What does an Endocrinologist do?

Endocrinologists are specially trained physicians who diagnose and treat diseases related to the glands in the body. They hold a medical degree and undergo a further 5 years of specialist physician training before attaining the consultant endocrinologist qualification. The glands are responsible for productions of secreted substances known as hormones.

Endocrinologists treat people who suffer from these hormonal imbalances with the aim to restore normal balance. Some of the more common conditions treated by Endocrinologists include Diabetes, Thyroid Disease, Osteoporosis and Menopause. The spectrum of endocrine disorders is varied and they also deal with the rarer disorders of the pituitary, adrenal and parathyroid glands.

Dr Devina Joshi

Dr Devina Joshi manages all forms of endocrine disease including:

• Type 1 diabetes
• Type 2 diabetes
• Gestational Diabetes
• Insulin pump therapy for type 1 diabetes
• Polycystic ovarian syndrome
• Thyroid disorders (Hashimoto’s, Graves, multinodular goitre)
• Endocrine disorders in  pregnancy (including diabetes and thyroid conditions)
• Adrenal disease (Addison’s disease, Adrenal masses)
• Bone disorders (osteoporosis)
• Parathyroid and Calcium disorders
• Pituitary disease

Areas of Interest

Diabetes Mellitus

Diabetes is caused by lack of insulin (type 1 diabetes) or insulin resistance (type 2 diabetes). It may be related to pregnancy (diabetes of pregnancy or gestational diabetes). There is an increasing number of treatments available for the treatment of diabetes and, according to Dr Devina Joshi, it is a wonderful time to be a diabetes specialist.

Obesity

Obesity is caused by both genetic and lifestyle factors. There are a number of rare hormonal disorders that can cause obesity. If obesity is hormonally-related then treatment of the underlying hormonal imbalance is the most effective treatment. If no hormonal imbalance is present, Dr Devina Joshi will still be involved in the management of weight loss using a variety of lifestyle and pharmacological interventions. Dr Joshi works closely with surgeons that manage weight loss (bariatric surgery) – also known as lap band, gastric sleeve and bypass surgeries so that a continuum of treatment is available to you.

Osteoporosis

Osteoporosis, or weak bones is an asymptomatic condition that increases the risk of a broken bone(fracture). Fractures cause pain, impair your mobility and can increase the risk of death. Fortunately, our understanding of osteoporosis is much better now and there are a number of recognisable risk factors and screening tests available. There are a number of effective medication that can slow down the progress of this disease and decrease the risk of fracture.

Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome is a condition of overproduction of male hormones, menstrual irregularities, insulin resistance and which may be related to reduced fertility in some women. Some women may be overweight. Not all women will have the same presentation and treatment is directed at the presenting complaints e.g. extra facial hair, menstrual disturbance or subfertility.

Thyroid over- & under-activity

The thyroid is the metabolic regulator of the body. It is responsible for the rate at which our bodies burn energy. An overactive thyroid is akin to your body being in “fast-forward”. Symptoms can include weight loss, feeling hot, tremor and feeling anxious. An underactive thyroid is akin to your body being in “slow-motion”. It can lead to weight gain, feeling cold, constipation and feeling depressed. Key investigations and effective treatments are available for both types of disorders.

Thyroid nodules and thyroid cancer

Thyroid nodules are usually benign (not cancerous). Surveillance and monitoring are often the only action required for thyroid nodules. However, in some instances further treatment is required including surgery and radioactive iodine. Also, patients with known thyroid cancer will require surveillance and monitoring. The frequency and intensity of follow up is highly variable and individualised to the specific type of cancer.

Pituitary disease

The pituitary gland is a small gland located in the brain. It is known as the “master gland” in the body and regulates many different systems. Diseases of the pituitary gland are rare and problems  can be related to over or under production of hormones. Abnormal growths in the pituitary can cause hormone overproduction but also interfere with the production of normal hormones.

Adrenal disease

The adrenal glands sit on top of the kidneys and regulate various aspects of health including generating a normal “stress” response and regulation of blood pressure. Disease can be associated with congenital (present from birth) for example congenital adrenal hyperplasia or acquired for example adrenal nodules. There can also be tumours that produce excessive hormones or do not produce necessary hormones for example Addison’s disease.

Menopause

This is the normal cessation of menses (periods) and occurs around the age of 51. It coincides with a large decrease in sex hormones (oestrogen and progesterone). Many women have transient and mild symptoms while others are more seriously affected. There are a number of treatment options available taking into account an individual’s health profile

Men’s health

This encompasses a range of disorders including management of side effects of treatment for men with prostate cancer as well as problems due to testosterone deficiency, low sex drive and problems with erections.