Endocrine Abstracts

Background: It is well known that care must be taken in initiating testosterone replacement in individuals with historically low androgen levels. However less is reported about the influence of restoration of normal endogenous testosterone production on behaviour.Here, we report the how adverse sequelae of successful treatment of secondary hypogonadism were managed through a joint approach.Case report: A 34-year-old Business Accoun...

We present the case of a 49 year old man who initially presented to his GP with complaints of tiredness, weight gain and tingling in his right hand. GP requested thyroid hormone measurements which showed FT4 level of 3.4 picomoles per litre and TSH 10.89 milli international units per litre. The inappropriately low TSH level raised the possibility of central hypothyroidism and triggered further investigations which revealed a low level for GH, LH, FSH, testosterone and cortisol...

In Central and Eastern Cheshire, Secondary Care endocrinology/diabetes clinicians can now access a summary of the patient’s primary care electronic patient record (EPR), using a secure Web browser for GP data held by the GP provider EMIS. This improves decision making at the point of care.The clinicians, including consultants, SpRs, dieticians and specialist nurses can access details of medication, allergies, and previous diagnoses, available for 95...

Most tests of the hypothalamo-pituitary-adrenal axis (HPA) use total cortisol measurements, although only free cortisol is biologically active. Total cortisol is 90% bound to cortisol binding globulin (CBG). CBG varies between individuals, is elevated by oestrogens and reduced by acute illness or surgery. Low CBG levels may result in individuals apparently failing such tests, and receiving inappropriate steroid replacement. We hypothesised that correcting total cortisol for CB...