Endocrinology

Endocrinological services at Da Medika Polyclinic

Specialist diagnostics and treatment of endocrinological diseases, including thyroid and adrenal gland disorders, using the latest methods. The Centre for Endocrinology is led by Prof. Jasmina Ćirić, MD, PhD, an eminent endocrinologist at the Endocrinology Clinic of the University Clinical Centre of Serbia, a full professor at the Faculty of Medicine of the University of Belgrade, with invaluable experience in treating endocrinological diseases.

What is endocrinology and what does it focus on?

Endocrinology is a branch of medicine which studies the endocrine system, its functions, hormones it produces as well as disorders and diseases related to that system and hormones.

Endocrinology uses various diagnostic methods, such as blood tests for measuring hormone levels, ultrasonography, CT scanning and magnetic resonance imaging (MRI) for inspecting the structure of endocrine glands. The treatment includes medications for the regulation of hormonal balance, drugs which supplement the lack of hormones and, in certain cases, surgical interventions.

The most common diseases and conditions diagnosed and treated by an endocrinologist

The endocrine system consists of glands which secrete hormones directly into the bloodstream. These hormones regulate different body functions, including metabolism, growth and development, function of tissues, sexual function, reproduction, sleeping and mood. Endocrinologists are doctors specialised in diagnosing and treating hormonal disorders. Some of the most common conditions endocrinologists treat include the following:

Diabetes (Diabetes mellitus)

What is diabetes?

Diabetes is a chronic disease which occurs when the pancreas does not produce enough insulin or when the body cannot use the insulin it produces effectively. Insulin is a hormone which regulates blood sugar (glucose) levels.  Without enough insulin, glucose cannot enter the cells properly, which leads to high blood sugar levels.

 

Types of diabetes

  • Type 1: an autoimmune disorder in which the body attacks the cells of the pancreas which produce insulin. This condition usually starts in childhood or adolescence and requires taking insulin for a lifetime.
  • Type 2: occurs when the body becomes resistant to insulin or when the pancreas does not produce enough insulin. It most usually develops in adults, but it is increasingly diagnosed with children, mainly as a result of obesity.
  • Gestational: diabetes which develops during pregnancy and which usually passes after delivery. However, women who have had gestational diabetes are at a higher risk from developing Type 2 diabetes later in life.  

Symptoms of diabetes

  • Excessive thirst and hunger
  • Urinating often
  • Fatigue
  • Blurred vision
  • Slow-healing sores
  • Inexplicable weight loss (type 1)
  • Frequent infections
 

Reasons for which it occurs

An inherited tendency may play a part in the development of all types of diabetes. Excess weight, especially abdominal obesity, increases the risk from the development  of type 2 diabetes. A lack of physical activity may contribute to insulin resistance. Diet high in sugar and fat and low in fibre may also increase the risk from diabetes. The risk from the development of type 2 diabetes also increases with age.

 

 

How does it affect the quality of life?

Diabetes mellitus may have a significant effect on the quality of life for the fact that constant supervision of the blood sugar levels and management of diet and physical activity are needed.  Apart from that, diabetes involves the risk from the development of serious complications, such as the risk from heart diseases and a stroke, renal diseases, nerve damage (neuropathy), vision problems (retinopathy). Psychological stress and anxiety are also common with diabetes for constant concern about health and potential complications. Diabetes requires careful management and supervision so that the risk from complications would be reduced and good quality of life maintained.

 

Obesity

What is obesity?

Obesity is a condition of excessive body mass, which can have a negative impact on health.  Body mass index (BMI) over 30 is considered to be obesity. BMI is calculated by dividing the body mass (in kilograms) by the square of the body height (in meters). Obesity may increase the risk from numerous health problems and reduce the quality of life.  

 

Symptoms and signs of obesity

– Excess body weight is the main sign.

– Tiredness occurs as a result an additional effort which the body must invest to perform daily activities.

– Difficulty performing physical activities  as a result of excess weight and low fitness

– Breathing problems, especially while asleep (apnoea), which may lead to rather serious health problems.

 

Reasons for which it occurs

Heredity may have a role in the predisposition to obesity, affecting the way in which the body stores fat and manages energy. High intake of calories, fat and sugar, accompanied with low intake of fruit, vegetables and fibre, is also a contributing factor. A lack of physical activity  reduces energy expenditure, which can result in the increase in body mass. Certain hormonal disorders, such as hypothyroidism or Cushing’s syndrome, may also contribute to obesity. Low socioeconomic status may also restrict access to healthy food and possibilities for physical activity, which contributes to the development of obesity as well.  

 

How does it affect the quality of life?

Obesity may have a significant impact on the quality of a person’s life. Some of the main problems include the higher risk from the development of type 2 diabetes, elevated blood pressure and high cholesterol as well as heart diseases and certain types of cancers. Excess weight can burden the joints, especially the knees and the hips, which may lead to arthritis, osteoarthritis and problems with mobility. Physical appearance and limitations obesity imposes can have a negative effect on self-confidence and mental health, increasing the risk from depression. Obesity requires careful management through changes in the diet, increased physical activity and, in certain cases, a medical intervention so as to reduce health risks and improve quality of life.

Insulin resistance

What is insulin resistance?

Insulin resistance is a condition in which body cells do not respond properly to insulin, i.e. the hormone which enables glucose (sugar) to enter cells and provide them with energy. As a result,  the pancreas produces more insulin so as to compensate for the ineffectiveness of the cells, which over time may lead to high blood glucose levels and eventually to type 2 diabetes. 

 

Symptoms of insulin resistance

– Fatigue due to the fact that the cells do not receive enough energy  

– Hunger as a result of ineffective use of glucose

– Difficulty concentrating as the brain lacks energy  

– Dark patches of skin around the neck, the armpit and the groin.  

Reasons for which it occurs

Inherited tendency as well as abdominal obesity may have a part in the development of insulin resistance. Diet high in sugar and saturated fat and low in fibre can also increase the risk from this disease. A lack of physical activity as well as certain hormonal disorders reduce the ability of the body to use insulin.

 

How does it affect the quality of life?

Insulin resistance may have a significant impact on the quality of life for the higher risk from the development of chronic diseases such as type 2 diabetes. With women, insulin resistance can contribute to the development of polycystic ovary syndrome (PCOS), which can affect fertility and the menstrual cycle. What can also occur is metabolic syndrome as the combination of high blood pressure, high blood sugar levels, excessive body mass around the waist  and abnormal cholesterol levels, which increases the risk from heart diseases and a stroke.  Fat deposits in the liver may cause the inflammation of the liver and its damage. Fatigue and difficulty concentrating can disrupt everyday activities and reduce productiveness. Concerns about the health condition and the risk from the development of serious diseases can cause stress and anxiety. Insulin resistance requires changes in the lifestyle, including healthy diet, regular physical activity and weight management so that the health risks would be reduced and the quality of life improved.  

 

Disorders of the thyroid gland (hypothyroidism, hyperthyroidism, Hashimoto’s thyroiditis)

 

Disorders of the thyroid gland relate to the conditions which affect functioning of this small gland which is situated in the neck and which releases thyroxine (T4) and triiodothyronine (T3) hormones. These hormones regulate metabolism, growth and development.  The most common thyroid disorders are hypothyroidism, hyperthyroidism and Hashimoto’s thyroiditis.

 

Hypothyroidism

The condition in which the thyroid gland does not produce enough hormones, which slows down metabolism. The most common symptoms are fatigue, weight gain, sensitivity to the cold, dry skin and hair, depression, constipation. This condition may arise as a result of autoimmune disorders such as Hashimoto’s thyroiditis, low iodine diet, thyroid gland surgery, radiation, certain medications. Hypothyroidism increases the risk from heart diseases, high cholesterol, obesity. There is greater likelihood that the patient will suffer from depression, memory loss, poor concentration. Reduced energy and productiveness as well as difficulty performing everyday activities are also present.  

 

Hyperthyroidism

The condition in which the thyroid gland produces too much thyroid hormone, which speeds up metabolism. The most common symptoms are loss of weight, increased heart rate (tachycardia), nervousness and anxiety, sweating, trembling, sleeping problems, bulging eyes (with Graves’ disease). This condition occurs as a result of autoimmune disorders (Graves’ disease), thyroid nodules, excessive intake of iodine or the inflammation of the thyroid gland (thyroiditis). The most common consequences that can ensue are osteoporosis, heart arrhythmia, muscle weakness, followed by anxiety, nervousness, sleeping problems. Loss of weakness, sweating, social interaction difficulties are also present.  

 

Hashimoto’s thyroiditis

An autoimmune disorder in which the immune system attacks the thyroid gland, often leading to hypothyroidism. The most common symptoms are the enlarged thyroid gland (goitre), fatigue, neck pain. This condition may occur as a result of an autoimmune reaction, genetic factors, excessive intake of iodine or hormonal changes, e.g. during pregnancy. The consequences may include hypothyroidism, goitre, fatigue, depression,  difficulty understanding, thinking and making conclusions. Quality of life is reduced for constant need for medical treatment and supervision.  

KaWhat does an examination by an endocrinologist involve?

How should one prepare for an examination by an endocrinologist?

What can be expected from this examination?

An expert examination by an endocrinologist comprises several steps and thorough evaluation of a patient’s medical condition in relation to his or her endocrine system. This is what such an examination usually involves:

Medical history

During the in-depth interview with a patient,  an endocrinologist will inquire about your personal and family medical history, focusing in particular on endocrine disorders, such as diabetes, diseases of the thyroid and adrenal glands etc. The doctor will ask you about all the symptoms you feel, such as fatigue, weight changes, sleeping problems, mood swings, changes related to appetite or thirst, menstrual cycle with women, and you will be asked questions about the diet, physical activity, smoking, alcohol consumption and stress.  

Examination

A general physical examination involves height measurement and weighing, calculation of the body mass index (BMI), a blood pressure test, the examination of the thyroid gland with a view to establishing its size, shape and whether thyroid nodules are present. In order to establish whether any signs of endocrine disorders, such as dry skin, dark patches of skin, bulging eyes, are present, skin and eyes are also checked as well as the abdomen, i.e. the size of the liver and the spleen.

 

Laboratory tests

If need be, specific tests and analyses, such as the hormone, blood glucose, lipid profile, electrolyte, sodium,  potassium, calcium, phosphorus blood tests etc., are requested.

 

Additional diagnostic tests

Along with the examination, the ultrasonography of the thyroid gland is conducted, as necessary, in order to evaluate the structure and functioning of the thyroid gland.  If the doctor assesses so, a CT or MRI scan for a more thorough examination of the adrenal glands or the pituitary gland as well as biopsy, i.e. taking of a sample of thyroid tissue or the tissue of other glands in case nodules or tumours are suspected, may also be requested.

 

Treatment plan

Eventually, an individualized treatment plan is proposed.  Hormones, antithyroid drugs, insulin and other medications are prescribed in accordance with the patient’s needs.  Advice on healthy diet and regular physical activity is given. Regular check-ups and laboratory tests are scheduled so that the progress would be monitored and that the treatment would be adjusted as necessary.

 

An expert examination by an endocrinologist is thorough and comprehensive with the aim to have the disorders of the endocrine system diagnosed precisely and treated effectively.  

 

Endocrinological examinations which you can have at Da Medika Polyclinic

 

At Da Medika Polyclinic, you can have an expert examination by an endocrinologist and an ultrasound of the thyroid gland done, which are of key importance for diagnosing and managing the disorders of the endocrine system as they enable precise determining of the condition and planning of an adequate treatment.   

 

An examination by an endocrinologist can reveal hypothyroidism, hyperthyroidism, type 1 and type 2 diabetes, insulin resistance, hormonal disorders, disorders of the pituitary gland, disorders of the adrenal glands etc.

 

How can you prepare for an examination by an endocrinologist?

Bring all previous medical reports, laboratory test results, the list of medications you are taking currently. Make a list of the symptoms you feel, including even those which seem to be unrelated to endocrine problems. Prepare a list of questions which you wish to ask an endocrinologist.  

 

What can you expect from this examination?

You can expect an in-depth interview on your medical condition and an examination. An examination by an endocrinologist and an ultrasound of the thyroid gland are of key importance for diagnosing and managing the disorders of the endocrine system as they enable precise determining of the condition and planning of an adequate treatment.   

 

Experts at Da Medika Polyclinic who perform endocrinological examinations

 

Da Medika Polyclinic has a top-notch team of experts, and the doctors available to patients in the field of endocrinology are Prof. Jasmina Ćirić, MD, PhD, an eminent endocrinologist with invaluable experience in treating endocrine diseases, as well as Dr. Slavica Ćirić, a leading expert in the ultrasonography of the thyroid and parathyroid glands.

 

For prices of endocrinological examinations, please see our price list.

Our team of endocrinologists

Impressions of our patients

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