The Risk of Taking Compound GLP-1s

Posted on August 20, 2026 by Patrick Hercules

Over the past few years, GLP-1 medications, such as semaglutide and tirzepatide, have become a popular way to help people lose weight.

However, some patients and healthcare providers have turned to compounded versions of semaglutide and tirzepatide called compounded GLP-1 antagonists.

Glucagon-like peptide-1 or GLP-1 antagonists are a class of medications that mainly manage blood sugar levels in people with Type 2 diabetes. In 2024, nearly one in three Americans taking a GLP-1 drug said they were getting it from a compounding pharmacy.

Compounded GLP-1 antagonists are custom-mixed weight loss medications made by certain pharmacies, not drug companies, and use the same active ingredients as the brand names, but they don’t have approval from the U.S. Food and Drug Administration (FDA) for safety or effectiveness, and some compounded GLP-1 drugs have additional ingredients or alternate chemical forms of the active drugs.

This is why the FDA has warned against taking compounded versions of semaglutide and tirzepatide, as they don’t undergo regulatory testing for safety, quality, or effectiveness. They also issued a warning about a spike in overdoses and adverse side effects largely attributed to dosing errors with these drugs, due to them coming with syringes for people to draw the medications themselves, unlike brand-name GLP-1 injections that come in prefilled pens.

In 2024, the FDA raised concerns about the increased risk of dosing errors, improper storage, and fraudulently labeled GLP-1s from compounding pharmacies. Consequently, hundreds of people reported serious problems, including dangerous dosing mistakes, where patients got five to twenty times more than the proper dose.

By April of 2025, the FDA had logged over 520 reports linked to compounded semaglutide and 480 for compounded tirzepatide.

Additionally, U.S. poison centers have seen a nearly 1,500% increase in calls related to overdose or side effects of injectable weight-loss drugs since 2019. What’s more, as of April 30th, 2025, poison centers have managed 3,633 GLP-1 agonist-related exposure cases and 22,966 cases from 2019-2025.

The common side effects of GLP-1 antagonist poisoning include:

Nausea and vomiting
Constipation and diarrhea
Abdominal pain

Other symptoms and side effects to watch out for include:

Signs of severe dehydration such as fainting and confusion or not urinating for eight hours.
Pancreatitis, which usually feels like sharp pain in your upper abdomen and back.
Gastrointestinal symptoms that don’t improve when you eat smaller meals or take anti-nausea medications.
Gastrointestinal symptoms that grow worse rather than easing the longer you’re on the drug.

However, there are instances when it might be appropriate for a person to take a compounded drug, such as when a patient’s medical need can’t be met by an FDA-approved drug, or the FDA-approved drug is not commercially available.

If taking a compounded GLP-1 is your only option, it is important to confirm if it is coming from a 503B-registered outsourcing facility, rather than an unregistered seller, and that you remain under close medical supervision while using it.

Other clues that your compounded prescription may not be legitimate:

It does not require a prescription.
The pharmacy is not located within the U.S.
The medication arrives in packaging that is damaged, open, labeled in a foreign language, or has no expiration date.
Unusual delivery methods. Delivery methods other than injections and oral pills, such as sublingual drops and dissolving tablets, have not been tested in clinical trials.
Vague or proprietary ingredient lists. Products marketed as “personalized” blends with added vitamins or other ingredients, without a clear clinical rationale, are often designed to promote those additions to sidestep regulations rather than to benefit the patient.

If you need help locating a licensed online pharmacy, you can use the FDA’s BeSafeRx program. For more information about the Bariatric Surgery Services at Flushing Hospital or procedures performed by our doctors, please call 718-408-6977 or 718-670-8908.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Ultrasound vs Sonogram: What Is the Difference?

Posted on August 14, 2026 by Patrick Hercules

For many of us, medical terminology can be confusing. When you are scheduled for an exam, such as an ultrasound or a sonogram, they might sound like they are the same thing. However, ultrasounds and sonograms are two different parts of the same medical test.

An ultrasound exam is a procedure that uses sound waves beyond the range humans can hear to create images of soft tissues inside the body, helping healthcare providers diagnose or rule out several conditions. It is noninvasive, painless, and doesn’t use radiation.

An ultrasound can spot growths or abnormalities inside your body and can also clearly show and measure fluids.

Healthcare providers will use ultrasound exams to view:

Breast lumps and cysts

Muscles and tendons

Blood flow in your arms, neck, and legs

Abdominal organs, including your gallbladder, liver, pancreas, and spleen

Your urinary system, including your bladder and kidneys

Pelvic organs such as your ovaries, prostate, and uterus

Fluids, such as amniotic fluid during a pregnancy or urine in your bladder

An ultrasound can’t see everything, as it is usually not the best test for viewing bones, which block sound waves. Ultrasounds also can’t see structures inside your joints, such as cartilage.

Healthcare providers don’t just use ultrasound as a standalone medical exam. They also use it to guide minimally invasive procedures, such as breast biopsy.

A sonogram is a real-time, moving image created by an ultrasound machine. It can be printed, saved digitally, or used to show organs, soft tissues, blood flow, or a developing baby. Sonograms will be viewed and interpreted by a radiologist who will send a report to your referring healthcare provider with a diagnosis or other information based on your results. A healthcare provider will then study and review the sonogram images and video loops to detect abnormalities, monitor health conditions, and support treatment planning. These images help healthcare providers explain findings clearly and give patients a better understanding of their medical care.

Understanding the difference between an ultrasound and a sonogram helps patients navigate medical imaging more confidently. Both are safe, noninvasive, and widely used in medical diagnostics.

The Flushing Hospital Department of Radiology offers a wide variety of advanced, state-of-the-art diagnostic imaging services. To schedule an appointment, call 718-670-5458. To schedule an appointment for an MRI or learn more about the MRI, please call 718-670-8851.

Wellness Wednesday Tip: Staying Physicall Active

Posted on August 12, 2026 by Patrick Hercules

Life can move fast, and we may not have enough time to exercise as much as we would like to. Most people spend half of their day sedentary. The more you sit, the more your large muscles aren’t using glucose, the body’s main source of energy. Sitting for long periods of time can cause blood sugar levels to rise, triggering the body to release insulin.

Over time, sedentary habits cause the body to become less sensitive to insulin, resulting in insulin resistance.

Regular physical activity is one of the most important things you can do for your health. What’s more, any kind of exercise can reduce fatigue and improve sleep, decrease anxiety and depression, improve weight management, and promote brain health. It can also help prevent and reduce the risk of long-term health problems, such as heart disease, type 2 diabetes, high blood pressure, and obesity.

Additionally, regularly moving your body lowers your risk for some types of cancers, fatty liver disease, chronic pain, arthritis, and even dementia.

According to the Centers for Disease Control and Prevention (CDC), adults need at least 150 minutes of moderate-intensity physical activity each week. Moderate-intensity physical activity can be any activity that gets you to breathe harder and your heart beating faster, such as:

Brisk walking

Dancing

Swimming

Roller skating

Jogging

Riding a bike

Playing a sport

Moving your body doesn’t always have to involve working out in a gym. You can also climb the stairs, garden, or play with your children or pets.

Whether you are just starting or haven’t been physically active for a while, there are ways to get started. Here are some tips to help you add more physical activity to your daily life:

Look for ways to make physical activity a part of your daily routine, such as walking the dog or walking in place during commercial breaks while watching TV

Start with activities, locations, and times you enjoy

Find a place near your home or work to be physically active

Try activities with friends or family that you enjoy together

If you lack the time, space, energy, skill, or if something else is preventing you from being more physically active, such as a fear of injuring yourself, here are ways to overcome these obstacles:

Add physical activity to your daily routine, such as parking farther away from your destination or taking the stairs instead of the elevator

Schedule physical activity for times in the day or week when you will feel more energetic

Invite a friend or family member to exercise with you regularly

Choose activities you can do safely, and increase the amount you do gradually as your confidence and abilities grow

Be sure to warm up and cool down before walking to avoid injury

Regular physical activity is one of the most important things you can do for your health. Everyone can experience the health benefits of physical activity, as it gets your body moving and your heart beating faster.

It is recommended that you consult your doctor before starting or adding new exercises to your routine. You can schedule an appointment with a doctor at Flushing Hospital’s Ambulatory Care Center by calling (718) 670-5486.

TMJ Disorders

Posted on August 6, 2026 by Patrick Hercules

Temporomandibular joint disorders (TMDs) affect the temporomandibular joints and muscles around them. The temporomandibular joints help you chew, talk, and move your jaw.

TMD is common in adults and affects up to 12 million people in the U.S., with females being twice as likely to have it. It often starts between the ages of 20 and 40 years old.

Signs and symptoms of TMD can include:

Jaw or face pain
Jaw stiffness or locking
Headaches or migraines
Trouble opening or closing your mouth
Clicking, popping, or grinding sounds
Earaches or ringing
Neck or shoulder pain
Eye pain
Tooth pain

TMD can happen for several reasons, including:

A jaw injury, such as a break or dislocation
Arthritis in the jaw
Teeth grinding or clenching
Stress that causes jaw tension
A misaligned bite

Several habits can make TMD worse, such as:

Chewing on pens, ice, or nails
Taking large bites of food
Daytime clenching or sleeping on your stomach
Using teeth as tools
Poor posture

A healthcare provider can diagnose TMD after performing a physical exam and ordering imaging tests to check how your jaw moves and look for signs of pain or stiffness.

The physical exam may include:

Seeing how wide you can open your mouth
Feeling your joints as you open and close your mouth
Pressing around your jaw to check for tenderness

Imaging tests include:

Dental X-rays
MRIs
CT scans

Treatment for TMD depends on what’s causing your symptoms and their severity. Most people with TMD start treating it with noninvasive options such as medications and nonsurgical therapeutic options, which focus on relaxing your jaw and improving movement.

Medications to treat TMD can include:

Acetaminophen
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen
Muscle relaxers for clenching or grinding
Antidepressants to help with chronic pain

Nonsurgical therapeutic options to treat TMD can include:

Custom mouth guards or splints
Jaw exercises through physical therapy
Ultrasound therapy to relax muscles
Trigger point injections, such as dry needling or steroids
Changing habits, such as avoiding hard foods or improving posture
TENS (gentle electrical currents) to ease tension

If medications or nonsurgical therapeutic options don’t help manage TMD symptoms, a healthcare provider may suggest surgical options, such as:

TMJ arthroscopy
Arthrocentesis to flush the joint
Open-joint surgery for more serious problems

TMD is treatable and rarely causes lasting problems, especially if it is diagnosed and treated early.

If you are experiencing symptoms of TMD, you can schedule an appointment at Flushing Hospital Medical Center’s Department of Dental Medicine. Please call (718) 670-5521.

Autoinflammatory Awareness Month

Posted on August 5, 2026 by Patrick Hercules

August is Autoinflammatory Awareness Month, a month that recognizes the importance of raising awareness and promoting improved care, research, and treatments for autoinflammatory diseases.

Autoinflammatory diseases are rare diseases that stem from the dysregulation of the innate immune system, which is the first responder that reacts quickly to any perceived threats using inflammation as a symptom. These diseases are typically caused by single-gene mutations that affect the inflammatory signaling pathways. These can include:

Familial Mediterranean Fever (FMF)

TNF Receptor-Associated Periodic Syndrome (TRAPS)

Cryopyrin-Associated Periodic Syndromes (CAPS)

These genetic changes cause inflammatory molecules to be released inappropriately, creating the characteristic pattern of episodic attacks or periods of intense inflammation followed by symptom-free intervals.

Additionally, those who have autoinflammatory diseases suffer from systemic inflammation, which includes:

Fevers

Rashes

Abdominal pain

Joint pain

Vomiting and diarrhea

Red eyes

Severe organ inflammation

Most autoinflammatory diseases affect people throughout their entire life. However, a few may develop in adulthood. Many people can have improved quality of life and fewer complications or damage from these complex diseases if they are diagnosed earlier and controlled properly with targeted treatments.

Autoinflammatory diseases can affect anyone. However, certain risk factors cause some people to be affected by autoinflammatory diseases more than others, including:

Familial Mediterranean Fever, which is more common in people of Mediterranean, North African, Middle Eastern, and Sephardic Jewish ancestry

TRAPS and CAPS can occur across ethnic groups, but remain quite rare overall

Family history can play a role as these conditions follow inheritance patterns, although some cases result from new mutations

Autoinflammatory diseases often run in families. When one family member has been diagnosed with FMF, TRAPS, or another autoinflammatory condition, relatives may benefit from getting a genetic screening, especially if they are experiencing any suggestive symptoms.

For families who are planning to have children, understanding carrier status can inform reproductive decisions and help pediatricians watch for early symptoms of infants and young children who may be at risk.

Research into autoinflammatory conditions also contributes to understanding immune dysregulation and cytokine-related disorders, benefiting broader medical knowledge. Raising awareness helps improve diagnosis, treatment, and care for patients with these rare diseases

The goal of Autoinflammatory Awareness Month is to emphasize patient advocacy, education, and global collaboration to enhance the lives of those affected. Autoinflammatory Awareness Month also offers an opportunity to shine light on these often-misunderstood conditions and the biomarkers that can help families and healthcare providers track inflammatory activity over time.

If you or your child experiences recurrent unexplained fevers, particularly with a pattern of accompanying symptoms, consider seeking an evaluation at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

Emotional Fatigue

Posted on August 4, 2026 by Patrick Hercules

When stress from negative or challenging life events occurs repeatedly without adequate recovery, you may find yourself feeling emotionally worn out and drained. This is known as emotional fatigue or exhaustion. Although emotional fatigue is most associated with workplace burnout, it can happen outside occupational contexts in:

Anyone whose emotional labor consistently exceeds their capacity to restore

Caregivers supporting ill or dependent family members

Individuals processing prolonged grief, trauma, or stress

People in chronic, conflict-heavy relationships

Parents of young children or children with complex needs

Emotional fatigue falls between ordinary stress, which most people can bounce back from quickly, and clinical disorders such as major depression or anxiety disorders. If it is left unaddressed, it frequently progresses toward both.

Emotional fatigue can present itself as emotional, physical, and performance signs and symptoms.

Emotional symptoms include:

Depression

Anxiety

Apathy

Irritability

Difficulty making decisions

Feeling hopeless

Feeling powerless or trapped

Lack of focus or forgetfulness

Lack of motivation

Negative thinking

Tearfulness

Nervousness

Physical symptoms include:

Persistent headaches or migraines

Heart palpitations or chest tightness

Fatigue

Poor sleep

An elevated susceptibility to illness

Nausea or upset stomach

Lack of appetite

Sore muscles or muscle tension

Performance symptoms include:

Performing work duties more slowly

Difficulty completing daily tasks for responsibilities

Failing to meet deadlines

Isolation or avoidance

Increased absences

Lower workplace commitment

You can address emotional fatigue by identifying the stressors you can reduce or prevent. When you are unable to change a stressor because it is out of your control, it is important to focus on the here and now. Try to focus on the various neutral and positive events that are happening. Focusing on these types of events can give you a better perspective about what is happening around you, allowing you to shift your focus away from the stressors.

Your body can often interpret stress as a threat to your survival. When this occurs, your brain releases stress hormones throughout your body, which can contribute to your emotional fatigue. As you focus on neutral or positive events in your life, your brain learns that the threat is not as bleak as it may seem. The amount of stress hormones released decreases, causing you to feel more emotionally balanced.

Some other strategies that can help reduce emotional fatigue include:

Practicing mindfulness to engage in the present moment

Eliminating or minimizing the stressor when possible

Identifying and challenging unhelpful thoughts and replacing them with balanced thoughts

Eating a healthy, balanced diet

Exercising

Getting adequate sleep

When emotional fatigue is addressed early, it often clears considerably with the proper rest and load reduction.

If you are experiencing emotional fatigue, you can discuss your signs and symptoms with a mental health professional. They can help you sort through the causes and symptoms you’re experiencing to determine a plan that will help you regain a sense of well-being.

To learn more about our mental health services or to schedule a virtual appointment, call (718) 670-5316 to speak with our intake coordinator or call (718) 670-5562 to reach the clinic.

Wellness Tip: Prioritizing Sleep

Posted on July 31, 2026 by Patrick Hercules

Prioritizing sleep is essential to help you function properly throughout the day.

Getting adequate and restful sleep has several benefits, as it supports the immune system, helps control weight, aids physical and mental well-being, and cognitive functions, such as memory and judgment. It may even extend longevity.

The amount of sleep needed every night varies with age and other factors. The Centers for Disease Control and Prevention (CDC) recommends at least seven hours of sleep per night for most adults. However, it is important to note that getting more than the recommended hours of sleep on a consistent basis can be detrimental to your health. In a study done by the National Library of Medicine, getting nine hours or more of sleep is linked to a higher risk of early death.

Practicing good sleep hygiene can help you get the recommended seven to nine hours of sleep. Here are a few tips for better sleep hygiene:

Getting regular exercise

Setting regular bedtime and wake-up times

Avoiding caffeine in the afternoon and evening

Avoiding large meals before bedtime

Avoiding drinking alcohol before bedtime

Turning off screens at least 30 minutes before going to bed

If you are having difficulty falling asleep, frequently wake up throughout the night, or often feel tired during the day, talk to your healthcare provider about ways to improve your sleep. In some cases, sleep apnea or another sleep disorder may be preventing you from getting a restful night’s sleep.

If you or a loved one is having trouble sleeping, you can receive treatment at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

Stiff Person Syndrome

Posted on July 24, 2026 by Patrick Hercules

Stiff person syndrome (SPS) is a rare autoimmune neurological disorder that most commonly causes symptoms of muscle stiffness in your trunk and abdomen, with stiffness and painful spasms in the legs and other muscles developing over time.

Symptoms of stiff person syndrome can develop at any age, but it most often begins in your 30s and 40s. Scientists believe stiff person syndrome can range from just one area of a person’s body to a widespread syndrome that affects multiple parts of the body, and involves the brain, brain stem, and spinal cord. Stiff person syndrome is a progressive disorder, which means symptoms can get worse over time, and can take several months to a few years to develop.

In most cases of stiff person syndrome, muscle stiffness in the abdomen, chest, or back muscles is the first symptom experienced. This rigidity causes pain and an aching discomfort that can fluctuate in severity without a clear trigger or reason. These symptoms can also affect the arms and legs. As stiffness increases, some people may develop an abnormal posture that can make it difficult to walk or move. Individuals may also experience painful muscle spasms that can involve the entire body, or only a specific area. These spasms can last a few seconds, minutes, or occasionally, a few hours.

Symptoms of stiff person syndrome, such as muscle spasms, can be triggered after:

Physical touch or stimulation

Unexpected or loud noises

Changes in temperature, including cold environments

Stressful events

The triggers of stiff person syndrome-related muscle spasms can be unpredictable. This can cause some people with stiff person syndrome to develop anxiety and agoraphobia because it is more difficult to avoid the triggers of muscle spasms in public.

Researchers don’t know the exact cause of stiff person syndrome, but they believe it is an autoimmune condition. Some studies suggest antibodies may play a role in stiff person syndrome, as many people with the condition make antibodies against glutamic acid decarboxylase (GAD). GAD makes a neurotransmitter called gamma-aminobutyric acid (GABA), which helps control muscle movement.

Unfortunately, researchers don’t yet understand the exact role that GAD plays in the development and worsening of stiff person syndrome. However, it is important to note that having GAD antibodies doesn’t mean that you have stiff person syndrome. A small portion of the general population has GAD antibodies without any adverse effects. There are other antibodies associated with stiff person syndrome, including:

Glycine receptor

Amphiphysin

Dipeptidyl peptidase-like protein 6 (DPPX)

Additionally, some people with this condition don’t have any detectable antibodies, but ongoing research is investigating whether other potential antibodies may also cause symptoms.

Stiff person syndrome is very rare, as about one out of every one million people has this condition. What’s more, it is twice as common in females, and may also occur with other autoimmune conditions, such as:

Type 1 diabetes

Autoimmune thyroid disease

Celiac disease

Vitiligo

Pernicious anemia

A healthcare provider can diagnose stiff person syndrome by looking for specific signs of the condition through exams and tests. They will ask questions about symptoms during physical and neurological exams. If the healthcare provider suspects stiff person syndrome, they may recommend other tests, including:

Antibody blood test

Lumbar puncture

Electromyography (EMG)

Stiff person syndrome can be difficult to diagnose, as it is rare and has similar symptoms to other conditions, such as ankylosing spondylitis, multiple sclerosis (MS), or other autoimmune conditions.

Unfortunately, there isn’t a treatment that cures stiff person syndrome. However, working with a specialist and maintaining symptom control can make it easier to live with the condition. Specialists include:

Neurologists, specifically neuroimmunologists

Physical medicine and rehabilitation specialists

Occupational and physical therapists

Mental health specialists, such as psychologists

Speech therapists

To treat stiff person syndrome, two main treatment strategies can be used, such as:

Medications and therapies for symptom management

Immunotherapy or disease-modifying treatment

Treatment for stiff person syndrome varies based on your symptoms. The goal of treatment is to manage how symptoms affect you and improve your mobility and comfort.

If you or a loved one is experiencing symptoms of stiff person syndrome, you can receive treatment at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

How Hormones Affect Weight Gain

Posted on July 23, 2026 by Patrick Hercules

Weight fluctuation is something that many of us experience throughout our lives. When you gain weight for no obvious reason, it may be connected to hormone fluctuations that can occur with age, menopause, or a medical issue. These changes in hormone levels can affect major body functions, including the way you gain and lose weight. While hormonal weight gain affects both sexes, the distribution of fat differs between men and women.

Men generally gain weight in their abdominal area. Premenopausal women often gain weight around their hips and thighs, while postmenopausal women may gain weight in their abdominal area.

Treating hormonal weight gain consists of finding the cause of and fixing the hormonal imbalance. There may also be a need to treat the underlying medical issue causing a shift in your hormone levels.

Hormonal weight gain resulting from hormone imbalances can lead to different symptoms and can vary on the specific hormone and whether its levels are too high or too low. The common symptoms of hormonal weight gain besides difficulty losing weight include:

Depression

Insomnia

“Brain fog” or an inability to think clearly

Fatigue

Constipation

Thirst that persists despite drinking water

Frequent urination

Irregular menstrual cycle

Irregular heartbeat

Acne

Hormonal weight gain can be caused by changes to the normal level and function of several important hormones that help regulate appetite, the sense of fullness, metabolism, and how body fat is distributed. These hormones include:

Estrogen

Insulin

Leptin

Cortisol

Ghrelin

There are several conditions that can cause hormonal weight gain, including:

Menopause

Endometriosis

Polycystic Ovary Syndrome (PCOS)

Hypothyroidism

Insomnia

Losing hormonal weight gain starts with finding the hormones that affect your weight. It may also be necessary to get the right diagnosis and treatment if you have a hormonal imbalance caused by an underlying medical issue.

Any weight loss goal generally involves lifestyle changes that consist of the following strategies:

A daily program to maintain activity levels

A change in diet to reduce calories

Adequate sleep every night

Behavior strategies to encourage commitment

Working with a fitness professional can help you find exercises to target areas where you have excess weight due to hormonal weight gain.

Hormonal weight gain supplements or medications may also be advised. They can reset hormone levels, treat the effects of abnormal levels, or control any underlying problems. Some common treatments include:

Insulin therapy for type 2 diabetes

Bioidentical hormone therapy

Sleep medications

Hormonal birth control pills for controlling endometriosis

Synthetic thyroid hormone levothyroxine (a T4 preparation) for hypothyroidism

In extreme cases, treatment may involve surgical intervention to treat underlying problems. These therapies may include:

Bariatric weight loss surgery

Ovarian cyst surgery

Hysterectomy

Hormonal weight gain can look like any other type of weight gain. To determine if your weight gain is hormonal, visit your healthcare provider.

If you or a loved one is experiencing symptoms of hormonal weight gain, you can receive treatment at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

Scleroderma

Posted on July 22, 2026 by Patrick Hercules

Scleroderma is a rare chronic condition that causes the body to produce tissue that is thicker than it should be. It usually affects the skin, but it can also cause symptoms in other parts of the body.

If a person has scleroderma, their immune system triggers the body’s cells to produce too much collagen. Collagen helps the body have strong, healthy connective tissue to support the organs and hold parts of the body in place. However, when the body produces too much collagen, the skin and other tissue can become thicker and more fibrous than they should be.

Some people who have early scleroderma don’t have any symptoms. Some of the most common symptoms include:

Joint pain
Stiffness, especially first thing in the morning
Fatigue
Patches or streaks of thickened, waxy skin
Raynaud’s syndrome
Unexplained weight loss
Heartburn or acid reflux

There are two main types of scleroderma: localized and systemic sclerosis.

Localized scleroderma only affects one part of the body, usually the skin, and causes thick patches or streaks on the skin that feel waxy. This type of scleroderma is most common on the chest, arms, legs, stomach, hands, and feet. Localized scleroderma may get better on its own, and it doesn’t usually spread to other parts of the body.

Systemic sclerosis can affect other organs as well as the skin, including the lungs, heart, stomach, and small bowels. It can affect a person’s ability to breathe or process nutrition. Systemic sclerosis has three subtypes:

Diffuse sclerosis
Limited sclerosis, also known as CREST syndrome
Sine sclerosis

Systemic sclerosis can cause symptoms that may seem unrelated to each other, such as:

Coughing or shortness of breath
Trouble swallowing
Muscle numbness or tingling
Heartburn, bloating, constipation, diarrhea, or trouble controlling your bowels
Abnormal heartbeats, including heart blocks
Dry eyes and mouth
Itching
Erectile dysfunction or vaginal dryness

Experts aren’t sure of what causes scleroderma, but they know it is an autoimmune disease. Scleroderma can be hereditary, as biological parents can pass it on to their children. However, it is rare enough that there isn’t any definitive proof that it is a genetic disorder.

Anyone can develop scleroderma, but you may be at a higher risk if you are:

Female
Black
Between the ages of 30 and 50 years old

Black people are more likely to have scleroderma, and it is more common to develop it earlier in life and experience more severe skin and lung symptoms.

A person with scleroderma is more likely to have Raynaud’s syndrome and Sjögren’s syndrome. Some types of scleroderma can cause severe complications, including:

A weakened immune system
Cardiovascular disease
Congestive heart failure
Kidney failure
Pulmonary fibrosis
Pulmonary hypertension
Needing a finger or toe amputated
Cancer
Gastrointestinal diseases

Diagnosing scleroderma is usually part of a differential diagnosis, which means a healthcare provider will have to use a few tests to rule out other conditions that can cause similar symptoms before giving you a scleroderma diagnosis. A healthcare provider will perform a physical exam and tests, including:

Blood tests to see how well your immune system is functioning
A biopsy to remove a sample of your affected skin or other tissue for lab testing
Pulmonary function tests to show if your lungs or respiratory system are affected
Endoscopy if you are experiencing any gastrointestinal symptoms

A healthcare provider may also recommend imaging tests, such as:

CT scan
Chest X-ray
Echocardiogram
Electrocardiogram (EKG/ECG)

Unfortunately, there isn’t a cure for scleroderma. A healthcare provider will help you find treatments that manage the symptoms and lessen how much they impact your daily life. The treatments you receive depend on where you’re experiencing symptoms and their severity. Some treatment options include:

Immunosuppressants
Medicines to manage specific symptoms
Skin treatments
Physical therapy
Phototherapy or light therapy
Stem cell transplants

If you or a loved one is experiencing symptoms of scleroderma, you can receive treatment at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.