Professor of NKUA, George Chrousos, received the Andrea Prader Prize 2023

The European Society of Paediatric Endocrinology (ΕSPE – awarded the Andrea Prader Prize 2023 to Professor of the National and Kapodistrian University of Athens (NKUA) George Chrousos.

ESPE announced the award during its 61st Annual Meeting, which took place in The Hague, Netherlands, from 21 to 23 September 2023 (

The Andrea Prader Prize is the most significant ESPE award. A distinguished ESPE member receives this award every year in appreciation of their excellence in leadership, lifetime achievements in teaching and research, and outstanding overall contribution to paediatric endocrinology. The prize is awarded through final selection by the Andrea Prader Committee.

George P. Chrousos, CV

George Chrousos is Professor Emeritus of Paediatrics and Endocrinology, Head of the NKUA’s Unit on Clinical and Translational Research in Endocrinology, and Director of the Research Institute for Maternal and Child Health and Precision Medicine of the same University. He has held the UNESCO Chair on Adolescent Health Care at NKUA since 2010. Also, in 2011, he held the John Kluge Distinguished Chair in Technοlogy and Society at the US Library of Congress.

Before returning to Greece in 2000, he was Chief of the Paediatric and Reproductive Endocrinology Branch of the National Institute of Child Health and Human Development in Bethesda, Maryland, and Professor of Paediatrics, Physiology, and Biophysics at Georgetown University, Washington, DC, titles he holds to the present day.

G. Chrousos is well-known for his work on the glucocorticoid signalling system of the cell, the diseases of the HPA axis, and the physiologic and molecular mechanisms of stress. He has made significant contributions to the biomedical literature and thus expanded our understanding of chronic complex human disorders, such as depression, the metabolic syndrome, and autoimmune diseases.

Throughout his career, he has worked as a mentor and collaborator with an impressive group of young scientists, including doctors and researchers from other disciplines, such as biologists, psychologists, nutritionists, and so on. All of them are now successful in their fields and/or enjoy positions in the academic, clinical, and industrial sectors.

He has authored over 1,000 original scientific papers, and his work has been cited internationally in more than 190,000 scientific publications, an eloquent testimony to the significance and influence of his research. According to the Institute of Scientific Information, he is one of the most cited scientists (ISI highly cited) in Clinical Medicine and Biology & Biochemistry, and the most cited clinical paediatrician and endocrinologist worldwide. He is also the only Greek doctor-scientist in the list of 100 most cited doctors-scientists in the world.

Professor Chrousos is a Master of the American College of Physicians and the American College of Endocrinology and a Fellow of the Royal College of Physicians, London, UK. Among other things, he is a Doctor Honoris Causa of the University of Liège, Belgium, the University of Ancona, Italy, and the University of Patras, Greece, and an Honorary Professor of the University of Warwick, UK, Saint Petersburg State Paediatric Medical University, Russia, Xi’an Medical University, China, and Democritus University of Thrace, Greece.

He is an elected member of the National Academy of Medicine, Washington, DC, USA, and the European Academy of Humanities, Letters, Law, and Sciences (Academia Europaea), London, UK.

Professor Chrousos has received numerous international awards for his work. These include the Richard E. Weitzman Memorial Award, US Endocrine Society (1987), the Superior Service Award, US Public Health Service (1992), the Clinical Investigator Award, US Endocrine Society (1997), the Hans Selye Award, Hans Selye Foundation, Montreal, Canada (1997), the Pharmacia-Upjohn International Award for Excellence in Published Clinical Research (First Prize), US Endocrine Society (1999), the Novera Herbert Spector Award, International Society for Neuroimmunomodulation, Lugano, Switzerland (1999), the Henning Andersen Prize, European Society for Paediatric Endocrinology, Brussels, Belgium (2000), the Sir Edward Sharpey-Schafer Medal, British Endocrine Societies (2002), the Lifetime Achievement Award, International Society for Psycho-Neuro-Endocrinology, Glasgow, UK (2006), the Henning Andersen Prize, European Society for Paediatric Endocrinology, Helsinki, Finland (2007), and the Geoffrey Harris Prize in Neuroendocrinology, European Society of Endocrinology, Berlin, Germany (2008). In 2011, the competent international committee awarded him the Bodossaki Excellence Award of the namesake Foundation. In 2014, he received the Fred Conrad Koch Award, the highest honour of the US Endocrine Society.

Recent Awards/Distinctions

2021 – Elected Member, Sigma Xi (ΣΞ) Scientific Research Honor Society, USA

2021 – Prix Gallien Award in Scientific Research, Athens Greece

2022 – Delbert Fisher Research Scholar Award, US Endocrine Society, Atlanta, GA, USA

2022 – Carl Gemzell Lecture, Uppsala University, Uppsala, Sweeden

2023 – Transatlantic Alliance Award, Endocrine Society and European Society of Endocrinology, Chicago, Illinois, USA


The “Congenital” Scientist


Honored by both the Endocrine Society and the European Society of Endocrinology with the 2023 Transatlantic Alliance Award, George Chrousos, MD, ScD, has made significant contributions to endocrine research on both sides of the Atlantic! Endocrine News speaks with Chrousos about what this award means to him, conducting pioneering research on two different continents, the importance of studying stress, and why he became an endocrinologist in the first place.

In October, the Endocrine Society and the European Society of Endocrinology (ESE) jointly awarded the 2023 Transatlantic Alliance Award to Prof. George P. Chrousos, MD, ScD.

The Transatlantic Alliance Award, which began in 2021, recognizes a leader who has made significant advancements in endocrine research in Europe and the U.S. Chrousos, who is professor emeritus of pediatrics and endocrinology at the National and Kapodistrian University of Athens (NKUA) School of Medicine in Athens, Greece, as well as UNESCO Chair on Adolescent Health Care and director of the University Research Institute on Maternal and Child Health and Precision Medicine, both at NKUA, exemplifies transatlantic endocrine leadership.

Earlier in his career, Chrousos was chief of the Pediatric and Reproductive Endocrinology Branch at the National Institutes of Health (NIH)’s Eunice Kennedy Shriver National Institute of Child Health and Human Development and John Kluge Distinguished Chair in Technology and Society at the U.S. Library of Congress in Washington, D.C. His transnational training of more than 60 renowned physician-scientists coupled with his extensive research contributions — he has written more than 1,000 original papers — make him a worthy recipient of this prestigious award. In 2014, he received the Endocrine Society’s Fred Conrad Koch Lifetime Achievement Laureate Award.

Chrousos has made outstanding and ongoing contributions to the endocrine community’s fundamental and clinical understanding of stress biology and medicine, the diseases of the hypothalamic–pituitary–adrenal (HPA) axis, and many stress-related disorders, including anxiety, depression, eating disorders, obesity, metabolic syndrome, sleep disorders, and inflammatory autoimmune and allergic diseases. He has even conceptualized and described new diseases: the chronic stress and inflammation syndrome (CSIS) and primary generalized glucocorticoid resistance, also known as Chrousos syndrome.

Chrousos’s achievements reflect a dual combination of outstanding basic and clinical creativity underscoring his standing as an international researcher and clinical leader of endocrinology and metabolism. Endocrine News is honored to have interviewed this luminary in the field.

Endocrine News: You are only the third recipient of the Transatlantic Alliance Award — that must be quite an honor. What does it mean to you?

George P. Chrousos: It certainly means a lot to me. It is a recognition of the biomedical research, teaching, and training work that I have done in both continents, the U.S. and Europe. I had the opportunity to mentor many physician-scientists and basic scientists, who now have top positions in academia, industry, and clinical practice in these continents and beyond.

EN: To have led two teams of physician-scientists both in the U.S. and in Europe is a remarkable accomplishment. What drives you?

GC: I am a “congenital” scientist and teacher. I enjoy biomedical research (i.e., the production of new knowledge), and I get a lot of satisfaction out of teaching younger colleagues the scientific method. I also appreciate the success of my trainees and see them as a projection of myself into the future.

EN: You are presenting “The Endocrine Basis and Implications of Stress and Its Management” at ENDO 2023 — can you explain briefly what this research has uncovered?

GC: When I started my scientific career in the late 70s, the term “stress” was almost prohibited to use in the scientific literature (for various reasons). However, studying glucocorticoids, their molecular and cellular actions, the regulation of their secretion, and their effects in experimental animals and humans made it apparent to me that stress represents a major concept, as it plays key roles in both physiology and pathophysiology. After I reviewed the seminal work of two great endocrinologists, Walter Cannon and Hans Selye, on stress, I proceeded to clearly define stress as “the state of threatened homeostasis,” and to distinguish it both from “disturbing stimuli,” or “stressors,” and from “the adaptive response or stress response” of the organism.

Then, it became clear that the adaptive response is subserved by a heuristic “stress system,” whose proper function during stress is beneficial in the maintenance of homeostasis. This system’s response during stress, however, is beneficial only within certain activity and temporal limits and becomes detrimental when it goes outside these limits. (This concept fully complies with the Aristotelian principle that “the good lies between two evils, too little or too much”!) Indeed, a tremendous amount of pathology results from the “adaptive response” to stress, when this response becomes “maladaptive” (i.e., pathogenic). In fact, the detriment to the organism when these limits are not respected is mediated by the actual mediators of the stress system, with the main ones being the glucocorticoids (i.e., cortisol in humans) and the catecholamines.

“I am a generalist at heart, and endocrinology, with its cybernetic roles involved in every bodily function, is ideal for me. Also, it is a very “scientific” field with both a clinical and a laboratory component, while its key involvement in homeostasis and stress gives it ancient philosophical roots and a glorious history.” – George P. Chrousos, MD, ScD, professor emeritus, pediatrics and endocrinology; UNESCO Chair on Adolescent Health Care; director, University Research Institute on Maternal and Child Health and Precision Medicine; National and Kapodistrian University of Athens (NKUA) School of Medicine, Athens, Greece

EN: How did stress become a major area of interest for you?

GC: As I was working with the rare but scientifically very interesting Cushing syndrome, it became apparent to me that the entire clinical picture of this condition, including its psychologic, phenotypic, cardiometabolic, and immune manifestations, were quite reminiscent of the clinical picture of many middle-aged people of both sexes, for some of whom, for obvious reasons, we reserve the term “pseudo-cushing.” At that time, corticotropin-releasing hormone (CRH) was isolated by W. Vale, and the 41–amino acid peptide became available for studies.

Several experiments performed by us and other groups demonstrated that intra-cerebro-ventricular administration of this stress mediator completely reproduced the phenomenology of the stress response, including not only HPA axis stimulation, but also activation of the locus caeruleus–norepinephrine/autonomic nervous system. When I realized the central role of the stress system in physiology and pathophysiology, stress really became my guide and main research focus. Now I have concluded that all the so-called “chronic noncommunicable disorders,” including anxiety, depression, obesity, the cardiometabolic syndrome, diabetes mellitus type 2, allergic and autoimmune diseases, the psychosomatic disorders, etc., are, to a great extent, the result of chronic psycho-socio-economic stress. The latter is ubiquitous in modern societies.

When I became a senior investigator at the NIH, a young psychiatrist from the National Institute of Mental Health (NIMH), Philip W. Gold, came to work with me. He became my long-term collaborator and friend and introduced me into psychiatry and the main disorders studied at his institute at the time, mainly anxiety, major depression, and the eating disorders anorexia and bulimia nervosa, all of which we now know are strongly related to stress. His team and mine then started a major long-term collaboration that resulted in a strong “infusion” of endocrinology and, to some extent, immunology, into psychiatry, a collaboration that resulted in the elucidation of pathogenetic mechanisms in a series of psychiatric disorders, including the so-called melancholic and atypical depression.

A little after Philip Gold, another psychiatrist with expertise in sleep disorders, Alexander Vgontzas, from the Penn State College of Medicine [Hershey, Pa.], joined me for collaborative research on sleep. He also became a long-term collaborator and friend. A series of studies were undertaken that represented a strong “infusion” of endocrinology and immunology into sleep physiology and pathophysiology, with the elucidation of many pathogenetic mechanisms in sleep apnea, disorders of daytime sleepiness and fatigue, idiopathic insomnia, etc.

At about the same time, two rheumatologists/immunologists, Ronald Wilder and Esther Sternberg from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), collaborated with me in immunological projects, including the study of the Lewis rat model of “global” inflammation, and such diseases as rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, and so on, again with interesting endocrine results, with hypocortisolism being a common key factor in the expression of these autoimmune and allergic disorders (e.g., including fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis, asthma, etc.). Interestingly, hypocortisolism also characterizes the recently described long-COVID syndrome.

EN: What other topics are foci of your research?

GC: I started my research career with the study of the HPA axis, both its molecular and cellular biology and physiology, and the diseases related to it, such as glucocorticoid resistance and hypersensitivity, Cushing syndrome and Addison disease, congenital adrenal hyperplasia, polycystic ovary syndrome, premature adrenarche, and premature and delayed puberty. In the context of my clinical work, I continue to have an interest in and study these diseases and states to this day.

“Research advances in endocrinology are rapid, novel, consequential, and very exciting. Novel hormones and mechanisms are being discovered almost every week, and it will not be long before we solve clinical problems that today we consider unsolvable. Obesity, type 1 diabetes mellitus, endocrine tumors, cardiometabolic problems, etc., will become the past.” – George P. Chrousos, MD, ScD, professor emeritus, pediatrics and endocrinology; UNESCO Chair on Adolescent Health Care; director, University Research Institute on Maternal and Child Health and Precision Medicine; National and Kapodistrian University of Athens (NKUA) School of Medicine, Athens, Greece

EN: Do any specific papers among your 1,000+ stand out to you as favorites or especially important?

GC: Of course, some papers stand out. Especially those that represent the synthesis of my work regarding “Glucocorticoids, tissue sensitivity, and disease[KH1] ” (Annals of Internal Medicine), “Stress and health and disease[KH2] ” (JAMA, Nature Endo Rev, Mol Psychiatry), “Stress and immune function[KH3] ” (N Eng J Med, Annals of Internal Med), “Stress and reproductive functi[KH4] on” (Annals of Internal Medicine), etc.

EN: What are you currently working on?

GC: Based on my work on the interaction of the Clock-BMAL1[KH5]  heterodimer of our biological circadian clock with the glucocorticoid receptor, which suggested that evening cortisol elevations — as they occur in chronic stress, major depression, Cushing syndrome, night shift work, or traveling across time zones — are more detrimental to brain and cardiometabolic functions than morning elevations, my colleagues and I performed a very large epidemiologic study, which continues to this day, in which the so-called “medically unexplainable symptoms” (MUS) correlated well with body composition parameters, such as visceral fat and sarcopenia, morning plasma hsCRP and interleukin-6 levels, and loss of salivary cortisol circadian rhythm, with increased evening cortisol elevations. These data suggested that starting from the pediatric age range, chronic stress and stress-related “para-inflammation” gradually alter body composition and cause a cluster of absolutely explainable psychologic and physical manifestations, including MUS. These manifestations should be collectively called “chronic stress and inflammation syndrome,” or “CSIS,” which is ubiquitous and affects more than two thirds of middle-aged people. My current work extends the study of this syndrome, by examining how brain networks, especially those residing in the frontal cortex, participate in its genesis and on ways to prevent its development and to reverse its course.

My colleagues and I also study children conceived by assisted reproductive technology (ART), both by classic in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).[KH6]  We have shown that they have an increased risk of developing “(dys)metabolic syndrome” by blood biochemistry and by metabolomic and proteomic evaluations. We also study women with gestational diabetes and determine prognostic biomarkers of the pregnancy outcome. I am also involved in several large multicenter, multinational studies on pregnancy, gestational weight gain, and pregnancy outcome. In addition, I participate in studies on the healthy nutrition and growth of European children and adolescents.

In the context of glucocorticoid resistance,[KH7]  we isolated a long noncoding RNA called Gas5 that interacts with the glucocorticoid receptor and prevents it from interacting with glucocorticoid response elements in the cell nucleus. This RNA is expressed in starving cells and protects them from the catabolic actions of glucocorticoids. Interestingly, the same RNA, along with many others, is expressed in exosomes of human milk. Currently, we examine the ability of these exosomal RNAs to enter the infant systemic circulation via breastfeeding. This likely represents horizontal epigenetic transmission.

EN: What led you to become an endocrinologist?

GC: I am a generalist at heart, and endocrinology, with its cybernetic roles involved in every bodily function, is ideal for me. Also, it is a very “scientific” field with both a clinical and a laboratory component, while its key involvement in homeostasis and stress gives it ancient philosophical roots and a glorious history.

EN: What is especially exciting in the field of endocrinology today? In medical research in general?

GC: Research advances in endocrinology are rapid, novel, consequential, and very exciting. Novel hormones and mechanisms are being discovered almost every week, and it will not be long before we solve clinical problems that today we consider unsolvable. Obesity, type 1 diabetes mellitus, endocrine tumors, cardiometabolic problems, etc., will become the past. In general, biomedical research, on the other hand, mental health, and cancer mechanisms are being gradually deciphered and understood, and I believe curative treatments are not far in the future, I can see them coming.

“I am a “congenital” scientist and teacher. I enjoy biomedical research (i.e., the production of new knowledge), and I get a lot of satisfaction out of teaching younger colleagues the scientific method. I also appreciate the success of my trainees and see them as a projection of myself into the future.” – George P. Chrousos, MD, ScD, professor emeritus, pediatrics and endocrinology; UNESCO Chair on Adolescent Health Care; director, University Research Institute on Maternal and Child Health and Precision Medicine; National and Kapodistrian University of Athens (NKUA) School of Medicine, Athens, Greece

Chrousos will present his award lecture, “The Endocrine Basis and Implications of Stress and Its Management,” at ENDO 2023, which will take place from June 15 to 18 in Chicago, Ill. Chrousos also will speak at ECE, the 25th European Congress of Endocrinology in Istanbul, Turkey, May 13-16, 2023.

Horvath is a freelance writer based in Baltimore, Md. She compiled and wrote the annual Eureka! feature in the December issue.


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George P. Chrousos delivers the Honorary 2022 Gemzell Lecture at the University of Uppsala, Sweden, for Major Contributions to Reproductive Science, Obstetrics and Gynecology

On 22 September 2022, Professor Emeritus of Pediatrics and Endocrinology of the National and Kapodistrian University of Athens George P. Chrousos delivered the honorary 2022 Carl Gemzell  Lecture, at Uppsala University, Uppsala, Sweden. Professor Chrousos was appointed as Carl Gemzell lecturer for his for major contributions to Reproductive Science, Obstetrics and Gynecology. His lecture was entitled  “The Roles of Genetics and Epigenetics in Human Evolution and Development”.

Within the context of his well known studies on stress and steroid hormone mechanisms of action, professor G.P. Chrousos described target-tissue resistance to the steroid hormones estrogen and progesterone in an experimentally useful, unique animal model, the New World primates, which he subsequently demonstrated to have a form of generalized tissue “pan-steroid/sterol” hormone resistance. This model predicted the existence of common cellular co-activators and co-repressors in the steroid/sterol signaling systems and the presence of several steroid resistance and hypersensitivity  syndromes in humans. In parallel, he studied various issues in human reproduction. He published one of the first descriptions of Late-onset Congenital Adrenal Hyperplasia (CAH) in adult women, men, and children, first determined the incidence of 21-hydroxylase deficiency in women with the polycystic ovary syndrome (PCOS), and performed the first human study on the effects of dexamethasone therapy of CAH in utero. He then described the increased presence of sleep apnea and elevated circulating cytokines in young women with PCOS.

He also studied the interactions of pubertal and stress hormones, the pubertal stages, and the psychosocial adjustment in adolescents of both sexes during the pubertal period. He continued with studies on the effects of stress on adolescent and/or adult pregnancy, labor, delivery, and birth outcome. Determined and studied the secretion of corticotropin-releasing hormone (CRH) by female reproductive tissues, such as the ovaries, the endometrium and the placenta, and demonstrated  its physiologic importance in blastocyst implantation, pregnancy, labor and delivery and the postpartum. He performed detailed studies on affective and eating disorders in female adolescents and adults, and examined the effects of stress hormones on several reproductive functions in animal models and humans. He reported studies on the endocrine, immune, and emotional changes in pregnancy and the postpartum and uncovered the hormonal etiology of the postpartum “blues” and depression. He also performed the early, seminal pre-clinical and clinical studies on the reproductive, metabolic, inflammatory, and behavioral effects of the anti-progestin RU 486 in rodents, nonhuman primates and humans.

Prof. Chrousos studied children conceived by ART, both by classic IVF and ICSI, and showed that they have an increased risk of developing dysmetabolic syndrome by blood biochemistry, and by metabolomic and proteomic evaluations. He also studied women with gestational diabetes and determined prognostic biomarkers of the pregnancy outcome. In Europe, he was involved in several large multicenter, multinational studies on pregnancy, gestational weight gain and pregnancy outcome. He also participated in studies on the healthy growth of European children and adolescents.

Greek – Chinese Symposium: Science in the time of COVID-19

Natural disasters and diseases have always been an integral part of human history. The instinct for survival was the ever-present trigger for researches and discoveries, as humans were forced to deal with Nature’s phenomena.

The proportional relationship between human comprehension and natural phenomena, led to the development and advancement of Science and Technology. As Science comprises the observation, study and research of Nature, Technology comprises the support, application and implementation of scientific discoveries and conclusions. They are interrelated and indispensable to humanity’s existence.

The COVID-19 pandemic led to an overload of scientific researches, studies and publications, to such extent that the data flow and information are overwhelming for the human mind. Scientists around the world search for solutions and ways to deal with this new threat to humankind.

We organized the online Symposium “Science in the Time of COVID-19”, on the 27th of June, at 15:30, inviting Chinese and Greek scientists to share experiences, observations, acquired knowledge, studies and researches, regarding the pandemic COVID-19 recent developments.

Additionally, the symposium will cover prospects for breakthroughs and pathways, through which artificial intelligence, genetics and clinical research will surpass potential limitations of approaches and methods employed by states, when dealing with such threats to humankind.

Biomedical research: lessons from the last decade’s crisis and austerity-stricken small countries for the current COVID-19-related crisis

The 2007–2008 economic crash has had long-lasting effects on Greece’s biomedical research landscape. It has exposed a gap in support for countries that are classified as high income but are living under austerity measures. A new model is needed for optimal utilization of the intellectual and natural resources that such countries can offer to improve the global research landscape.

Many countries were afflicted by the most recent decade-long financial crisis and its accompanying austerity measures. In Greece, Spain, Portugal and other countries, funding scarcity has greatly impeded the performance of expensive biomedical research in particular1. This field was particularly hit because the crisis took place while there was, at the same period, an explosion of costly, resource-expensive studies of biological pathways, precision medicine, big-data science, super-resolution imaging, robotics and high-throughput experimental technologies.

There are several long-standing programs that support research in low- and middle-income countries. For instance, such countries could benefit from the Research4Life programs AGORA, Hinari, OARE, ARDI and GOALI, or they could be entitled to request waivers for full tuition fees for their graduate students in leading foreign academic institutions. These countries face fundamental difficulties of their own, and such programs are sorely needed. In contrast, when small, high-income, developed countries are stricken by decreases in their gross domestic product, they cannot benefit from the developmental policies and remedial programs available to developing countries. Therefore, they could be fairly described as ‘research resource–poor countries’.





Οnce, as a small child growing up in Patra, George Chrousos came very close to dying and was saved by the family doctor who made a house call to treat him. It was the late 1950s and, playing with some boys in the neighborhood, he had suffered a bad cut on his face from an old German bayonet. Infection set in and, if he hadn’t been treated promptly with penicillin, a drug newly introduced to Greece, he might well not be alive today. He tells me this as we talk almost six decades later at Aghia Sofia Children’s Hospital in Athens, Greece’s biggest university hospital pediatric clinic, which he headed until just a few months ago.

George Chrousos is a professor of pediatrics and endocrinology, and has held the UNESCO Chair for Adolescent Medicine since 2010. Before returning to Greece in 2001, he was the director of the Pediatric and Reproductive Endocrinology Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) in Bethesda, Maryland, and a professor of pediatrics, physiology and biophysics at Georgetown University, Washington, DC.

He has received worldwide recognition for his research on the physiological and molecular mechanisms of stress, and on the diseases of the hypothalamic-pituitary-adrenal axis (HPA). According to both the Institute of Scientific Information and Google Scholar, which measure the number of searches for scientific articles and publications, he is the most cited clinical pediatrician or endocrinologist in the world and is listed among the 100 most-cited scientists worldwide.

After so many years of international recognition in the field of science, and having now permanently returned to Greece, do you feel that your Greek background played a role in your successful career path?

I consider myself as a Greek citizen of the world, and the US as my scientific homeland. As a Greek, I have always had a keen passion for philosophy and history, and I relate everything I read to medicine. When I began to focus on stress, I wanted to study its history in other, older societies at the same time. In 2011, I was appointed to the Kluge Chair in Technology and Society at the Library of Congress in Washington, where I discovered and collected a vast bibliography on the subject.

I discovered that the need to find a cure for stress has been very prominent since the beginning of the history of humankind. In the ancient Greek and Roman world, three philosophical currents for stress management were developed, by the Stoics, the Sceptics and the Epicureans, who even went as far as to speak about a “cure for the soul.” The psychotherapy we use today for cases of stress, anxiety or depression is called cognitive-behavioral therapy, and it has its roots in the philosophical schools of ancient Greece.

What are the findings of your research regarding stress management?

Exercise, a diet of high nutritional value, a regular daily routine, and good sleep are among the sine qua non. It’s far easier to enjoy a good psychological state if you’ve slept well! Beyond this, studies have shown that stress can be managed more effectively by those who have a more philosophical outlook on life. Do you know who lives more than 100 years? Those who can control their baser instincts and regulate their emotions. In the past few years, we’ve studied more than 450 centenarians in the Attica region.

On average, they were never overweight, hadn’t suffered bouts of clinical depression, ate a healthy diet and led lives of impressive regularity. Several of them had seen their children predecease them. Yet they’d say stoically, “What can you do? It was God’s will to take them.” Human beings are the only creatures to have developed a formidably complex prefrontal cortex, which can exert control over instincts, impulses and emotions, stimulate hope and assist in the attainment of a sense of well-being, of a lasting state of happiness.

Can someone train their brain to feel better?

Of course. As human beings, we can harness the systems of our brain that control stress and the emotions by means of philosophy, psychotherapy, meditation or prayer. All religions, irrespective of how dissimilar they may seem, inherently contain the necessary “ingredients” conducive to a better and happier life. Isn’t Buddhism a way of managing stress? Isn’t meditation and prayer the monks’ way of doing the same? Doesn’t Sufist mysticism claim to do the same for Muslims?

We could become a hub for the study and teaching of wellbeing, more specifically of eudaimonia, a Greek word, both in its original sense as defined by Aristotle, and in its current usage in modern English.

Have you arrived at a conclusion as to what constitutes happiness?

Aristotle said that in order to be happy, one must be good. Plato and Epicurus used to say that happiness (eudaimonia) could only be achieved by following a path of virtue and wisdom. One must have attained a certain maturity, gained a certain amount of experience and wisdom, and have the ability to regulate one’s emotive side and one’s instincts. You need to feel a sense of contentment that in your life you’ve tried your best to give to those around you. I personally believe that Epicurus had reached the highest point of human wisdom. Nietzsche used to say that we haven’t progressed a single step beyond Epicurus.

The link between mind and body and its effect on health is being studied at medical institutions everywhere. Does Greece have something to contribute to the world community today as regards this issue?

Greece can and does still contribute quite a lot. First of all, Greece carries out and often generates more scientific research than what would normally correspond to its population. One of the new postgraduate programs that we have introduced revolves around the science of stress and the promotion of health through a knowledge of the basic principles of biology. I’m surprised that there isn’t a comparable postgraduate module anywhere else in the world, and I’m currently in discussion with the University of Oxford regarding the possibility of setting up a similar program there.

Greece was and still is a beacon of philosophy and well-being. We could become a hub for the study and teaching of wellbeing, more specifically of eudaimonia, both in its original sense as defined by Aristotle, and in its current usage in modern English. We possess the right climate, conditions and environment, the necessary human resources, and a spectacular quotient of history. As Epicurus used to argue, we only get to live once. He entreated us to enjoy this one time. And by enjoyment, he did not mean food or sex, especially given how frugal he was in his own lifestyle – he only ate bread and olives, and, very occasionally, cheese. It is perfectly clear that he meant the kind of eudaimonia, the kind of happiness and pleasure, that can be achieved by developing good habits and by following the path of a virtuous life. True happiness comes from the meaning that life can hold for each of us, a meaning that we must each seek for ourselves.

How does one discover the meaning of one’s life?

It requires a lot of searching and self-reflection. We each have our own, different meaning. Yet we all have the responsibility to seek our life’s true meaning. And, of course, the act of giving to others is in itself the very meaning of life. A doctor has no need for any other kind of meaning in life, in my view, except for the substantial contribution to his fellow human beings that he can make through his profession. Bertrand Russell used to say that scientists and artists were the happiest people. Why? Because the pursuit of truth and the practice of the arts are by themselves contributions to our fellow human beings.

Have you yourself discovered the meaning of life?

Yes, I’ve found the meaning of my own life. I like to study and investigate the evolution and development of human beings, and to use this knowledge in order to help my fellow men.

Why did you decide to return to Greece after such a long and successful professional career and a comfortable private life in the US?

I like Greece and I’m Greek. The world here is vibrant. There’s a certain polymorphy and diversity, a distinct sense of humor and a feeling of solidarity. I do, of course, go back to the US often, not only to carry out scientific research and to teach, but also because two of my daughters and my grandchildren live there.

As a scientist, which factor do you think played the most significant role in your own development? Heredity or the environment in which you grew up?

I do believe that heredity was good in my case. But I also had an exceptional mother, who gave me her attention from very early on. She taught me how to read and write when I was three years old, and she inspired in me a love for books and knowledge. I read constantly and continue to learn even today.

Plato used to say that the virtues of education should be cultivated in children first of all. We know today that our brains begin to develop synapses, that is to say nerve circuits, very rapidly during the last three months of pregnancy, a process that reaches its peak at around the time of a child’s second year of life; that children have an already developed “moral intelligence” at four; and that most of the higher functions of the brain have been fully developed by the age of five. The conclusion is that if we wish to influence our society towards a more positive state of things, we need to start from a very early stage. Besides, there are socioeconomic studies that prove that a healthy pregnancy and a good early years education yield more benefits to society than school and post-secondary education.


The polycystic ovary syndrome

The polycystic ovary syndrome – Not just a disorder caused by an imbalance of reproductive hormones

The polycystic ovary syndrome (PCOS), the most common endocrinopathy in women of reproductive age (5-8% of women), was first described in 1935 by Stein and Leventhal. Seventy-five years later, it’s known as an heterogeneous endocrine and metabolic disorder of unknown etiology. Many medical research projects are carried out due to the frequent clinical heterogeneity as well as its long-term metabolic and cardiovascular effects.

Polycystic ovary syndrome is a clinical diagnosis that has at least two of the following three characteristics:

  1. Chronic anaphylaxis (which manifests itself in case of amenorrhea or postmenopause, ie less than six cycles over a year).
  2. Biochemical hyperandrogenemia (increase of androgen levels in blood) or hyperandrogenism (clinical hyperandrogenemia without similar biochemical findings)
  3. Polycystic ovarian morphology during ultrasound scan

An important condition for the correct diagnosis of PCOS is to exclude the presence of any other endocrine disorder and / or the use of drugs that can cause anovulation and clinical or biochemical hyperandrogenemia.

The aetiopathogenesis of PCOS has not yet been clarified, although there are several theories about its causes. The most important are ovarian and adrenal function disorder, insulin resistance and compensatory hyperinsulinemia, Gonadotropin-releasing hormone (GnRH) and  luteinizing hormone (LH) and three of them cause androgen excess. In case of the familial appearance of the syndrome, sometimes we found a positive family history of PCOS in our patient.

As mentioned above at the diagnosis characteristics, patients usually visit us if they has symptoms such as menstrual disorders (heavy periods or irregular frequent bleeding / absence of menstruation), infertility, hirsutism, androgenetic alopecia, acne. The recognition of the syndrome in its complete clinical expression has no pathognomonic signs and its phenotypic heterogeneity is a diagnostic challenge. Here, the assessment of the patient by an Endocrinologist plays an important role in ensuring that the medical history, objective examination and appropriate examinations make the right diagnosis and hence correct and personalized treatment.

As far as the patient’s therapeutic approach is concerned, it is important to bear in mind that PCOS is primarily a reproductive and metabolic disorder. 30-75% of women with PCOS are obese and in most cases have an abdominal body fat distribution, which is beneficial for well-known to all of us metabolic syndrome. Also in overweight and obese premenopausal women, the prevalence of PCOS is four times higher than in the general population. Women with PCOS and the absence of menstruation (obese and no) have an increased risk of Type 2 diabetes, which is even higher when obesity and family history of diabetes occur. In addition, PCOS is accompanied by a risk of high cholesterol, while postmenopausal women with PCOS have a high blood pressure levels.

In summary, the multisystemic clinical expression of PCOS implies a multidimensional therapeutic approach, and here, besides personalized medication, a change of a lifestyle, by adapting a right nutrition and physical activity, plays also an important role.


The thyroid gland is located in the anterior neck; it is a butterfly-shaped organ that is usually visible on inspection. It produces hormones, triiodothyronine (T3) and thyroxine (T4), which mostly controls how your body uses energy (metabolism). The thyroid is controlled by a gland located in the brain, the pituitary gland, which produces thyroid-stimulating hormone (TSH) to stimulate secretion of thyroid hormones (T4, T3). These two glands works together very closely and any functional thyroid disorder influences inversely the production of TSH.

Thyroid nodules are round or oval-shaped of thyroid tissue usually of different structure relative to the rest of the parenchyma. Thyroid nodules are common in the general population, especially in recent years thanks to the extensive use of ultrasound. The factors that can cause the creation of the nodules vary, while about 95% of them are benign.



There are different diagnostic tools that help determine whether a nodule is benign or cancerous and therefore to find the best treatment options (surgical removal, monitoring or other treatment). The diagnostic approach is not always the same for all patients.

If one or more nodules are detected during a physical examination (palpation) or during a carotid ultrasound (triplex), cervical CT/MRI  scan in other cases, your doctor should refer you to an Endocrinologist for more specific examinations:

  • All patients should undergo hormone test to evaluate thyroid function. In some patients, thyroid antibodies may also be required.
  • Thyroid ultrasound to evaluate the dimensions and morphology of the nodule, the presence of other nodules, the parenchymal echotexture and the evaluation of the cervical lymph nodes.
  • If there is no disorder in thyroid function, then, depending on the ultrasound and / or nodal size, as well as the individual and / or family history, it may require immediate puncture, under ultrasound guidance, to analyze the cells of the nodule.

If the hormone test shows hyperfunction (TSH production is at lower levels or suppressed) then we should do first a thyroid scintigraphy to see if it is a hot nodule (use of radiopharmaceuticals) or a cold nodule (without the use of radiopharmaceuticals). In the latter case, if most of the cold nodes are benign, a further investigation with a puncture is required for a cytology (see above). Hot nodules should not be punctured because it is rare to be cancerous.

– In case of hypothyroidism (abnormally high TSH levels) and if a patient needs a thyroxine replacement therapy, the investigation of nodules should be performed as thyroid function is normalized.

In some cases, the Endocrinologist may request calcitonin measurement, which is high in patients with a type of a thyroid cancer, a medullary thyroid carcinoma. Moderately elevated levels of calcitonin may also be detected in other benign thyroid diseases or other disorders, where a patient need a further investigation.


In case of hyperfunctioning nodule/warm nodule the treatment may be done from the mouth to suppress a thyroid hormone synthesis, surgical removal or treatment with radioactive iodine. Choosing an appropriate treatment depends on the age of the patient, the characteristics of the nodule and the presence of other nodules, contraindications between various treatment methods, as well as the preferences of a patient.

If a puncture is necessary as a first choice or after a scintigraphy because the nodule is cold, the therapeutic approach depends on the results of the cytology test.

In some cases, the material is not sufficient for an exact cytologic evaluation and so a puncture procedure should be repeated.

  • In a small percentage (10%) cytology provides unclear results, a so-called “gray zone” results. In this case, the therapeutic option may be surgical removal, repetitive puncture and / or close monitoring depending on the age of the patient, the presence of comorbidities as well as factors that increase suspicion of malignancy (clinical, ultrasound, individual and / or family history)
  • In cases of benign cytology, the patient needs continuous monitoring of the nodule. If, over time, the characteristics of the nodule change, then it should be necessary to repeat the puncture. Nodules of a large size (> 3-4 cm), even if they are benign, especially with compressive symptoms on the throat, should be removed with a surgical intervention.
  • The nodules that are cytologically malignant or suspected for malignancy require surgical intervention. In these cases, it is advisable before the surgery to check out the cervical lymph nodes using an ultrasound scan by an experienced radiologist, in order the surgeon to have all the required information. In some cases, post-operative care with the radioactive iodine may be necessary to counteract the remaining benign but also malignant cells in order to better monitor the patient.

It is important to know that a small percentage (about 5%) of all thyroid nodules are malignant and that thyroid cancer, in most cases, has high survival rates.

A brief description of thyroxine suppression therapy for the treatment of benign and cystic nodules. Nowadays, according to the latest global data, thyroxine suppression therapy is not recommended because it does not reduce all the nodules and if it reduces, the amount is not big enough to justify the use of the treatment which is maybe harmful (heart arrhythmia, osteoporosis) especially among older patients.

Cystic nodules, usually benign lesions of the thyroid parenchyma, need simple monitoring. However, it they are large and symptomatic, an evacuative puncture is carried out in the first stage. Unfortunately, most of the time they recur so the best treatment, excepting contraindications, is their surgical removal.


Increased body weight predisposes to type 2 diabetes. Weight reduction and the maintenance of a healthy weight is a key component of diabetes management, either type 1 or type 2. In many cases of type 2 diabetes, losing just 5 -10% of body weight can improve blood sugar numbers and lipids as well as a blood pressure. It is important to understand that the goal is not to cut quickly the quantity of food in order to lose weight but to consume smaller quantities following a weight-management program and improving your eating habits. So cutting calories can lead to weight loss.

  • Consume daily the same amount of calories.
  • Eat your meal at the dining table, without watching a TV or magazines.
  • Make sure there is a vegetable salad on the table and start your meal with it.
  • Eat low-fat foods, avoid fried food and add a small amount of olive oil to your meal.
  • If you are hungry and cannot wait until your next meal, eat a green salad without oil.
  • Drink plenty of water throughout the day. Avoid alcohol; it contains many calories.
  • Keep your refrigerator empty rather than full. Avoid nuts, biscuits and sweets.
  • Always leave some food on your plate, put a small portion or use a smaller plate.
  • Do not forget about physical activity. Exercise daily, e.g. one hour walking, gardening etc.
  • Frequent visits to your doctor or dietitian will help you with your efforts.


Insulin and Nutrition

When insulin is the main part of therapy then you need to eat at regular times and amounts. It is very important to be properly trained for this, so you should contact your health care team (dietician).