Hormones regulate energy, weight, mood, growth and much else, and when one is out of balance the effects are felt everywhere. Our diabetes and endocrinology service supports people living with type 1 and type 2 diabetes, thyroid disorders, adrenal conditions and other hormonal problems, bringing together diagnostic testing, a review of your medicines and practical guidance on daily life.
Conditions we see
- Diabetes: type 1, type 2, prediabetes, and planning a pregnancy when you have diabetes
- Thyroid: an underactive or overactive thyroid, thyroid nodules and goitre
- Adrenal and pituitary conditions
- Polycystic ovary syndrome and other hormonal causes of irregular periods
- Low testosterone in men: see also testosterone replacement therapy
- Calcium, vitamin D and bone health, including osteoporosis
- Unexplained symptoms where a hormone problem is suspected: persistent tiredness, weight change without a reason, excessive thirst, feeling hot or cold when others do not, hair loss
If you have, or may have, diabetes
The symptoms of high blood sugar are thirst, passing urine often, tiredness, blurred vision, slow-healing cuts and repeated thrush, but type 2 diabetes often has no symptoms for years and is found on a blood test. Diagnosis rests on blood tests, chiefly HbA1c, which reflects your blood sugar over the last two to three months.
If you already have diabetes, a review looks at your HbA1c, blood pressure, cholesterol, kidney function, weight and feet, at how your current treatment is working and at what stands in the way: hypos, side effects, shift work, a fear of needles. The aim is control you can live with, because that is what protects the eyes, kidneys, nerves and heart over the years. Eye screening, foot checks and structured education remain important, and we will make sure you know how to get them.
Thyroid problems
An underactive thyroid causes tiredness, weight gain, feeling cold, dry skin, constipation and low mood. An overactive one causes weight loss, palpitations, tremor, sweating and anxiety. Both are diagnosed with a blood test and both are treatable. A lump in the neck is assessed by examination, blood tests and an ultrasound scan.
What happens at the appointment
A detailed history, an examination and a look at any results you bring. Tests are arranged where needed; some hormone tests have to be taken at a set time of day or after fasting. You are given a diagnosis, or a plan to reach one, and a discussion of treatment. Many endocrine conditions are managed for life, so the plan includes who does what: which medicines are continued by your own GP, when you should be reviewed, and what should make you call sooner.
Urgent symptoms
Seek urgent help for very high blood sugar with vomiting, abdominal pain, drowsiness or fast breathing, especially in type 1 diabetes; and for a hypo that you cannot treat yourself.
Common questions
What should I bring? Your medicines, your meter or sensor readings, recent blood results and hospital letters.
Will you take over my care from the NHS? No. We work alongside your NHS team and share our findings with them if you agree.
Do I need a referral? Not necessarily. A GP appointment can arrange the first tests.
