General Endocrine Clinic

General Endocrine Clinic

The endocrine system consists of a collection of glands that form and release hormones that regulate many functions of the body, including the ability of the body to convert calories into energy that powers cells and organs. The endocrine system decides how your heart beats, how your tissues and bones grow, and how a female makes a baby. It plays a very important role in whether or not you develop diseases like thyroid disease, diabetes, sexual dysfunction, growth disorders, and an array of other hormone-related disorders.

Every gland of the endocrine system produces specific hormones and releases it into the bloodstream. These hormones move from the blood to other cells of the body and help regulate and coordinate many body processes.

Following are the different types of endocrine glands that regulate different body processes:

  • Adrenal glands
    These two glands lie on top of the kidneys and release a hormone called cortisol.
  • Hypothalamus
    It is the part of the lower, middle brain that directs the pituitary gland on when to release hormones.
  • Ovaries
    These are the female reproductive organs that produce sex hormones and release eggs.
  • Islet cells in the pancreas
    Pancreatic cells control the release of hormones glucagon and insulin.
  • Parathyroid
    These four tiny glands lie in the neck and they play a role in the development of bones.
  • Pineal gland
    This gland lies near the centre of the brain and is linked to the regulation of sleep patterns.
  • Pituitary gland
    This gland is found at the base of the brain behind the sinuses. It is also referred to as the “master gland” as it influences many other glands, including the thyroid gland. Pituitary gland problems can affect a woman's menstrual cycles, bone growth, and release of breast milk.
  • Testes
    These are the male reproductive glands that form and release sperms and sex hormones.
  • Thymus
    This gland lies in the upper part of the chest and helps in the development of the immune system.
  • Thyroid
    It is a gland shaped like a butterfly that lies in front of the neck. It is responsible for controlling metabolism. Even the slightest problem with the functioning of these glands can disturb the delicate balance of hormones in the body and give rise to an endocrine disorder.

Endocrine disorders are generally categorised into two categories:

Endocrine diseases that occur when a gland produces an excess amount or deficient amount of an endocrine hormone. This condition is called hormone imbalance.

Endocrine diseases that occur due to formation of lesions in the endocrine system, which may or may not affect the level of hormones.

The feedback system of the endocrine system helps regulate the hormonal balance in the bloodstream. If your body has too little or too much of a certain hormone, the feedback system signals the appropriate gland to correct the mismatch. If this feedback system has trouble keeping appropriate hormonal levels in the bloodstream or if the body is unable to clear them out properly, a hormonal imbalance may occur.

Decreased or increased levels of endocrine hormones may occur due to:

  • An issue with the feedback system of the endocrine
  • Failure of stimulation of a gland by another gland to produce hormones
  • A genetic disorder like congenital hypothyroidism or multiple endocrine neoplasia (MEN)
  • Tumour of an endocrine gland
  • Injury to an endocrine gland

Most endocrine nodules or tumours are benign or noncancerous. They don’t usually spread to other body parts. However, a nodule or tumour on the gland may interfere with the hormone production of the body.

Endocrine disorders are of many different types, with diabetes being the most common one.

Other endocrine disorders include:

Adrenal insufficiency

The adrenal gland releases too little of the hormone cortisol and sometimes, aldosterone. Symptoms include fatigue, stomach upset, dehydration, and skin changes. Addison's disease is a type of adrenal insufficiency. Adrenal insufficiency can also occur due to autoimmune disease or stopping steroids, used for other conditions, suddenly.

  • Diagnosis
    Adrenal insufficiency is diagnosed by doctors with blood tests. Other tests like magnetic resonance imaging and computed tomography may help find the cause of this disorder.
  • Treatment
    Adrenal insufficiency is treated by doctors with medications that replace the hormones that the body fails to make. The doctor will adjust the dose in certain situations like during an illness, surgery, pregnancy, or after a serious injury.
  • Diet and Nutrition
    Some people with adrenal insufficiency may require a high-sodium diet. Those who take medications to replace cortisol may also require plenty of vitamin D and calcium. A dietitian or healthcare provider can let you know how much is normal for you to have.

Cushing's disease

Cushing’s disease is a type of Cushing syndrome. It refers to a condition where the pituitary gland produces an excess amount of adrenocorticotropic hormone (ACTH). The pituitary gland is a part of the endocrine system. Other types of Cushing syndrome include Cushing syndrome cause by adrenal tumour, exogenous Cushing syndrome, and ectopic Cushing syndrome.


Cushing disease occurs due to a tumour or excess growth of the pituitary gland. The pituitary gland lies just beneath the base of the brain. A form of pituitary tumour called an adenoma is the commonest cause.

In people with Cushing disease, the pituitary gland produces an excess amount of ACTH, which stimulates the release of a stress hormone called cortisol. Excess amounts of ACTH stimulates the adrenal glands to produce too much cortisol. Cortisol is produced normally during stressful situations. It has many other functions including:

  • Regulating the body’s use of fats, carbohydrates, and proteins.
  • Regulating the body’s water balance and blood pressure.
  • Reducing the response of the immune system to inflammation.


The symptoms of Cushing disease include red, round, full face called moon face, upper body obesity with thin legs and arms, and slow growth rate in children. Some skin changes like acne or skin infections, purple stretch marks called striae, and thin skin susceptible to bruising are also seen. The muscles and bone changes seen in Cushing disease include bone pain or tenderness, backache occurring with routine activities, accumulation of fat between the shoulders, weak muscles causing exercise intolerance, and weakening of the bones leading to spine and rib fractures.

Women may experience irregular menstrual cycles and excess hair growth on the neck, face, abdomen, thighs, and chest. Men may experience erection problems and decreased libido. Other problems may include fatigue, mental changes such as anxiety, depression, and behavioural changes, headache, frequent infections, increased urination and thirst, diabetes, and high blood pressure.

Treatment involves surgery aimed at removing the pituitary tumour. The pituitary gland may start functioning slowly post-surgery and then return to normal in the long term. When recovering from surgery, the patient may require cortisol replacement treatments as the pituitary gland needs time to restart making ACTH. If the tumour is not fully removed due to surgery, radiation treatment may also be done. If the tumour fails to respond to radiation or surgery, you may require medications to stop the body from producing too much cortisol.

If the treatments listed above are not successful, removal of adrenal glands may be done so that the production of high levels of cortisol is stopped. Adrenal gland removal may cause the pituitary tumour to increase in size. This condition is called Nelson syndrome.


Acromegaly is a condition that develops when the pituitary gland releases an excess amount of growth hormone during adulthood. Due to too much growth hormone, the size of the bones increases. This leads to increased height in childhood and this condition is called gigantism. In adulthood, however, a change in height doesn’t occur. Instead, the bone size increase is confined to the bones of the feet, hands, and face.


Enlarged hands and feet are the commonest signs of acromegaly. For example, the person may notice he is not able to put on rings that used to previously fit and that his shoe size has progressively increased. Acromegaly may also lead to gradual changes in the shape of the face such as protruding brow bone and lower jaw, thickened lips, enlarged nose, and wider spacing between the teeth.

As acromegaly progresses slowly, early signs may not be obvious till years. The physical changes are sometimes only noticed by comparing older photos with current ones. The signs and symptoms of acromegaly usually vary from one patient to another and may include any of the following:

  • Enlarged facial features, including lips, facial bones, tongue, and nose
  • Enlarged hands and feet
  • Oily, coarse, thickened skin
  • Excessive body odour and sweating
  • Small skin tissue outgrowths
  • Muscle or joint weakness
  • Fatigue
  • Limited joint motility
  • Pain
  • A husky, deepened voice due to enlarged sinuses and vocal cords
  • Vision problems
  • Severe snoring due to obstruction of the upper airway
  • Severe or persistent headaches
  • Less of sexual interest
  • Menstrual cycle irregularities in women

If you notice that you have signs and symptoms of acromegaly, you must contact your doctor for an examination. Acromegaly develops gradually, so even your close family members may not notice the slow physical changes that first occur due to this disorder. However, early diagnosis of the disease is important to start getting proper treatment and care. If not treated at the right time, acromegaly may lead to serious complications.

Hyperthyroidism: Hyperthyroidism refers to a condition where the thyroid gland produces more hormones than the body needs. This condition is also known as overactive thyroid. The main hormones that the thyroid makes include thyroxine (T4) and triiodothyronine (T3).

Hyperthyroidism can involve the whole body and needs to be treated at the right time by a healthcare provider.

The symptoms of hyperthyroidism can affect the entire body. You may notice some of these symptoms or many of them at the same time. Following are some of the symptoms that point towards a diagnosis of hyperthyroidism:

  • Feeling shaky and/or nervous
  • Rapid heartbeat (palpitations)
  • Increased appetite
  • Weight loss
  • Vision changes
  • Diarrhoea and more frequent bowel movements
  • Thin, warm and moist skin
  • Intolerance to heat and excessive sweating
  • Menstrual changes
  • Swelling and enlargement of the neck from an enlarged thyroid gland (goitre)
  • Sleep issues
  • Bulging of the eyes (seen with Graves’ disease)
  • Muscle weakness
  • Hair loss and change in hair texture (brittle)

Following are some conditions that may contribute towards hyperthyroidism.

  • Graves’ disease
    This disorder is characterised by the attack of the thyroid gland by the immune system. This makes the thyroid gland produce an excess amount of thyroid hormone. Grave’s disease is passed down the generations, meaning if one of your first degree relatives has the disease, you also have a high chance of contracting it. It is more commonly seen in females and is the commonest cause of hyperthyroidism, with around 85% of cases occurring secondary to it.
  • Thyroid nodules
    A thyroid nodule is a growth of cells in the thyroid gland. They can release more hormones that are actually needed by the body. Thyroid nodules are rarely malignant.
  • Thyroiditis
    Thyroiditis refers to inflammation of the thyroid gland, which may be painless or painful. It may occur within a year of delivery in a female. After thyroiditis develops, it is hard for the thyroid to recover, so hypothyroidism can occur.
  • Consumption of excess iodine
    If you consume too much iodine and are also at a risk for developing hyperthyroidism, it can make your thyroid gland produce excess amounts of thyroid hormone. Iodine is a mineral that is used by the thyroid to produce thyroid hormone. Receiving iodinated contrast may also result in hyperthyroidism. Hyperthyroidism may also occur due to amiodarone, a medication containing high amounts of iodine.

Your doctor can establish a diagnosis of hyperthyroidism in several ways, such as:

  • Performing a physical examination of your neck to determine if the thyroid gland is larger than normal.
  • Carrying out several blood tests to look for high thyroid hormone levels in the body.
  • Imaging test of the thyroid gland to evaluate it.


Hypothyroidism refers to a condition where the body can’t release enough thyroid hormone in the bloodstream resulting in slowing down of the metabolism. The condition develops when the thyroid doesn’t produce enough thyroid hormone to meet the demands of the body. This results in a slow metabolism, causing problems in the entire body.

When the thyroid levels are too low, the condition is referred to as myxedema. It is a very serious problem and can cause symptoms like anaemia, low body temperature, heart failure, confusion, and coma. This is a life-threatening form of hypothyroidism. Generally, hypothyroidism is a very treatable condition and can be managed with regular medications and appointments with your doctor.


Hypopituitarism is the condition where one or more pituitary hormones are deficient in the body. The deficiency of these hormones can affect many body’s activities such as reproduction and general growth. The symptoms of hypopituitarism vary, depending on which hormone is missing from the body. Having hypopituitarism necessitates the intake of medications for the rest of the life. The missing hormones can be successfully replaced by medications and the symptoms can, therefore, be controlled.


The signs and symptoms of hypopituitarism generally develop very slowly and tend to worsen over time. Sometimes those are subtle and may be overlooked for years. However, for some people, the symptoms may develop rapidly. These symptoms vary from one patient to another, depending upon which pituitary hormone is affected and to what extent. Those people who have deficiency of more than one pituitary hormone, the symptoms of second hormone deficiency may increase or that of the first hormone deficiency may be masked.

Growth hormone (GH) deficiency

Growth hormone deficiency may result in short stature and growth problems in children. Most adults with growth hormone deficiency are asymptomatic. However, in some adults it may cause muscle weakness, fatigue, lack of ambition, and changes in the body fat composition.

Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) deficiency

Deficiency of LH and FSH hormones can affect the reproductive system adversely. In females, the deficiency causes a decrease in oestrogen and egg production from the ovaries. In males, the deficiency reduces the testosterone and sperm production from the testicles. Both males and females may experience a lower sexual interest, fatigue, and even infertility. In adolescents and children, the only symptom seen is delayed puberty.

Females may also present with symptoms like irregular periods or absence of periods, hot flushes, loss of pubic hair, and inability to produce milk for breast-feeding. On the other hand, males may present with additional symptoms like decreased body or facial hair, erectile dysfunction, and mood changes.

Thyroid-stimulating hormone (TSH) deficiency

This hormone regulates the functioning of the thyroid gland. Its deficiency results in low thyroid hormone levels, giving rise to symptoms like weight gain, fatigue, constipation, dry skin, and sensitivity to cold temperatures.

Adrenocorticotropic hormone (ACTH) deficiency

This hormone helps the adrenal glands to function properly and controls the reaction of the body towards stress. The symptoms of deficiency of ACTH hormone include low blood pressure which may lead to fainting, severe fatigue, prolonged and frequent infections, confusion, nausea and vomiting, and abdominal pains.

Antidiuretic hormone (ADH) deficiency

Also known as vasopressin, ADH helps the body balance its fluid levels. Deficiency of this hormone leads to a disorder known as diabetes insipidus. Its symptoms include extreme thirst, excessive urination, prolactin deficiency, and electrolyte imbalances.

Multiple endocrine neoplasia I and II (MEN I and MEN II)

These are rare, genetic conditions that are passed down through the generations. They give rise to parathyroid tumours, thyroid tumours, and adrenal tumours, leading to overproduction of these hormones.

Polycystic ovary syndrome (PCOS)

This is a hormonal problem that occurs in women in their reproductive years. If you are suffering from PCOS, you may be experiencing irregular menstrual periods. Your body may also have too much of a hormone named androgen.

In PCOS, multiple fluid-filled sacs called cysts develop along the outer edge of the ovary. These cysts contain immature eggs called follicles that fail to release eggs regularly. The exact cause of PCOS is not known. Early diagnosis and treatment along with lifestyle modification may lower the risk of developing long-term complications like heart disease and type 2 diabetes.


The symptoms of PCOS usually start at the time of the first menstrual period. The symptoms may sometimes develop later after having periods for a while. The symptoms of PCOS depend on many different factors. The symptoms are usually more severe in obese females. A diagnosis of the disease may be established if you have at least two of the following symptoms:

  • Irregular periods
    Having less menstrual periods or irregular periods is a common symptom of PCOS.
  • Too much androgen
    Excess amount of androgens in the body can cause facial and body hair. This condition is referred to as hirsutism. Sometimes, male-pattern baldness and severe acne can also occur.
  • Polycystic ovaries
    The size of the ovaries may be larger and many follicles may contain immature eggs that may line the edge of the ovary. The ovaries may also not function properly.

You must see a doctor if you are worried about your abnormal menstrual periods, have signs of excess androgen, or have trouble getting pregnant.

  • Precocious puberty
    Puberty that occurs abnormally early due to release of sex hormones too early in life is called precocious puberty.

If your primary doctor suspects you have an endocrine disorder, he may refer you to a specialist known as endocrinologist, who is specially trained in treating medical conditions of the endocrine system. The symptoms of endocrine disorders are quite different from one disease to another as they depend on the specific gland involved. However, most patients with endocrine disorders report two common symptoms - weakness and fatigue.

Urine and blood tests to determine the levels of hormones in your body helps doctors to diagnose endocrine problems. Imaging tests may also be performed to locate or pinpoint a tumour or a nodule.

The treatment of endocrine conditions can be complex, as change in the levels of one hormone can also affect other hormone levels. Your endocrinologist may order several tests to determine if your treatment plan is working as it should or if it needs any adjustments.

Getting a new diagnosis of an endocrine disorder can be stressful. But, the good news is that most of these conditions are treatable and manageable. If you are experiencing symptoms of an endocrine disorder or have risk factors for the same, you must contact an endocrinologist. If you are located in Indore, you can visit the Kokilaben Dhirubhai Ambani Hospital, Indore and get an appointment with an endocrinologist who can guide you to the next step.

Kokilaben Dhirubhai Ambani Hospital's endocrinologists use advanced diagnostic techniques and treatments to treat endocrinological diseases in the best way. The best endocrinologists in Indore will discuss all the suitable treatment options with you and help you choose the one best suitable to you. For many patients, that might mean selecting minimally invasive procedures that produce excellent outcomes and rapid recovery.

Endocrinological services at Kokilaben Dhirubhai Ambani Hospital include treatment for a wide range of endocrinological conditions like PCOS, hypothyroidism, hyperthyroidism, hyperparathyroidism, hypoparathyroidism, Addison’s disease, hyperaldosteronism, Cushing’s syndrome, and Acromegaly. When you come to Kokilaben Dhirubhai Ambani Hospital, Indore you are taken care of by one of the best endocrinologists in Indore who are committed to delivering advanced treatment and care at the hospital's campus in Indore.