Practice information from Dr Syed Kashif Hussain Kazmi, Consultant Endocrinologist. View professional profile on Top Doctors.
Endocrine (hormone) disorders arise when glands such as the pituitary, adrenals or parathyroids make too much or too little of a hormone. An endocrinologist investigates unexplained symptoms or abnormal results and treats the cause. Dr Kazmi offers virtual appointments across the UK and in person care in Cambridge.
What are endocrine and hormone disorders?
Hormones are chemical messengers made by glands such as the pituitary, thyroid, adrenals, parathyroids, ovaries and testes. Endocrine disorders arise when a gland makes too much or too little of a hormone, or when a growth in a gland affects its function. Because hormones influence many organs, the symptoms are often subtle at first and may be mistaken for other conditions.
Examples that an endocrinologist assesses include pituitary conditions such as prolactinoma and underactive pituitary; adrenal conditions such as Addison’s disease, Cushing’s syndrome and adrenal nodules; parathyroid disease and high blood calcium; polycystic ovary syndrome; low testosterone in men; and lipid (cholesterol) disorders.
Assessment of pituitary and adrenal conditions may involve reviewing hormone results, imaging and previous specialist letters. Some conditions require coordination with other specialist teams.
What are the symptoms of a hormone problem?
Symptoms depend on the gland involved. Features that can prompt assessment include:
- Persistent fatigue, weakness, dizziness or low blood pressure
- Unexplained weight change, easy bruising or new stretch marks
- Headaches with visual changes, or milky nipple discharge
- Irregular or absent periods, excess facial or body hair, or difficulty conceiving
- Low sex drive, erectile problems or loss of muscle mass in men
- High calcium found on blood tests, kidney stones or bone pain
- Difficult-to-control high blood pressure or low potassium
When should you see a hormone specialist?
A specialist assessment may be appropriate when:
- Blood tests show an abnormal hormone, calcium or electrolyte result that needs explaining
- A scan has found a pituitary or adrenal abnormality (sometimes called an incidentaloma)
- Symptoms suggest a hormone disorder but initial tests have been inconclusive
- Long-term steroid use or previous pituitary or adrenal treatment requires specialist review
- You would like a second opinion on a diagnosis or treatment plan
How are hormone disorders investigated?
Hormone testing needs care because levels vary through the day and are affected by medicines. Assessment may include:
- Morning or timed blood and urine hormone tests
- Dynamic tests, such as a Synacthen test or dexamethasone suppression test, arranged through an appropriate testing service
- Calcium, parathyroid hormone and vitamin D measurements
- Pituitary or adrenal imaging requested after biochemical findings, so that scans are targeted and meaningful
How are hormone disorders treated?
Treatment depends entirely on the diagnosis. Broad approaches include:
Hormone replacement
Replacing hormones that are lacking, such as hydrocortisone or testosterone, with safety advice and regular monitoring.
Medicines to reduce hormone excess
For example dopamine-agonist treatment for prolactin-secreting pituitary tumours.
Surgery and specialist teams
Referral to specialist surgeons or multidisciplinary teams when a gland needs to be removed or a tumour treated.
Monitoring
Surveillance of benign findings and long term follow up of conditions that need lifelong review.
PCOS: symptoms, tests and when to get specialist help
PCOS is a common hormonal condition. It is usually diagnosed when at least two of three features are present: irregular or absent ovulation, signs or blood tests showing raised male-type hormones, and polycystic-appearing ovaries on ultrasound, once other causes are excluded. Treatment depends on your symptoms and plans for pregnancy.
What are the symptoms of PCOS?
Features vary from person to person and can include:
- Irregular, infrequent or absent periods
- Excess facial or body hair, acne or scalp hair thinning
- Difficulty becoming pregnant
- Weight gain, particularly around the waist
- Darkened skin patches, a sign of insulin resistance
How is PCOS diagnosed?
Doctors usually use the Rotterdam criteria: at least two of irregular ovulation, clinical or blood-test evidence of raised male-type hormones (androgens), and polycystic ovaries on ultrasound. Other conditions that can look similar, such as thyroid disease, raised prolactin and some adrenal conditions, are checked and excluded first.
Which tests are used?
Typical assessment can include:
- Blood tests for hormones, including testosterone and related markers
- Thyroid function and prolactin
- Glucose or HbA1c and cholesterol, because PCOS is linked with insulin resistance and a higher risk of type 2 diabetes
- A pelvic ultrasound where appropriate
How is PCOS managed?
Management is tailored to what matters most to you: regular periods and protecting the womb lining, skin and hair symptoms, fertility, or metabolic health. Healthy eating and regular activity help many people, and medicines can be added depending on the goal. Plans change if you want to become pregnant, so discuss this early.
When is a specialist opinion useful?
A specialist review can help when the diagnosis is uncertain, when results do not fit together, when treatment has not controlled symptoms, when blood sugar or cholesterol is raised, or when you are planning a pregnancy and want your hormone and metabolic health reviewed first.
When to seek urgent help
Call 999 for severe weakness, vomiting, fainting or collapse in someone with known or suspected adrenal insufficiency or who takes long term steroids (possible adrenal crisis), and for a sudden severe headache with loss of vision. Do not stop steroid tablets suddenly.
Common questions
Do you see children?
Dr Kazmi’s clinic is for adults (aged 18 and over). Children and young people with hormone conditions need a paediatric endocrinology service.
Can you treat the menopause or fertility problems?
Endocrine assessment can help with hormone-related causes of menstrual disturbance or low testosterone. For menopause treatment or fertility, the right specialist depends on your situation and the clinic can advise.
How long do hormone tests take?
Some tests are single blood samples; dynamic tests take several hours. The timing and preparation are explained when they are arranged.
Does PCOS mean I cannot get pregnant?
No. Many people with PCOS conceive, sometimes with support. Ovulation can be irregular, so earlier advice can help if you are planning a pregnancy.
Does PCOS go away?
PCOS is a long-term condition, but symptoms can be managed and often change over time. Ongoing attention to blood sugar and heart health is sensible.
Related patient guides
- When should you see an endocrinologist?: Signs a hormone, thyroid, diabetes or bone problem may need a specialist, and how to prepare.
Further reading
- NHS: Addison’s disease
- NHS: Cushing’s syndrome
- NHS: Polycystic ovary syndrome (PCOS)
- NICE guideline NG132: Hyperparathyroidism (primary)
- NHS: Type 2 diabetes
Clinical content awaiting consultant review.