Treatments in diabetes and endocrinology
 

Dr Asjid Qureshi
MB ChB (Edin), MD (Lon), FRCP (Lon)
London Diabetes and Endocrinology
Consultant
Wellington Hospital and Clementine Churchill Hospital

 
 

London, UK

English / русский / العربية

 

   
 
Home Patients Testimonials Make a referral International Biography Contact us
 
 

 

 
 
Patients
Thyroid disorders
Poor diabetes control
Health screening
Diagnoses
Investigations
Treatments

 Radioiodine
 Thyroid surgery
 Parathyroid surgery
 Pituitary surgery
 Adrenal surgery
 Bariatric surgery
 

Dictionary
Leaflets
Testimonials
Links

T  R  E  A  T  M  E  N  T  S

To arrange a consultation, please call 07733 595 617 or
 
e-mail: secretary@endocrinologyspecialist.com

T  R  E  A  T  M  E  N  T  S
The comments contained below apply to adult endocrinology only. With the exception of a short synacthen test, the tests listed below are best performed and interpreted by an endocrinology specialist. The details contained below are for information only.

R a d i o i o d i n e

When is this performed?

  • With an overactive thyroid
  • With an enlarged thyroid
  • In thyroid cancer
What does the treatment involve?
  • Some centres do an uptake scan prior to administering radioiodine. This scan is painless. Radioiodine (I131) is radioactive iodine and is administered orally.
Are there any side-effects?
  • The main "side-effect" of the treatment is that with a large dose, the thyroid is likely to become under active. This however, is the aim of treatment in many centres. Some patients may experience some tenderness in their neck temporarily.
How long does this treatment take and is admission to hospital required?
  • The treatment (including scan, explanation and consenting) takes only a few hours and hospital admission is not required.
     
What should you tell your doctor?
  • A precise list of all your medication
  • Your allergies
  • Your occupation
  • Pregnancy status and plans
  • If you have young children at home
  • If you come into contact with pregnant women
  • If you are troubled with urinary incontinence
 

 

 

T H Y R O I D    S U R G E R Y

When is this performed?

  • In the treatment of an over active thyroid
  • For the removal of a large thyroid
  • For the removal of a thyroid nodule or lesion
What does the treatment involve?
  • Receiving an anaesthetic - usually general anaesthetic
  • Surgical incision around the necklace line in the neck
Are there any side-effects?
  • Immediately after surgery the neck can feel sore and swallowing may be a uncomfortable
  • The mortality rates with surgery are very low (0.16%)
  • A hoarse voice is common and usually temporary
  • Permanent change to the voice is rare (1-2%)
  • If the complete thyroid is removed, patients have an under active thyroid following surgery and require life-long thyroid hormone replacement
How long does this treatment take and is admission to hospital required?
  • Usually 1-3 days and hospital admission is required. Patients will also need to take time off work and avoid driving for about 2 weeks.
What should you tell your doctor?
  • A precise list of all your medication
  • Your allergies
 

 

 

P A R A T H Y R O I D    S U R G E R Y

When is this performed?

  • In patients with one or more over active parathyroid glands
  • In parathyroid cancer
What does the treatment involve?
  • Surgery can be performed using various approaches depending on the nature of the illness being treated and your local services
  • Examples of approaches include:
    Open (or explorative through larger incision)
    Focal (small incision beside parathyroid identified to be at fault)
    Endoscopic (small incision, but can be used to explore)
Are there any side-effects?
  • A low serum calcium after surgery is not uncommon and can be associated with tingling. Your calcium will be checked after surgery and treatment commenced if needed
  • A slight alteration in voice occurs rarely (<1%)
How long does this treatment take and is admission to hospital required?
  • The operative procedure may take less than an hour
  • The duration of stay in hospital is dependent on the surgical approach taken
  • Minimally invasive techniques can be performed as a day case, where as open explorative procedure may admission for several days
  • Patients undergoing a focal procedure may be back to work within days
  • The recovery time for open explorative procedures may be 1 week
What should you tell your doctor?
  • A precise list of all your medication
  • Your allergies
 

 

 

 

P I T U I T A R Y    S U R G E R Y

When is this performed?

  • To remove completely a pituitary lesion that is producing excess hormone
  • To remove completely or reduce in size a pituitary lesion that is pressing on local structures, e.g. nerves supplying the eyes
What does the treatment involve?
  • There are various approaches to pituitary surgery
    1. Transphenoidal - through the nose and sphenoid sinus
    2. Transcranial - through the skull (more major procedure)
Are there any side-effects?
  • Hormonal deficiencies may result from removal of pituitary tissue
  • Cerebro-spinal fluid may leak temporarily from the wound site
  • There is a small risk of meningitis is very small
How long does this treatment take and is admission to hospital required?
  • Surgery can take about 3 hours and does require admission to hospital
  • The recovery period after surgery is dependent on the patient and surgical approach
  • Patients may be off work for 2 weeks
     
What should you tell your doctor?
  • A precise list of all your medication
  • Your allergies
  • If you take steroid replacement
  • If you have diabetes mellitus
 

 

 

A D R E N A L    S U R G E R Y

When is this performed?

  • When there is a specific adrenal lesion that over produces hormones, e.g. Conn`s syndrome, phaeochromocytoma
  • When a malignant adrenal lesion cannot be ruled out, e.g. lesion greater than 5cm or lesion enlarging at fast rate
  • Both adrenal glands are sometimes removed in Cushing`s disease that has proved difficult to control
What does the treatment involve?
  • Adrenal surgery may be performed through an open (large) scar or laparoscopically. Which approach is used is dependent on the adrenal lesion being removed and local surgical experience
Are there any side-effects?
  • In Cushing`s syndrome, surgery may be followed by a period of glucocorticoid deficiency which is why steroids are usually prescribed
  • Other complications are rare, but as with any surgery may include those related to infection and poor scar healing
How long does this treatment take and is admission to hospital required?
  • Surgery may take a few hours to complete
  • Hospital admission for laparoscopic surgery may be up to 3 days
  • Hospital admission for open adrenal surgery may be up to a week
     
What should you tell your doctor?
  • A precise list of all your medication
  • Your allergies
  • If you take steroids
 

 

 

B A R I A T R I C    S U R G E R Y

When is this performed?

  • When there is a specific adrenal lesion that over produces hormones, e.g. Conn`s syndrome, phaeochromocytoma
  • When a malignant adrenal lesion cannot be ruled out, e.g. lesion greater than 5cm or lesion enlarging at fast rate
  • Both adrenal glands are sometimes removed in Cushing`s disease that has proved difficult to control
What does the treatment involve?
  • Adrenal surgery may be performed through an open (large) scar or laparoscopically. Which approach is used is dependent on the adrenal lesion being removed and local surgical experience
Are there any side-effects?
  • In Cushing`s syndrome, surgery may be followed by a period of glucocorticoid deficiency which is why steroids are usually prescribed
  • Other complications are rare, but as with any surgery may include those related to infection and poor scar healing
How long does this treatment take and is admission to hospital required?
  • Surgery may take a few hours to complete
  • Hospital admission for laparoscopic surgery may be up to 3 days
  • Hospital admission for open adrenal surgery may be up to a week
     
What should you tell your doctor?
  • A precise list of all your medication
  • Your allergies
  • If you take steroids
 

 

 
 

DISCLAIMER: The information contained in the Endocrinology Specialist website is general information and not specific endocrine or diabetes advice. Patients should always consultant their physician or an endocrinology specialist. For further details please read the full disclaimer.