Specialists

Endocrinology

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Endocrinology

Endocrinology is the study of hormones. Hormones are important chemicals that control and co-ordinate many of the body’s functions and are essential for our every day survival. The endocrine system includes the pituitary, thyroid, pancreas, ovaries, testes, and adrenal glands. Disorders resulting from under or overproduction of hormones within these organs include – diabetes, thyroid disorders and polycystic ovarian syndrome (PCOS)

An Endocrinologist is a specialty doctor that treats conditions that are caused by problems with hormones.

Virtually Endocrinologists offer diagnosis and care for a variety of hormone-related problems.

Symptoms and conditions

Each gland of the endocrine system releases specific hormones into your bloodstream. These hormones help control or coordinate many body processes.

Examples of these glands include:

Adrenal glands: Two glands that sit on top of the kidneys that release a stress hormone – Cortisol.
Hypothalamus: A gland in the brain that tells the pituitary gland when to release hormones.
Ovaries: Located in the pelvis making up the female reproductive system releasing eggs and producing hormones that control the menstrual cycle.
Islet cells in the pancreas control the release of the hormones insulin and glucagon to help keep your blood sugar levels balanced.
Parathyroid: Four glands in the neck that release parathyroid hormone to regulate the amount of calcium in your body.
Pituitary gland: A gland at the base of the brain. This gland controls other endocrine glands such as the ovaries, thyroid and testes.
Testes: The male reproductive glands that produce sperm and testosterone.
Thyroid : A butterfly-shaped gland in the the neck that controls the release of thyroid hormones.

Just a slight disruption in the functioning of these glands can lead to an endocrine disorder.

Examples of these conditions are below.

Possible symptoms:

Weight loss, increased thirst, increased urination, blurred vision.
Weight gain, excessive stretch marks, fat hump at the back of the neck, round face.
Weight loss, increased heart rate, anxiety, increased sensitivity to heat.
Weight gain, slow heart rate, fatigue, sensitivity to cold.
Irregular periods, acne, excess hair growth on the upper lip/abdomen.
Weight loss, fatigue, dark patches of skin , craving salty foods, muscle weakness and cramps.

Related conditions:

Diabetes
Cushing's Disease
Hyperthyroidism
Hypothyroidism
Polycystic ovarian syndrome
Addison's Disease

Tests & investigations

Examples of tests done in Endocrinology

HbA1C blood test

HbA1c is a measure of blood sugar control. Glucose sticks to red blood cells and when you are not using glucose effectively for energy more of it sticks to your blood cells and builds up in your blood.

This test should not be done any more frequently than every 3 months as this is how long the red blood cells stay in your system before being replaced.

A high HbA1c means you have too much sugar in your blood.

An ideal level is less than 42 mmol/mol. A level between 42 and 48 is an indicator of prediabetes and a reading of 48mmol/mol or higher is classed as diabetes.

Thyroid Stimulating Hormone blood test

Thyroid stimulating hormone (TSH) is a hormone that is produced in Pituitary gland that tells the Thyroid gland to produce thyroid hormones.

It works in a feedback loop to control levels of thyroid hormone being produced.

For example if circulating of thyroid hormone levels are low, the Pituitary gland will be stimulated to increase the amount of TSH to increase stimulation of the thyroid gland to produce more thyroid hormones. However, if circulating levels of thyroid hormone are high, signals to the Pituitary gland to reduce secretion of the TSH will be received to prevent the thyroid from producing more hormones.

If your TSH is high with low thyroid hormones – this is known as hypothyroidism. If TSH is low with high thyroid hormones – this is known as hyperthyroidism. Each disorder affects the body differently.

FSH, LH, Prolactin and Testosterone blood tests

These are hormone blood tests that can be done to check for conditions such as Polycystic Ovarian Syndrome.

Dexamethasone suppression test

This is a blood test used to assess abnormal cortisol (the stress hormone) levels in response to an injection of dexamethasone. This is used to diagnose Cushing’s syndrome.

A blood test is done to detect normal levels of cortisol in the morning. An injection is given that night followed by a morning blood test the next day.

Please note that many medications interfere with the test, so you should tell our Virtually consultant if you are on any other medications.

Synacthen stimulation test

If cortisol in your blood is low or your symptoms strongly suggest Addison’s disease, you’ll need to have a synacthen stimulation test to confirm the diagnosis.

Synacthen is a synthetic copy of a hormone naturally made by the body to stimulate the adrenal glands to release steroid hormones.

You will have a blood test to check the level of cortisol before being given an injection of Synacthen and then 2 more blood tests will be done at 30 and 60 minutes after the injection.

Depending on the levels measured – a diagnosis of Addison’s can be either made or ruled out.

24 hour urinary metanephrines test

This test measures the amount of metanephrines in your urine that your body makes over a 24-hour period.

Metanephrines are sometimes called “fight or flight” hormones. These include noradrenaline, adrenaline, and dopamine.

This test is done to check for a tumour on the adrenal glands called a phaeochromocytoma.

What's involved?

Consultation Process

Symptom assessment

The consultant will ask you to describe your symptoms and concerns and take a medical history.

Physical examination

The consultant will carry out an appropriate physical examination.

Tests and investigations

The consultant will arrange appropriate tests and investigations such as blood tests and imaging.

FAQs

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For instant access to high quality, regulated healthcare the costs of the service are very reasonable. Our service is linked to healthcare insurance providers and your medical care from Virtually maybe covered by your health insurance. Interest free payment plans are also available.

Do my NHS records get transferred to Virtually?

No. However, to provide Virtually clinicians as much information as possible to provide you with the best care possible, we would ask you to allow us to have temporary electronic access to your medical records. We will give you simple instructions on how to give our clinicians access if needed.

Is Virtually right for me?

Virtually is a great service for anyone who doesn’t currently have a GP or who struggles to get an appointment with their existing NHS GP. The app is built for people of all ages and backgrounds. If you like the idea of speaking to a clinician online from the comfort of your own home or workplace then use Virtually. We have online appointments available Monday to Sunday. You won’t be giving up the ability to see your own GP. Any virtually consultation will be forwarded to your NHS GP.

Can I choose whether I speak with a male or female clinician?

Yes. Not only can you choose whether your clinician is male or female, but you can also choose the specific person you wish to speak with. We’ll display a list of the available clinicians, and you can choose the doctor or nurse you want to speak to. That means if they are available you can speak to the same clinician every time.

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All of the personal or sensitive information we hold about you is protected by encryption and held in secure UK-based data centres. We ask you to not share the password to your Virtually account with anyone to ensure the security of your account.

How does it work when things can’t be done digitally?

Sometimes we may need to see you in person. For example, for vaccinations, smear tests or to carry out an appropriate physical examination. If we need to see you in person, we’ll ask you to book an in-person appointment by calling or emailing our patient support team.

Can you refer me to a hospital near me?

If you need to be seen at a hospital our doctors will refer you to any NHS or private hospital in England of your choice (although most patients choose a hospital near their home or workplace).

Do I have to switch from my current GP?

No. Virtually is not an NHS service. We will liaise with your current GP with your permission to ensure your NHS medical records are kept up to date.

Where is your clinic?

If you do need to see a doctor in person, our specialists see patients both in consulting rooms and at private hospitals in and around London.

How long are the appointments?

Unlike most GP appointment slots which are 10 minutes. Virtually appointments are at least 30 minutes long allowing enough time to address the nature of your condition or symptoms.

How soon can I get an appointment?

We have clinicians available within an hour for digital appointments. In-person appointments may be a slightly longer wait.

How do prescriptions work?

A private prescription will be sent to you online, within one hour of your consultation.

Who are the clinicians?

Our team of clinicians are made of GPs, Pharmacists, Physicians Assistants and Nurses, all of whom are employed by Virtually. All our clinicians are UK based with some working remotely.

Can I see you face to face?

For some conditions we may request to see you in person at our clinic. You are always welcome to book a face-to-face appointment with our team if you wish, however you may have to wait slightly longer for in-person appointments than you do for digital appointments.

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