Endocrinology

 

What is endocrinology?

Endocrinology is the branch of medicine that deals with the endocrine system – this is a body system consisting of a number of glands that secrete various types of hormones. These hormones act as special signals throughout the body to control many aspects of physiological function, such as blood sugar levels, growth, development, digestion, temperature and sexual function. Glands that form the endocrine system include the hypothalamus and pituitary gland in the brain, thyroid gland and parathyroid gland in the neck, pancreas, adrenals, ovaries and testes.

These glands operate through complex pathways that regulate themselves. Endocrine disease can occur when there is a disruption in any of these pathways. An endocrinologist is a doctor who specialises in treating disorders of these systems. Sometimes treatment can involve surgery that is performed by endocrine surgeons.

There are many different endocrine diseases – some are very common, whilst others are extremely rare. The more common endocrine disorders amongst the UK population include the following:

Diabetes mellitus

Usually referred to as ‘diabetes’, this is a condition caused by problems regulating blood sugar levels. It can occur either because the pancreas produces too little insulin (the hormone that tightly regulates sugar levels in the blood), or because the body does not respond appropriately to the insulin that is produced. This results in erratic blood sugar levels, which can be dangerous if they become very high or very low. 

There are 2 main types of diabetes: type 1 and type 2. Type 1 diabetes is more common in younger people and is caused by the body destroying its own insulin-producing cells in the pancreas. This is usually treated with careful monitoring of blood sugar levels and direct insulin replacement via injections. Type 2 diabetes is associated with obesity and a development of resistance to insulin due to persistently high blood sugar over a long period of time. This can be managed well through lifestyle and dietary adjustments, and medications that help to stabilise blood sugar levels. Having higher blood sugars for a long time can cause damage to blood vessels and other organs such as the eyes and kidneys.  It is also a risk factor for developing heart disease and stroke. 

Thyroid disease

The thyroid gland is located in the neck and produces the hormone ‘thyroxine’, which regulates the body’s metabolism, which affects temperature and growth. Too much thyroxine results in hyperthyroidism and too little causes hypothyroidism. These can both produce symptoms in bodily functions that impact day-to-day life, including problems in regulating temperature, mood swings, bowel changes, skin changes and alterations in weight. Thyroid disorders are common and well treated with daily medication, however more severe cases may need surgery. In some cases, thyroid disease can be caused by cancer. These cases are usually treated with a combination of specialist medications and surgery.

Parathyroid disease

There are four parathyroid glands positioned within the thyroid gland in the neck that produce parathyroid hormone (PTH). The function of PTH is to maintain the level of calcium in the blood by regulating the calcium turnover in bones and the absorption of calcium from food. The main symptoms of parathyroid disease are caused by the calcium levels either being too high or low, and usually relate to conditions of the bones, kidneys or muscles. If PTH production is too high, this is usually due to one of the four glands overproducing the hormone, and can be corrected by surgical removal of the overactive gland. Low PTH levels are most commonly due to damage to a gland from previous neck or thyroid surgery and can be treated with calcium and/or hormone replacement medication.

Polycystic ovary syndrome (PCOS)

PCOS is a condition that affects the ovaries in women. It causes them to become enlarged with excess follicles (not cysts as the name suggests) and, as a result, various hormones are affected. Common symptoms of PCOS include irregular periods, excessive hair growth, particularly on the face, and enlarged ovaries. Although the definitive cause of PCOS is not known, it is associated with increased levels of insulin and testosterone. It can be managed effectively with weight loss, medications or surgical procedures and in some cases, fertility assistance.

What is endocrinology surgery?

Many endocrine conditions can be managed with medications that aim to replace the hormone insufficiency or suppress any excess hormone production, as well as lifestyle modifications to control symptoms. However, in cases where the disease becomes severe or is not managed effectively with medication, a surgical solution may be required. For example, in cases where hyperthyroidism is not treated effectively with medication to suppress the production of thyroid hormone, it may be more beneficial to surgically remove the thyroid gland and start thyroid hormone replacement. 

Endocrine disease can also sometimes be caused by hormone-secreting tumours, which may require surgical removal.

If endocrine disorders are not treated effectively, they can have long-standing effects on the body. For example, poorly controlled diabetes can lead to kidney failure, which can result in the need for dialysis or kidney transplant

What we offer

Here at the Royal Free Hospital Private Patients Unit, we aim to deliver the high standard of care that you would associate with an acute NHS hospital. We are unique in that we reinvest all of our profits into our NHS services for the benefit of all patients. We are proud to offer access to leading specialists and treatment with convenience, comfort and personalised attention.

Our main endocrinology services are provided in outpatient clinics and supported by a wide multidisciplinary team of clinical specialists, including expert physicians, surgeons, specialist nurses and dieticians. Our leading endocrine investigation unit facilitates any necessary endocrinology tests. We support the latest in endocrinology research at our laboratories so that we provide cutting-edge treatments for our patients.

In addition to our general endocrinology clinic, we offer specialist advice and treatment for a variety of other conditions, including:

  • Thyroid and parathyroid assessment and surgery
  • Gynaecology-related conditions, including PCOS
  • Adrenal surgery (both open and laparoscopic [‘key-hole’])
  • Acromegaly
  • Neuro-endocrine tumours
  • Antenatal endocrinology

Our expert team of specialists

We work with some of the leading experts in endocrinology and endocrine surgery, who are all supported with the expertise of a multidisciplinary team. Our consultant team of expert medical doctors and surgeons includes: