Endocrinology

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  Hypothyroidism
After diabetes, hypothyroidism is the most common endocrine condition that we diagnose and treat in primary care. Commonly we detect thyroid disease in patients who present with nonspecific symptoms or signs such as fatigue, weight gain, hair loss or sub-fertility.
  Hirsutism
Hirsutism can have a significant impact on psychological well-being and quality of life. It may be seen as a cosmetic problem but patients often want to discuss this issue.
  Prolactinomas
I have to confess to feeling rather ignorant during my consultations with both patients and as always, promised to go away and find out some more and get back to them – I found this review in the NEJM really helpful and hope you do too!
  Hypercalcaemia and primary hyperparathyroidism
You are duty doctor in the middle of the school summer holidays, you are screening colleagues' blood test results. A 56-year-old woman has a calcium of 2.8mmol/l (normal range 2.2–2.6 mmol/l). You look back in the notes and find the blood tests were taken because of unexplained fatigue.
What other tests should you arrange? Is any immediate intervention needed?
  Vitamin D
Vitamin D insufficiency and deficiency is 'hot' in the medical press at the moment and has been cited as associated with many medical conditions including cancer, autoimmune disease and metabolic syndrome!
  Opoid-induced hypogonadism
This case review in the BMJ highlighted the issue of hypogonadotrophic hypogonadism in patients taking long-term opiate medication. This may be particularly relevant to our chronic pain patients.
  Late onset hypogonadism in men

The clinical importance of the age related decline in circulating testosterone levels in men remains controversial. This phenomena has been named the ‘male menopause’, the ‘andropause’ or perhaps more biochemically accurately late onset hypogonadism. Periodically it is features in the Sunday papers or on a television program and I find for a few weeks I have male patients requesting tests of their testosterone levels.