antithyroid medicines help control an overactive thyroid. Rarely, they can greatly reduce infection-fighting white blood cells.
Read the guide
Know the urgent instruction
If you develop fever or a severe sore throat while taking methimazole or propylthiouracil (PTU), stop taking further doses and seek medical care immediately for a blood count. Do not restart until your clinician tells you it is safe.
Why evaluation matters
An infection can also lower white blood cells. Symptoms alone cannot distinguish infection from a serious medication reaction. The case report on transient neutropenia does not remove the need for urgent testing or justify continuing the medicine while waiting.
When to act If you cannot reach your clinician promptly, go to urgent care or an emergency department. Also seek prompt care for yellow skin or eyes, dark urine, or significant abdominal pain.
General patient education · Updated October 7, 2026.
Endocrinology
An adrenal nodule found by chance: what happens next?
An adrenal incidentaloma is a growth found on a scan done for another reason. Many are benign, but the scan alone does not show whether hormones are being overproduced.
Read the guide
What your evaluation may include
Your clinician reviews the imaging appearance, symptoms, blood pressure, medications, and relevant hormone tests. Testing is individualized and may assess cortisol, adrenaline-related hormones, or aldosterone. Feeling well does not always exclude hormone excess.
Questions to bring
Ask whether the nodule produces hormones, whether its appearance is reassuring, and whether additional scans, surgery, or follow-up are needed. Bring the actual imaging report and prior scans if available.
When to act Tell any team planning an adrenal procedure about the nodule and its hormone evaluation. Do not assume a biopsy is the next step; a pheochromocytoma must be considered before an invasive procedure.
General patient education · Updated October 7, 2026.
Endocrinology
Diabetes during a hospital stay
Illness, surgery, steroids, and changes in eating can alter blood glucose. Your hospital diabetes plan may differ from your usual home plan.
Read the guide
Help your team prepare
Bring your medication list and let staff know your diabetes type, usual insulin, CGM or pump use, and history of severe low glucose. Do not operate a pump independently in hospital without agreeing on the plan with your care team.
Before discharge
Ask for a written medicine and insulin plan, supplies, clear sick-day instructions, and follow-up. Confirm which pre-hospital medicines to restart and who to call about glucose problems. A 2013 review provides historical context; current decisions depend on today’s clinical guidance and hospital policy.
When to act If you depend on insulin, make sure your team knows. Do not omit insulin or restart old doses on your own when your eating pattern or health has changed.
General patient education · Updated October 7, 2026.
Bone health & autoimmune overlap
Both specialties
When autoimmune conditions overlap
Autoimmune conditions sometimes occur together. Hashimoto’s thyroiditis, autoimmune diabetes, and some rheumatic diseases can overlap, but having one does not mean you will develop another.
Read the guide
Follow symptoms, not a checklist
Tell your clinician about new thirst, frequent urination, unexplained weight loss, persistent joint swelling, or dry eyes and mouth. Fatigue has many possible causes. Testing should follow your symptoms and clinical history rather than an automatic broad panel.
Connect your care teams
Keep a shared medication list and tell each specialist about your other diagnoses. Ask whether steroid treatment could affect glucose, whether new symptoms need evaluation, and who will coordinate follow-up.
When to act Do not interpret an antibody result in isolation or change treatment because of an online symptom list. Diagnosis requires clinical evaluation.
General patient education · Updated October 7, 2026.
Both specialties
Osteoporosis: protect bone health before a fracture
Osteoporosis makes bones more likely to break. It often causes no symptoms before a fracture. Rheumatologists and endocrinologists both evaluate bone health.
Read the guide
Understand your risk
Age, prior fractures, family history, low body weight, smoking, and certain medicines can increase risk. Long-term glucocorticoid use is important to discuss. A DXA bone density test and fracture-risk assessment help guide decisions.
Build a practical plan
Ask about calcium and vitamin D needs, safe weight-bearing and strengthening activity, fall prevention, and whether medication is appropriate. Bring previous DXA reports and a list of fractures. Tell your team about dental procedures and kidney problems.
When to act Do not delay or stop osteoporosis medicine without discussing the next step with your clinician. Different medicines need different stopping plans. Sudden severe back or hip pain after a minor fall needs assessment.
General patient education · Updated October 7, 2026.
Coming soon — around December 2026
Your next chapter in care starts here.
ArthritisPlus Rheumatology & Osteoporosis Center and ThyroidPlus Endocrinology & Diabetes Center will share one convenient location. We anticipate opening around December 2026. Call for practice updates and appointment information.
