What to Expect from a Visit to the Endocrinologist

What is an Endocrinologist?

An endocrinologist is a medical expert specializing in hormonal disorders of the endocrine system. These can include difficulties related to hormone production and release, as well as problems with the coordination between hormones and the organs that produce and use them.

How does the endocrinological examination proceed and what are the different diagnostic steps?

First step: medical history and physical examination

The endocrinological examination is painless and non-invasive. During your appointment, the doctor will spend approximately 30 minutes with you, analyzing your potential disorders. They will begin by asking you questions about your lifestyle, medical history, family history of certain diseases, and current symptoms. Then, they will perform a physical examination to assess the symptoms you have mentioned and detect other signs that may be related to endocrine and metabolic disorders. This will include measuring your height, weight, blood pressure, and pulse using a sphygmomanometer. Auscultation may also be performed. Based on the symptoms mentioned, the doctor will gather valuable clues to aid in diagnosis, such as blemishes, rashes, striae, fatty deposits, or signs of infection. They will pay particular attention to your hands, feet, abdomen, and oral cavity. They may also check the condition of your teeth and palpate for protrusions on the abdomen and neck (for example, checking for thyroid nodules).

Second step: additional examinations

In some cases, additional investigations may be necessary. For example, if diabetes is suspected or diagnosed, blood glucose levels will be measured. The endocrinologist may also perform an ultrasound endocrinological examination: using a probe that emits ultrasound waves, they can view the internal structures of the body on a screen. The examination is harmless, even for pregnant women, quick, and painless. It can be included, for example, in endocrinological examinations of the thyroid gland (detection of nodules and other abnormalities). Based on the results, the endocrinologist will prescribe treatment or further tests. Want to know more about your endocrine and metabolic health? Detecting hormones and other compounds in the blood or urine is a valuable method. Furthermore, through imaging, it is possible to precisely visualize nodules, tumors, and other irregularities in your body.

What are the main examinations performed during a consultation with an endocrinologist?

Blood tests

Using a blood sample, laboratory technicians can identify the presence of cholesterol, triglycerides, minerals, circulating hormones, or markers representing them. If autoimmune diseases are suspected, antibodies specific to the thyroid can also be sought. To assess thyroid function, blood tests are performed to detect TSH, T3, and T4 levels, hormones that are produced or regulated by the thyroid gland. The level of hormones produced by the body often varies throughout the day (such as melatonin) or month (such as progesterone in women). Therefore, these tests often require samples taken at different times of the day or at intervals of a few weeks.

Urine tests

Urine tests are very practical because they allow for the detection of acids and ketones, which can signal alcoholic ketoacidosis or diabetes, as well as cortisol, a possible indicator of Cushing's disease.

Ultrasound

The ultrasound probe, a tool that emits sound waves, is essential in the study of tissues. Indeed, it penetrates them, and its refractions vary depending on the various cells it encounters. Painless and harmless, it is also suitable for pregnant women. It is recommended, for example, to detect nodules in the thyroid gland or to study the parathyroid glands. For certain diagnoses, you may be recommended a transvaginal ultrasound. Using a technique called echo-endoscopy, a probe can be inserted through the mouth or nose into the digestive tract to detect potential abnormalities, including tumors such as those that cause insulinoma. This method also allows biopsies to be performed.

X-ray

This examination requires the use of very low doses of X-rays, electromagnetic waves that pass through certain tissues and thus allow observation and photographing of certain internal structures of the body. The procedure is simple and non-invasive. It is harmless, but not for embryos and fetuses, and therefore pregnant women cannot undergo it. An endocrinologist will prescribe an X-ray, for example, if growth problems are suspected in children and adults.

Magnetic Resonance Imaging (MRI)

MRI can also be performed on pregnant women (after the third month). This examination is the best diagnostic imaging method for the analysis of soft tissues. It is therefore used, for example, to detect masses in the adrenal and pancreatic glands.

Scintigraphy

This examination involves the administration of a tracer that is detected by an instrument called a gamma camera. The way the tracer accumulates allows the detection of pathologies, for example, tumors of the parathyroid glands.

Stimulation test

This dynamic test involves the operator administering a hormone to the patient, at controlled doses, in order to test the body's response. It measures hormone levels in the blood before administration, then several hours later during the day or the following day. Individuals taking supplements or hormone replacements should discontinue them on the day of the test, following medical advice.

Suppression test

In this dynamic test, the specialist administers a medication that lowers the level of a given hormone. When studying hormonal levels before and after taking a medication, we can determine our body's reaction. For example, dexamethasone, which prevents cortisol production in healthy individuals, has no impact on individuals suffering from Cushing's syndrome. In other words, this measurement method provides a reliable means of making a diagnosis.

What is the gynecological and endocrinological examination?

The doctor performs a complete assessment of reproductive health, including delayed pubertal development, menstrual irregularities, infertility, hyperandrogenism, polycystic ovary syndrome, osteoporosis, and premenstrual syndrome. Patient interview and observation of skin and hair are the first steps in detecting these problems, with additional tests prescribed as needed. Before or during pregnancy, it is crucial to consult an endocrinologist for a complete health check-up, as diseases such as diabetes and hypothyroidism can impact the successful outcome of delivery if not well managed.

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What to expect during your visit to the endocrinologist?

During your consultation with an endocrinologist, several steps will be necessary. First, you will be asked to share your medical history. Then, your weight will be measured and your vital signs will be taken, such as blood pressure, pulse, respiratory rate, and body temperature. In addition, the endocrinologist will examine your skin, mouth, teeth, and hair to detect any potential impacts of hormonal diseases on these areas. They may also order laboratory tests to help diagnose and treat endocrine diseases and other hormone-related disorders. Some commonly used diagnostic tests include:

• Complete blood count;
• Thyroid function test;
• Blood glucose testing and monitoring;
• Bone density screening;
• Biopsy;
• Urinalysis;
• Ultrasound and other imaging tests (e.g., MRI or CT scan);
• Depending on the results of your visit, the endocrinologist may prescribe medication or refer you to a specialist for further treatment;

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