Service
Endocrinologist consultation and examination
Short answer
At an endocrinologist consultation, complaints are heard first and the patient is examined (including a manual examination of the thyroid gland — palpation). Then the existing test results are reviewed and any necessary tests are ordered. A thyroid ultrasound is not necessarily needed for every patient, but when it is indicated, it is an integral part of the examination. Treatment is prescribed individually, and only after the cause has been identified.
In the doctor’s practice
How the consultation goes
- Complaints and medical history. The doctor asks about diabetes and thyroid disease in the family and about the medications you take (including medications that contain cortisol, vitamin D and “weight-loss” products).
- Palpation. The doctor explains: palpation is a manual examination of the thyroid gland and is done in two ways — approaching from the front and from behind. The role of palpation:
- to assess the size, shape and firmness of the gland;
- to find nodules, cysts and solid masses in the gland;
- if there is pain and tenderness, to get information about inflammation (thyroiditis);
- if the enlargement is asymmetric, to suspect nodular goiter;
- to look at mobility — whether or not the nodule is attached to nearby tissues helps tell benign and malignant nodules apart.
During the examination, the patient is asked to swallow: it is checked whether the nodule moves up and down with swallowing.
- Tests. Existing results are reviewed and any necessary tests are ordered. More details: Endocrine tests and examinations
- Ultrasound. When indicated, ultrasound of the thyroid and neck is done at the consultation.
- Plan. Treatment, monitoring, or referral to another specialist. The doctor's principle: “The foundation of endocrinology is hormones. Prescribing any medication without seeing the patient can be wrong. That is why it is recommended that you have your examination done in person.”
When to see an endocrinologist
Based on the doctor's posts
- unexplained weight gain or loss; being unable to put on weight;
- constant fatigue, lack of energy, drowsiness;
- intolerance to cold or heat, sweating, palpitations, irritability, trembling;
- hair loss, brittle nails, dry skin, constipation;
- swelling in the neck, difficulty swallowing, hoarseness, a choking sensation, a feeling of a foreign body in the throat;
- thirst, dry mouth, frequent urination, including at night;
- menstrual disorders in women, excess hair growth on the face and body, acne;
- infertility;
- slowed growth in height in children, signs of early puberty;
- fractures from minor injuries, chronic lower back pain, loss of height (suspected osteoporosis).
What to bring to the consultation
- previous test and ultrasound results;
- a list of the medications you take (with doses);
- if you have diabetes, your records of the sugar levels you measured at home.
The doctor's notes on preparing for tests
- For a fasting blood sugar test, you need to fast for 8 hours or more.
- For HbA1c, it does not matter whether you are fasting or have eaten.
- For the prolactin test, at least 2 hours must have passed since you woke up, and you should be as stress-free as possible. Otherwise, the test may have to be taken again using a different method.
Q&A
Does every patient need a thyroid ultrasound?
No. In the doctor's words: “A thyroid ultrasound is not necessarily indicated for every patient. But in important cases it is an integral part of the examination.”
Can I take someone else's medication that seems to suit me?
A detailed answer is on the Q&A page: Can two people with the same disease take the same medication?.