Endocrinology

Care begins with assessing the concerns and needs of each individual, with communication of information that increases understanding of the disease process, allays anxiety, and enhances coping skills. 
Treatment plans are individualized and are designed to maximize safety, address the most troubling symptoms, anticipate and minimize future problems, and reflect up-to-date knowledge.

Patients contact the clinic or are referred by specialists for conditions including the following:

Thyroid diseases

  • Thyroid goiter
  • Schilddrüsenknoten, Schilddrüsenzysten, Schilddrüsenkarzinom
  • Schilddrüsenüberfunktion (Morbus Basedow, einzelne oder multiple Autonomie (heiße oder kalte Knoten)
  • Schilddrüsenunterfunktion (z.B. als Folge von Autoimmunerkrankungen, häufig nach Thyreoiditis, Schilddrüsenentzündung) Nebenschilddrüsenerkrankungen die mit zu viel oder zu wenig Calcium im Blut bei Hypoparathyreoidismus oder Hyperparathyreoidismus einhergehen

Diseases of the adrenal glands

  • Cushing-Syndrom = Hypersecretion of cortisone or drug induced with symptoms of overweight, striae and sometimes infections
  • Hyperaldosteronisms: Conn Syndrom = Hypersecretion of aldosterone with Hypopotassianemia
  • Adrenal tumours without hormone activity
  • Morbus Addison: Lack of cortisone and other adrenal hormones with feelings of weakness dehydration, hypotension, or shock out of proportion to severity of current illness, Unexplained hypoglycaemia, Hyponatremia, hyperkalemia, azotemia, hypercalcemia, or eosinophilia, Hyperpigmentation or vitiligo
  • Adrenogenitales Syndrom = Vermännlichung der primären und sekundären Geschlechtsmerkmale bei Frauen
  • Pheochromozytoma = Excess of adrenaline with hypertension, arterial hypertension hormonally conditioned

Dysfunction of the pituitary

  • Acromegaly = Gigantism Prognathism, Arthralgias and arthritis, Carpal tunnel syndrome, Acroparesthesia Hypertrophy of frontal bones Menstrual abnormalities, Galactorrhea, Decreased libido, impotence, low levels of sex hormone-binding globulin. Multiple endocrine neoplasia type 1, Hyperparathyroidism, Pancreatic islet-cell tumors
  • Cushing-Syndrom (excess of cortisol) = Centripetal obesity, Facial plethora Glucose intolerance, Weakness, proximal myopathy, Hypertension, Psychological changes Easy bruisability, Hirsutism, Oligomenorrhea or amenorrhea, Impotence, Acne, oily skin, Abdominal striae, Ankle edema
  • Prolactinoma = Hyperprolactinemia in premenopausal women causes hypogonadism, manifested by infertility, oligomenorrhea, or amenorrhea and less often by galactorrhea
  • Hormone-inactive tumours
  • Panhypopituitarisms = Lack of pituitarian hormones

Diabetes mellitus = Hyperglycemia often accompanied with hyperlipidemia (metabolic syndrom)

Hyperlipidaemia and metabolic syndrome
World Health Organization - A World Health Organization (WHO) diabetes group proposed a set of criteria for the metabolic syndrome in 1998 with the recognition that these criteria could be modified as more was learned about the syndrome. Insulin resistance, impaired glucose tolerance, or diabetes were included in this definition, which follows: - Hyperinsulinemia or a fasting plasma glucose (FPG) 110 mg/dL (6.1 mmol/L) or a plasma glucose two hours after an oral glucose tolerance test 200 mg/dL (11.1 mmol/L). - PLUS at least two of the following: Abdominal obesity, defined as a waist-to-hip ratio >0.90, a body mass index (BMI) 30 kg/m2, or a waist girth 94 cm (37 in) (see "Clinical evaluation of the overweight adult", section on Determination of degree and type of overweight) Dyslipidemia, defined as serum triglyceride 150 mg/dL (1.7 mmol/L) or high-density lipoprotein HDL cholesterol <35 mg/dL (0.9 mmol/L) Blood pressure 140/90 mmHg or the administration of antihypertensive drugs.

Investigation of an under- or oversupply of vitamins
A common phenomenon, e.g. during the menopause

Hirsutisms 
Hirsutism, defined as excessive male-pattern hair growth, affects between 5 and 10 per cent of women of reproductive age. It may be the initial, and possibly only, sign of an underlying androgen disorder, the cutaneous manifestations of which may also include acne and male-pattern balding (androgenic alopecia). Depending upon the body site, hormonal regulation plays an important role in the hair growth cycle. Race and ethnicity are important determinants of body hair distribution in women. Polycystic ovary syndrome is the most common cause of hirsutism. The diagnosis of idiopathic hirsutism is given to women with hirsutism with normal serum androgen concentrations, no menstrual irregularity, and no identifiable cause of their hirsutism. Other causes include congenital adrenal hyperplasia, ovarian and adrenal androgen-secreting tumors, medications, and other rare disorders.

Excess or lack of sexual hormones
Women: After excluding pregnancy, the most common causes of secondary amenorrhea are: Ovarian disease - 40 percent Hypothalamic dysfunction - 35 percent Pituitary disease - 19 percent Uterine disease - 5 percent Men: When testosterone deficiency first occurs after puberty has been completed, symptoms may include a decrease in energy and libido, erektile dysfunktion, that occur within days to weeks. However, sexual hair, muscle mass, and bone mineral density do not fall to a readily detectable degree for several years. Men may also present with infertility. Some may present with hiperlipedemia.

Osteoporosis
Reduced bone mass is the most common clinical skeletal disorder. An age-related decline in bone mass begins around age 35 years and accelerates in women after menopause. Early diagnosis and quantification of bone loss and fracture risk have become more important because of the availability of therapies that can slow or even reverse the progression of osteoporosis.

Disorders of the sex hormone metabolism
which can cause erectile dysfunction, cycle disorders, hirsutism or hair loss and poor performance as well as adynamia

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