Dr. Gage is an expert diabetologist. He uses state-of-the-art equipment to diagnose and manage his diabetic patients. Guided by initial history and physical exam, Dr. Gage performs a panel of comprehensive tests including HGA-1C (Hemoglobin A1C), insulin, and C-peptide levels to properly diagnose diabetes. He is able to closely monitor patients by downloading patient blood sugar monitoring device measurements onto his computer. Using this information, he designs an accurate, comprehensive plan that combines diet, exercise, medication, and insulin (as needed) to ensure excellent control. In many cases, patients can be taken off insulin and/or medications when appropriate diets are followed, particularly by type 2 diabetics. Dr. Gage also has a special interest in managing difficult to control type 1 (insulin-dependent diabetes). Patients can improve control using a variety of insulin pumps and simplify their regimen and lives. State-of-the-art continuous glucose monitoring systems (CGMS) are now available in the office to refine treatment patterns. Individualization remains paramount, as no two diabetics are alike.
PCOS appears to be one of the most rapidly developing illnesses in females. Occurring after the onset of menarche, women may complain of increased weight, carbohydrate cravings, irregular menses, hair growth where it doesn’t belong, and hair loss from the scalp. Researchers have discovered a link between PCOS and obesity. Such patients frequently have severe insulin resistance, with diabetes occurring in up to fifty percent of PCOS patients. They develop upper body obesity and accelerated heart disease risk.
Dr. Gage describes the ill effects of insulin in his book, The Thinderella Syndrome: A Practical Guide to Individualized Permanent Weight Loss. “The higher the insulin, the more illness we see.” Insulin resistance in women with PCOS seems to resemble what which occurs in the obese type 2 diabetic. Per Dr. Gage, the difference is that the insulin resistance of PCOS occurs first, with the obesity and carbohydrate-cravings becoming a secondary phenomenon. Many women complain of excessive weight gain despite all efforts of dieting. Metformin and Glitizones (insulin-sensitizer medications) can correct this problem, and many patients may see weight loss as a result as well. Dr. Gage cautions, “Beware, because without strict lifestyle change, the medical effect seems to wear off.” Just like many obesity medications, patients can develop resistance to the medication or overeat despite taking the medicine. Dr. Gage explains, “These patients must protect themselves from the carbohydrate environment. Low carbohydrate diets don’t just happen; it takes behavioral planning and preparation. From shopping to dining out, patients need to keep their guard up.” Dr. Gage has seen several patients reverse the syndrome with behavior modification, even without medications.
The Permanens™ Lifestyle Change Program (PLC) and Permanens™ Weight Management System (WMS) were created by Dr. Gage to induce PERMANENT weight maintenance. The PLC Program provides sixteen weeks of educational instruction (using behavior modification techniques and meal replacement food). Our licensed Nutrition Professionals or licensed clinical practitioners provide ongoing weekly 1-hour group or individual meetings conducted in-person or online.
The PLC Program uses the behavioral and defensive eating techniques discussed in Dr. Gage’s book, The Thinderella Syndrome. The WMS is the key component in aiding and achieving PERMANENT, SUCCESSFUL weight loss with our PLC Program. It is an innovative, computer-driven, secure, internet-enabled weight tracking device. This educational tool allows communication between the health care provider and client.
We offer a “turn-key” program that is user-friendly and practitioner-friendly and can easily be integrated into a busy practice
As an endocrinologist, Dr. Gage has expertise in treating thyroid disease. Individuals may present with different symptoms, including thyroid nodules and/or signs of underactive or overactive function. After a comprehensive history and physical exam, Dr. Gage sets up an appropriate testing schedule depending on the type of thyroid disease suspected. This will include lab tests and thyroid function tests including "supersensitive TSH". Many patients also require autoimmune testing to detect thyroid antibodies, which may have initiated the disease in the first place. Ultrasound (sound wave testing) can also be ordered as needed. Dr. Gage's treatment of thyroid disease is individualized. Some patients with fatigue, weight gain, dry skin, or other signs may still have normal thyroid function testing but already test positive for antibodies. Specific diet and nutritional recommendations and thyroid medications are used in treatment, depending on the clinical situation.
Dr. Gage's philosophy is to integrate wellness into your lifestyle. By combining traditional evidence-based medicine with a host of preventative techniques, each patient is offered an individualized plan to optimize wellness. The individual is treated as a whole, not as a series of patchwork diagnoses with separate treatments. Patients are instead educated about the various causes of their underlying illnesses. They are taught to use lifestyle pattern changes, nutritional remedies, and foods to alleviate symptoms and disease. For example, a healthy diet with appropriate fiber may be a remedy for a patient suffering from irritable bowel syndrome, instead of just “the laxative pill”.
When possible, chiropractic care, provided by Dr. Richard Janof, is recommended to alleviate a whole host of musculoskeletal symptoms. By utilizing chiropractic techniques, patients may safely be treated without the use of strong medications, where there may be possible side-effects. Patients are thoroughly evaluated before treatment. X-ray, CT, or MRI testing is ordered as indicated. Traditional medical therapies can be added to the regimen, as can trigger point injections, if needed.
Patients are taught to introduce lifestyle, behavioral, and nutritional changes to combat various illnesses. They are educated on the use, disuse and abuse of nutritional supplements and dietary regimens. They learn how to combine nutrition and herbal products into their daily routine safely, without causing adverse reactions with the traditional medicines. Patients are constantly re-evaluated until optimal wellness is achieved.