The patients who come in to see Dr. Khaldoun Al-Rayess are often sad and tired.
Sad because they’re fighting depression, and many times unwanted weight gain. Tired because they’re, well, just tuckered out.
Many times, these are the symptoms that bring patients into the office of this Tanner Clinic endocrinologist. And, as a specialist in disorders of the thyroid, adrenal and other glands, he’s able to tweak and repair the delicate balance of hormones that keep our bodies running.
Sometimes it’s too little hormone produced by the thyroid; sometimes it’s the pancreas inhibiting insulin, resulting in type 1 diabetes.
Hormones are the electronic signals that keep the hard drive of our bodies programmed and performing. These chemical messengers carry information and instructions from one set of cells to another. Our more than 20 different hormones move through the bloodstream, with each hormone designed to affect only certain cells.
Our various glands are designed to produce the right amount of hormones. But “those glands sometimes fail,” says Dr. Al-Rayess. “For one reason or another, they start producing a lower amount of the hormone. In other situations, they can produce too much.”
Hormonal disorders can be complex
Dr. Al-Rayess works with all types of hormonal disorders, as does his colleague Brett Rawlins, a family nurse practitioner. Brett works primarily with diabetes management.
Symptoms such as fatigue and depression can signal a range of problems. And how the hormone system — primarily the thyroid — can produce these symptoms is often misunderstood. Hormonal issues are “more complex,” he said. “You have to ask a lot of questions, you have to run a lot more tests, and you have to be experienced in interpreting the results.”
Many patients are referred to Dr. Al-Rayess from their family doctors. When normal treatments don’t produce the expected result, he said, these physicians “end up referring the patient to the endocrinologist to see if there’s anything else they can do beyond the general and usual treatments.”
One of the most common diagnoses he makes is that of a malfunctioning thyroid. All thyroid disorders, he says, are “autoimmune in nature — your immune system is attacking your own body.”
Such disorders as Hashimoto’s disease in the thyroid are well-known to be autoimmune. But autoimmune disorders can affect the entire endocrine system — for example, Addison’s disease is the result of under-producing adrenal glands.
Physician is a teacher at heart
Dr. Al-Rayess began his medical education in a much more peaceful Syria. After traveling to Turkey to take — and pass — the American medical exams, he settled on a residency in Michigan.
He chose the U.S., he says, because “it’s one of the best medical systems in the world regarding training.” Following his residency and fellowship, he opted to stay in the U.S. and specialize in endocrinology.
As a boy in Syria, Dr. Al-Rayess says he wavered between education and medicine as careers. Both, he explains, are about teaching.
“I think teaching and being a doctor are the most rewarding skills, and in medicine you get to do both — because you teach your patients as well as treat them,” he said. “If I weren’t a doctor, I’d be a teacher.”
All areas of medicine require physicians to educate their patients. However, many endocrine disorders require a higher learning curve for the patient. “Endocrinology is unique in that regard,” he said. “In a lot of specialties you have to do teaching, but in endocrinology it’s very prominent.”
Take type 2 diabetes, for instance. “Probably more than 50 percent of what we do for diabetes patients is to teach them — about a healthy diet, about exercise, about how to take medications and the side effects of medication,” he says.
The mix of teaching and doctoring delivers many rewards, he said. “When you treat for hormonal problems, you see results rather quickly, and it’s rewarding to say, ‘I’m able to help people’,” he said.
“This is not something I do for a living. I enjoy communicating with patients, I enjoy the feeling that I’m able to help.”