Metabolic syndrome
Metabolic syndrome may be diagnosed if you have 3 or more of the following:
Being very overweight or having too much fat around your waist
- HDL (the "good" cholesterol) has High triglyceride levels (fat in the blood) and low levels of
- High blood pressure that's consistently 140/90mmHg or higher.
- Type 2 diabetes mellitus or pre-diabetes with insulin resistance
Having more than one factor together carries a very high risk for cardiovascular complications such as heart attack or stroke and needs to be investigated and managed carefully.
Benefits of consultation – detailed clinical assessment, review of risk factors, plan for screening blood test, management plan with a detailed explanation of pros and cons of available medications, and if an appropriate prescription for treatment will be provided.
Thyroid gland
The thyroid is a butterfly-shaped gland that sits in the front of the neck. It’s responsible for secreting two hormones, thyroxine (T4) and triiodothyronine (T3), that are critical for the normal function of cells in the body, and critical for the intellectual development of your baby. Thyroid disorders could be:
- Related to abnormal thyroid function (underactive or overactive thyroid) due to autoimmune thyroid disease – Hashimoto disease or Graves’ disease, iodine deficiency or excess, post-viral infection, or intake of medications.
- Related to abnormal structure of the thyroid gland (thyroid nodules, goitre–diffuse thyroid swelling, or rarely -thyroid cancer)
- The reason for the bulging and red eyes, menstrual abnormalities, impaired fertility, and inappropriate baby growth.
Benefits of consultation - detailed clinical assessment, physical examination, review, or planning of relevant blood tests, including screen for autoimmune thyroiditis; referral, or review of the results of US thyroid, detailed management plan, including effect of diet and supplements, and if appropriate prescription for treatment will be provided.
Women's health – period irregularity, lack of period, and associated symptoms
Hormonal abnormalities could be the reason for period irregularity, excessive hair growth, infertility, and milk like secretion coming from the breasts. Symptoms could be due to:
- PCOS (polycystic ovaries syndrome)
- Hyperprolactinaemia
- Rare hormonal abnormalities with congenital pre-disposition as adrenal hyperplasia (CAH)
- Menopause
Benefits of consultation: detailed clinical assessment, plan for biochemical investigations, which could be done at clinic as: LH, FSH, oestradiol, Prolactin, androgen profile, screen for CAH with 17OH progesterone, and management plan based on personal goals and desire for fertility: discussion re different hormonal replacement therapy options based on individual risk factors and gynaecology assessment; referrals for more detailed investigations (as MRI) or escalation of care via the GP to specialised centres when appropriate.
Bone health
Bone disorders are conditions that cause weakened bone and could be the cause of frequent bone fractures or increased risk for hip fractures. Risk factors could be genetic or due to inappropriate nutrition, lifestyle factors, hormonal changes – such as low oestrogen levels during menopause, low levels of testosterone or elevated cortisol, certain medications – corticosteroids, thyroid medicines, or autoimmune conditions – type 1 diabetes mellitus, celiac disease, rheumatoid arthritis.
Benefits of consultation: detailed review of risk factors, review, or referral for bone density scan (DXA), plan for screening blood test including bone profile, 25OHD, and management plan, alongside diet and appropriate level of physical activity.
Men's health
Symptoms of low libido, reduced frequency of erections, breast enlargement, and infertility could be hormonal-related. They could be due to isolated hormonal deficiency (testosterone deficiency) or part of metabolic syndrome, other hormonal abnormalities (such as high prolactin, diabetes, thyroid dysfunction), or intake of other drugs.
Benefits of consultation: detailed clinical assessment and endocrine review, plan for an appropriate biochemical screening test which could be done at the clinic as testosterone, SHBG, LH, FSH, PSA, Prolactin, and management plan, based on the results (if an appropriate prescription for treatment will be provided).
Diabetes mellitus
There are different types of diabetes mellitus. Early stages could be asymptomatic or slowly progressing. General symptoms usually include increased thirst, increased frequency of urination, change in weight, and frequent infections. Some of the forms of diabetes could have a genetic predisposition and could be asymptomatic in the early stages.
Benefits of consultation: detailed clinical assessment and review of the risk factors, plan for screening tests which could be done at the clinic as fasting blood glucose, HbA1C, Ab screen for type 1 diabetes, measurement of C-peptide to assess insulin reserve; management plan.
Adrenal glands disorders
Adrenal glands are secreting multiple hormones such as cortisol, a deficiency of which could be the reason for chronic tiredness and fatigue or weight loss. Cortisol deficiency could be part of an autoimmune syndrome or related to the long-term use of medications. The opposite- too much cortisol secretion could be the reason for weight gain or hypertension. Other hormones secreted by the adrenal glands could be the reason for excessive hair growth within the female population or high blood pressure.
Benefits of consultation: detailed clinical assessment and review of medications with possible impact on adrenal glands hormonal synthesis; plan for biochemical investigations or review of available screening blood tests; referral for further investigations or escalation of the care plan, when appropriate.