- Health History: endocrine disorders often have specific clinical symptoms, but more general manifestations also occur. The patients are asked if there have been changes in energy levels, tolerance to heat or cold, weight, thirst, frequency of urination, bowel function, body proportions, muscle mass, fat and fluid distribution, secondary sexual characteristics (e.g. loss or growth of hair), menstrual cycle, memory, concentration, sleep patterns, mood, vision, joint pain, and sexual dysfunction.
- Physical Assessment: vital signs; head-to-toe inspection; and palpation of skin, hair, and thyroid. Changes in physical, psychological, and behavioral changes should be noted.
- Examples of notable changes include hirsutism, “moon face”, “buffalo hump,” exophthalmos, vision changes, edema, thinning of the skin, obesity of the trunk, thinness of the extremities, increased size of the feet and hands, edema, hypo- or hyperreflexia, nervousness, lethargy, and fatigue.
- Diagnostic Evaluation:
- Blood Test: determination of the levels of circulating hormones, the presence of autoantibodies often via radioimmunoassay (that result in hypofunction), and the effect of a specific hormone on other substances (e.g. insulin affecting blood glucose levels).
- Urine Tests: determination of the levels of hormones or their end products that are excreted via the urine, such as the determination of free catecholamines in the urine in patients with suspected pheochromocytoma.
- Stimulation or Suppression Tests are used to detect hypo- and hyperfunction respectively. This involves the creation of normally stimulating conditions (administration of stimulating hormones) or inhibitory conditions (administrating of exogenous hormones) on the endogenous secretion of the hormone or its stimulation hormone.
