Please feel free to access the following patient information to support your consultation.
Goitre - information from Dr Philip Kelly
The Pituitary Foundation has a very good website, full of helpful resources for patients/ family members and non-specialist heathcare providers:
Acromegaly - this can develop very insidiously, over decades in some patients, the symptoms can be very vague especially at first.
Adult Growth Hormone Deficiency - this is usually due to damage to the pituitary and/or the hypothalamus
Cushing's - Cushing's syndrome is most commonly due to prescribed or over the counter steroid containing medicines or products, Cushing's disease is caused by a pituitary tumour secreting ACTH. It can be a very very difficult condition to diagnose and to localise the precise cause even for endocrinologists.
Diabetes Insipidus - (DI) this can be difficult to diagnose, especially when it is not severe, and it might require a supervised water deprivation test in hospital, this is a specialist area even within endocrinology. It is critical to differentiate cranial DI, which will respond to DDAVP, from nephrogenic DI, which does not. Lastly a very similar clinical picture can occur from drinking too much, primary polydipsia - which some call dipsogenic DI
Prolactinoma/ lactotroph adenoma - a common clinical problem, presenting with menstrual irregularities, infertility in men or women, or breast milk - most commonly in women, It is important to consider prolactin elevation in patients who might have polycystic ovarian syndrome (PCOs). The usual treatment is a dopamine agonist, such as cabergoline.
Craniopharyngioma - these are very rare tumours, half occuring in childhood
Venous Thromboembolism (VTE)
Pulmonary Embolism (PE)
Deep Venous Thrombosis (DVT)
If you are prescribed certain medication it may be supported by specific information. These documents will not replace the information you have received in your consultation and are to support. They are general advice, rather than individualised.
Hormone Replacement Therapy (HRT) - benefits and risks - from Womens Health Concern
SELF ASSESSMENT - HEALTH
There are a number of resources available for you to assess your own health available below.
Osteoporosis, Fragility Fractures, Bone Health, Calcium intake and Vitamin D
Assessing for fragility fracture risk - vitamin D and calcium necessary for bone health and as part of assessing someones risk for fragility fractures it is necessary to assess for vitamin D deficiency and ensure there is adequate calcium intake.
People are at risk of vitamin D deficiency if they are aged over 65 years, or are not exposed to much sunlight (because they are confined indoors for long periods, or because they wear clothes that cover the whole body).
A calcium intake of at least 1000 mg/day is recommended for people at increased risk of a fragility fracture. To calculate dietary calcium intake there is a very useful calculator from the International Osteoporosis Federation here.
The calcium intake will be useful for the patient to know and also for their endocrinologist/ bone health/ osteoporosis specialist. If the calcium intake is low the patient might need supplemental calcium tablets. We firmly believe it is safer to have an adequate calcium intake from diet, rather than from supplementation if possible.
You may need to undertake specific tests to either diagnose or exclude certain conditions and below are specific resources and advice for those tests. They should be used only as support to specific advice from your consultation.
If Cushing's is being considered, or we are investigating a mass on your adrenal gland we may perform one of the following tests:
You might be asked to collect all your urine for 24-hours in certain situations, hypertension, hypercalcaemia/ hyperparathyroidism, kidney stones, diabetic kidney disease. The following is information to help the collection:
If thirst and/ or passing too much water (polyuria or frequency) are problems it is useful to assess your fluid balance. This can be done at home over two days. It is very useful to have an accurate assessment of total volumes drank and passed as well as urine passed at night. The following is information to help gather and record this information to support your consultation: