Professor Gordana Prelevic

Professor Gordana Prelevic
Endocrinology, diabetes & metabolism
Central London


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Professor Gordana Prelevic Endocrinologist in
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MD MSc DSc FRCP

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Professional statement

Professor Gordana Prelevic is one of London's leading endocrinologists. Her main area of expertise is reproductive endocrinology with special interests in the polycystic ovary syndrome, menopause and osteoporosis.

Professor Gordana Prelevic practises at the London Claremont Clinic and the Wellington Diagnostics and Outpatient Centre. She has published extensively in peer-reviewed journals and has contributed to numerous book chapters. She also works as an expert witness in endocrinology and forms an integral part of various reputable professional bodies.


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 Credentials

GMC: 4246626

 Professional experience

• More than 45 years of experience
• Consultant Endocrinologist, London Claremont Clinic (2014-present)
• Consultant Endocrinologist, The Wellington Diagnostics and Outpatient Centre (2013 – present)
• Consultant in Reproductive Endocrinology, Whittington Health (2002 - 2015)
• Expert Witness (2001 - present)
• Consultant Endocrinologist, Royal Free London NHS Foundation Trust (1996 - 2015)
• Consultant Endocrinologist, University College London Hospitals (1996-2004)

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 Sub-specialties

• Reproductive endocrinology
• Polycystic ovary syndrome
• Menopause
• Osteoporosis

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 Teaching posts

• Senior Lecturer in Reproductive Endocrinology at University College, London
• Professor of Medicine and Endocrinology, Belgrade University School of Medicine

 Education

• MD, University of Belgrade (1971)
• ECFMG (1972)
• MSc in Endorinology, University of Belgrade (1978)
• Specialist Certificate in Internal Medicine, Belgrade (1979)
• DSc, University of Belgrade (1985)
• FRCP London (1995)
• CUEW, Cardiff University (2005)

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 Publications and conferences

• Has over 300 publications including more than 100 scientific papers published in international medical journals and over 20 book chapters
• Co-editor of “Drug Therapy in Reproductive Endocrinology”, Arnold Publishing (1996)

 Prizes and awards

• Fellow of the Royal College of Physicians (FRCP) (1995)
• Diploma of the Serbian Endocrine Society (1992)
• Pioneer Scholar at Joint USA-Yugoslav Scientific Cooperation Program (1992)
• Diploma of the Serbian Medical Association (1987)

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 Professional membership

• Society for Endocrinology, UK (1993 - present)
• Endocrine Society, USA (1993 - present)
• British Medical Association (1993 - present)
• Member of Expert Witness Institute (2006 - present)
• Member of The Faculty of Expert Witnesses for Doctors (FEW) (2015 - present)

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Languages spoken

  • English
  • Serbian

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Diseases, Medical Tests and Treatments

Hyperparathyroidism

What is hyperparathyroidism? Hyperparathyroidism refers to an excess of parathyroid hormone in the bloodstream. This occurs due to overactivity in ...

Hypothyroidism

What is hypothyroidism? Hypothyroidism, otherwise known as underactive thyroid, is a condition affecting the thyroid gland, causing it to under ...

Menopause

What is the menopause? The menopause refers to the process which naturally occurs in women as a result of ageing, meaning they no longer have p ...

Osteoporosis

What is osteoporosis? Osteoporosis, meaning “porous bone” is a disease, in which the bones become weak and brittle due to the body either losing to ...

Polycystic ovaries

Polycystic ovaries is a condition that occurs when there is an imbalance in the female ovaries or adrenal glands so they produce more male hormones than normal. The result is the development of cysts (tiny fluid-filled balloons) in the ovaries. Women can develop the syndrome during the teen years or reproductive age, being more common in obese women. Although sometimes there are no symptoms, some symptoms the patient may experience include irregular, infrequent or absent menstrual periods, infertility, pelvic pain, excess hair on the face, chest, abdomen and fingers, hair loss or weak hair, acne, oily skin or dandruff. Birth control pills can help regulate the period and reduce male hormone levels, so this is the treatment usually prescribed for polycystic ovaries. When the ovaries produce multiple small cysts (no more than 1 cm in diameter), it is micropolycystic ovaries syndrome, which usually has the same symptoms. Likewise, the treatment for micropolycystic ovaries may also be based on the administration of the contraceptive pill. ...

Thyroid disorders

What are thyroid disorders? The thyroid is an essential gland in the body which produces thyroid hormones. These hormones control and influence many bodily functions, such as body temperature, energy levels, and metabolism. Thyroid disorders occur for different reasons, but they have an effect on the body’s metabolic functions and produce adverse reactions. Thyroid disorders are relatively common and worldwide, they affect more women than men. What are the symptoms? There are many types of thyroid disorder, meaning there are also many different symptoms. Symptoms depend on the kind of thyroid disorder the patient has. Some more common thyroid problems include goitre, hyperthyroidism, hypothyroidism, thyroid nodules, and thyroiditis. Thyroid cancer is another condition affecting the thyroid. These conditions affect bodily functions and the metabolic system, so symptoms can include: Weight gain Menstrual changes Poor concentration Nervousness Feeling depressed Fatigue Feeling cold Hair loss Mood swings Low sex drive Symptoms vary depending on the type of thyroid disorder, and doctors will take a medical history and assess the symptoms displayed in order to correctly diagnose the type of thyroid condition affecting the patient.   What causes thyroid disorders? Thyroid disorders can be caused in different ways, including related conditions such as autoimmune disease or inflammatory disorders, certain medication, radiation therapy (e.g for cancer), pregnancy, iodine deficiency, and congenital disease. There are various different causes and anyone can develop a thyroid condition. Some risk factors include: Being a woman over the age of sixty Having received radiation therapy in the neck or chest Being pregnant or having had a baby in the last 6 months Having an autoimmune disease Having a family history of thyroid disorder Having had thyroid surgery How can they be prevented? Thyroid disorders cannot really be prevented, but keeping the thyroid healthy is important and there are certain things you can do to reduce the risk. Cigarette smokers are more likely to develop thyroid eye complications related to Graves’ disease, and certain toxins in cigarettes can affect the thyroid, triggering thyroid disease. During X-rays, a special collar can be worn which covers the thyroid and reduces the chances of it being exposed to radiation.   What is the treatment? There are various treatments of thyroid disorders, as there are multiple types of condition and each case must be considered individually. In order to correctly diagnose the thyroid condition, a doctor must first investigate and take a medical history, and measure thyroid hormone levels. A medical evaluation is essential in order to assess what kind of care is needed. Treatments include medication to lower, supplement or eliminate hormone production, and surgery to remove the thyroid gland, sometimes indicated in those with cancer, or particularly large goitres.   ...

Adrenal glands disorders

What are adrenal gland disorders? Adrenal gland disorders are a group of conditions affecting the adrenal glands, which are endocrine glands located above the kidneys. These glands are responsible for producing a variety of hormones, which include adrenaline, steroid hormones such as androgens, and corticosteroids. These hormones help the body to control blood sugar, react to stress (e.g injury/illness), regulate blood pressure, and burn fat. Thus, if the adrenal glands are dysfunctional, this can result in an endocrine condition. There are various types of adrenal gland disorder, including Cushing’s syndrome, Addison’s disease, adrenal gland tumours, and hereditary disorders. What causes adrenal gland disorders? Adrenal gland disorders may occur for several reasons. In many disorders, hormone production is either too little or too high, causing an insufficiency or an abnormal abundance. Adrenal gland disorders can be a result of the following: Tumours Infection Particular types of medication Hereditary conditions/genetic mutation A problem in another of the body’s endocrine glands, e.g. the pituitary gland What are the symptoms? As there are various types of adrenal gland disorders, symptoms will vary depending on the condition. Cushing’s syndrome symptoms are more commonly: upper body obesity, high blood pressure, weakness in the muscles and in the bones, high blood sugar levels, skin conditions such as acne or marks/streaks on the abdomen, slow growth rates (in children), and irritability or depression. Addison’s disease symptoms include: weight loss, fatigue, low blood pressure, salt cravings, feeling dizzy when standing up, nausea, vomiting, feeling weak, noticing patches of dark(er) skin, and depression. Congential adrenal hyperplasia symptoms can be mild or more serious, and symptoms may even be so mild that they do not cause the individual problems. Symptoms of mild CAH include: early signs of puberty, acne, irregular periods, excess facial hair in women, and a shorter than average final height (in younger adults). Symptoms of more serious or severe CAH include: low blood pressure, low blood sugars, difficulty retaining salt in the body, excess facial hair in women, benign testicular tumours in men, infertility in men, abnormal development of the external genitalia in girls, and difficulty for women getting pregnant. Tumours of the adrenal gland can cause a variety of symptoms depending on the hormone which the tumour is overproducing. Some tumours do not produce hormones, but damage the pituitary and do not allow it to secrete the right level of hormones. As a result, the adrenal glands will not function as they should, either. What is the treatment? Treatment depends on the adrenal gland disorder affecting the individual, but generally treatment will be surgical or medical. Treatments include: Medication which seeks to stop excess production of hormones Hormone replacement medication/therapy Tumour removal surgery Surgery to remove one or both of the adrenal glands Surgery to remove tumours of the pituitary gland ...

Childhood obesity

Obesity is a disorder in which a person's weight is above what is considered healthy according to his height. Currently, childhood obesity is a problem that affects a large number of developed countries in which the number of children and adolescents who are overweight is growing at an alarming rate. Obese children can have serious health problems in adulthood, and develop heart disease, diabetes, asthma, high cholesterol, sleep apnoea, etc. In addition to physical consequences, childhood obesity can also lead to psychological problems, such as low self-esteem, depression or feelings of inferiority, which prevent the child from interacting with others and limiting their social relationships. Sometimes the problem of weight can be caused by a disease or a hormone imbalance, but most often it is due to poor diet, hence the importance of teaching healthy habits to children. ...

Cholesterol

What is cholesterol? Cholesterol is a fatty substance known as a lipid, which is mainly made by the liver and can also be found in some foods. It is vital for the human body to function properly but if the levels of cholesterol are too high in the blood, it can result in heart disease and heart stroke among other problems. Cholesterol can increase with age and is only detected through a blood test. There is also something else that may need to be monitored if someone has high cholesterol, and that is triglycerides. Having a high level of triglycerides, a type of fat (lipid) in the blood, can also increase the risk of heart disease. Why is it important to lower cholesterol? Evidence shows that high cholesterol levels can increase the risk of having a heart attack, a stroke, a mini-stroke (known as transient ischaemic attack) or a peripheral arterial disease (PAD). Cholesterol can build up in the artery wall, which restricts the blood flow to the heart, brain and the rest of the body. It can also increase the risk of a blood clot in other parts of the body. The risk of developing coronary heart disease is also higher when the blood’s cholesterol level increases. What causes high cholesterol? There are many factors that increase the chances of having high cholesterol, which include: An unhealthy diet – especially eating high levels of saturated fat. Smoking Diabetes Hypertension (high blood pressure). A family history of stroke or heart disease. Even people who eat healthily can inherit a condition called familial hypercholesterolemia, which can cause high cholesterol. What should my cholesterol levels be? The levels of blood cholesterol is measured in millimoles per litre of blood (mmol/L.) Total cholesterol levels should be 5mmol/L or less for healthy adults or 4mmol/L or less for those who are at high risk. Low-density lipoprotein (LPL) levels should at 3mmol/L or less for healthy adults or 2mmol/L or less for those at high risk. How to lower cholesterol levels? To reduce the level of cholesterol, it is recommended to maintain a healthy and balanced diet, which is low in fatty foods. Regular exercise and quitting smoking are also recommended to lower the levels of cholesterol. If following these steps does not reduce the cholesterol levels, a doctor may prescribe medication such as Statins to help. Statins block the chemicals in the liver that help to make cholesterol, which leads to a reduction the blood cholesterol level. They are only prescribed to people who are at a high risk of heart disease and will need to be taken for life. Low cholesterol diet A balanced diet, low in saturated fats can reduce LDL (bad cholesterol). The following foods should be avoided or the intake reduced: Fatty meats and meat products Butter and lard Cream, sour cream and ice cream Cheese Cake and biscuits Chocolate Coconut oil  ...

Diabetes

What is diabetes? Diabetes mellitus (DM), or just diabetes refers to a group of metabolic diseases which result in an inability to regulate blood sugar levels. Having too much glucose in your blood can damage the kidneys, eyes, nerves and other parts of the body, including the blood vessels themselves. In extreme cases, diabetes can cause heart disease and strokes, and patients may even require amputation of limbs. This inability to control blood sugar comes from a problem with the hormone insulin. Insulin is produced by the pancreas, enters the bloodstream, and moves glucose out of the blood and into cells, where it is used to generate energy. There are two types of diabetes: Type 1 diabetes – the cells that create insulin are attacked and destroyed by the body’s immune system as part of a defective immune response. It can develop rapidly over weeks or even days. Type 2 diabetes – either the body does not produce enough insulin, or the body’s cells stop responding to it. Patients may not be diagnosed for years, due to generic symptoms. It is by far the most common type of diabetes.   What are the symptoms? Classic diabetes symptoms include: Thirst Frequent urination Fatigue Itching around the genitals, or thrush Weight loss/muscle loss Blurred vision Slow healing   What causes diabetes? Type 1 diabetes is an autoimmune condition – something causes the immune system to attack healthy pancreatic cells that produce insulin. It appears to run in families, so may be genetic. No one knows exactly what causes the immune system to attack the pancreas, but one theory is that it is triggered by a virus. Type 2 diabetes is acquired, and usually affects older people. It tends to be associated with obesity and lack of exercise.   How can it be prevented? Type 1 diabetes appears to be genetic, so there is no way to prevent it. To reduce the risk of developing type 2 diabetes, it is important to have a healthy and balanced diet, take plenty of exercise, and lose weight if you are overweight or obese. Stopping smoking and drinking alcohol in moderation are also useful tips.   What is the treatment? Diabetes can’t be cured, but the symptoms can be managed. A healthy diet, regular exercise, and regular blood tests are essential to keep blood glucose levels in check. Type 1 diabetes patients require regular insulin injections for the rest of their lives to make up for the lack of insulin production by the pancreas. Type 2 diabetes patients may eventually need to take tablets, as the condition is progressive (it will worsen over time). You should see your doctor or a specialist as soon as possible if you are experiencing symptoms. If diagnosed with diabetes, a patient is usually referred to a specialist care team for treatment and long-term monitoring of the condition. ...

Diabetes diet

There is no one specific diet for those with diabetes, and a diabetic diet and its recommendations should be discussed with a dietician or specialist in the field. The general aim of a diabetes diet is to control the levels of glucose in the blood. Diabetes UK recommend a healthy balanced diet, which means eating lots of fresh fruit and vegetables, and limiting the amount of sugar and salt consumed.  Type 2 diabetes is a long term condition which requires regular contact with medical professionals, and getting the correct nutrition and maintaining a healthy diet is important in its treatment.  ...

Diseases of the pituitary and hypothalamus

There are a number of diseases which can affect the pituitary and hypothalamus. The hypothalamus is part of the brain and the pituitary gland is situated just underneath. Both are responsible for the production and regulation of various hormones. When either of these glands are affected, a range of conditions can occur. Common causes The most common cause of a problem is the growth of a benign tumour known as an adenoma. A benign tumour is non-cancerous, but when it grows it starts to push on the hypothalamus or pituitary gland it can cause problems with the production of hormones. More rarely, problems in the pituitary and hypothalamus can be caused by: a condition present from birth blood loss anorexia the complications of brain surgery. Common conditions Diseases of the pituitary and hypothalamus are rare, but the most common conditions include: Acromeglay – this involves having too much growth hormone in the body, leading to swollen hands and feet in adults and gigantism in children. Adult growth hormone deficiency – having too little growth hormone can cause loss of muscle and strength, fatigue, depression, and an increase in abdominal fat. Cushing’s disease – this condition involves the overproduction of the hormone cortisol. It is more commonly caused by taking steroids for arthritis, and can lead to weak muscles, weight gain, excessive hair growth, and mood swings. Diabetes insipidus – a problem with the production of the hormone vasopressin, hindering the ability of your kidneys to hold water. The main symptoms include urinating too often and thirstiness. Prolactinoma – an excessive production of the hormone prolactin, with symptoms including lowered sex drive, infertility, and irregular periods in women. Hypopituitarism – refers to the underproduction of two or more hormones in the pituitary glands, causing a wide range of symptoms, from tiredness and muscle weakness to dry skin, reduced fertility, and vision disturbance. Overall, the range of symptoms that can be caused by issues in the pituitary gland and hypothalamus is very wide, due to the central function they play in regulating hormone production all over the body. Which type of specialist treats diseases of the pituitary and hypothalamus? An endocrinologist specialises in the diagnosis and treatment of hormone problems. Generally, most conditions affecting the pituitary gland and hypothalamus can be treated. If the cause is a tumour, surgery will be considered. If not, it is possible to treat a deficiency in hormones with hormone supplements. To book a consultation with an endocrinologist, click here. ...

Eating disorders

Eating disorders are serious behavioural problems. A person who suffers from eating disorders follows eating patterns that can seriously damage his/her health. The common causes and symptoms of this disease include excessive concern about their weight, a distorted view of the body and low self-esteem. The most common eating disorders are anorexia and bulimia nervosa. When a person suffers from anorexia, he/she avoids eating and/or takes laxatives and diuretics. In addition to this, the person may also do intense physical exercise, which could endanger her/his life. The main characteristic of bulimia is that people do binge eating, followed by purging or self-induced vomiting to eliminate and compensate for overeating. All this with a sense of guilt. In these cases, the emergency treatment of patients through a comprehensive plan that includes psychotherapy and continuous monitoring is crucial. In severe cases, the admission of patients to a specialised centre for treatment may be necessary. ...

Growth hormone

Excess secretion of the growth hormone can cause disorders such as gigantism or acromegaly, characterized by abnormal body growth. When this adrenal disease occurs when the child is still growing, before the growth plates are closed, it is called gigantism and the most common cause is a benign tumour in the pituitary; if the disorder affects adults, it is called acromegaly. Children who suffer from this disease are often extremely large for his age. Some of the symptoms may include delayed puberty, front and mandibular prominence, large hands and feet with thick fingers, weakness, shortness of side vision, etc....

Hirsutism

Hirsutism is the presence of excessive body hair in places where hair does not usually grow. In most cases, this abnormal growth of hair is produced by a greater presence of androgen hormones. Hirsutism is usually hereditary, although polycystic ovary syndrome (PCOS) is another common cause. ...

Hyperandrogenism

Hyperandrogenism, or androgen excess is a disorder characterized by an excessive presence of androgens in women. Androgens are male sex hormones (testosterone, androsterone, androstenedione) that cause the development of certain male characteristics or body changes such as increased body hair (hirsutism), alopecia, acne or seborrhoea, disturbances in the menstrual cycle, elimination of ovulation, and change in the voice. The main causes of this disorder include polycystic ovarian syndrome, a malfunction of the adrenal gland, enzyme deficiency during pregnancy (aromatase deficiency, when the disorder is of gestational origin), or the administration of certain drugs. Treatment depends on the causes. ...

Hypercalcaemia

Hypercalcaemia is too much calcium in the blood. There may be many causes behind hypercalcaemia such as inherited disorders, hyperparathyroidism, or renal failure, among others. ...

Hypercholesterolemia

Hypercholesterolemia is the presence of cholesterol above the normal levels in the blood. This increase is often associated with coronary problems, diet, sex, lifestyle and endogenous synthesis. Therefore, the concentration of cholesterol in the blood involves hereditary and dietary factors, along with other factors related to physical activity. There are two types of hypercholesterolemia. Primary hypercholesterolemia, derived from problems in the cholesterol transfer systems and genetic factors, and secondary hypercholesterolemia, in which the increase in cholesterol is associated with certain liver, endocrine and renal diseases. ...

Hyperprolactinaemia

When prolactin levels in the blood it is above average, called hyperprolactinemia. The pituitary gland of our body is responsible for producing prolactin, a hormone that prepares the breast to produce milk during pregnancy and after delivery. Hyperprolactinemia can be caused by the presence of an adenoma, hypothyroidism, taking certain medications, kidney disorders, liver or endocrine disease. ...

Hyperthyroidism

What is hyperthyroidism? Hyperthyroidism, otherwise known as overactive thyroid, occurs when the thyroid gland produces an excess of thyroid hormone. The thyroid gland is located in the base of the neck, and it is responsible for producing thyroid hormone, which helps to control metabolism. This affects functions in the body such as temperature, and the internal body clock (affecting sleep). An excess of thyroid hormone can therefore affect the metabolism and cause problems in the body. Hyperthyroidism more commonly affects women, and while it can occur at any age, it is usually seen appearing more in those between 20 and 40 years of age. What are the symptoms of hyperthyroidism? As the thyroid gland affects many bodily functions connected to metabolism, hyperthyroidism has a wide range of symptoms. These include: Heat sensitivity Feeling nervous, anxious, or irritable Fatigue Mood swings A more frequent need to pee Weakness in the muscles Trouble sleeping Lack of sexual interest Feeling constantly thirsty Swelling in the neck (due to an enlarged thyroid gland) Irregular heart beat Excessive sweating Hair loss Weight loss An itchy rash (hives) Symptoms of hyperthyroidism can have a number of causes, but it is always best to have them checked by a GP. What causes hyperthyroidism? Hyperthyroidism can have multiple causes. The majority of cases occur as a result of Graves’ disease, a condition in which the immune system attacks the thyroid, causing it to produce too much thyroid hormone. Hyperthyroidism can also be caused by certain types of medication, typically those which contain iodine. An increase of iodine in the body can cause the thyroid to produce too much thyroid hormone. Nodules, which are lumps occurring on the thyroid, can also cause hyperthyroidism as they contain thyroid tissue. This excess in thyroid tissue can result in an excess of thyroid hormone. Less commonly, thyroiditis (inflammation of the thyroid), thyroid cancer, and benign tumours of the pituitary gland can cause hyperthyroidism. How can it be prevented? Hyperthyroidism is usually caused by Graves’ disease, which is a genetic disorder. As such, there is no means to prevent the condition. However, certain lifestyle measures can help reduce the risk, such as not smoking, keeping a healthy diet, exercising, and keeping stress levels minimal. What is the treatment for hyperthyroidism? Hyperthyroidism is usually treatable and patients are advised to see an endocrinologist, who specialises in hormone conditions, to advise the most suitable treatment method. Treatment usually comes in the form of medication, radiation therapy (radioiodine treatment which damages the thyroid and causes it to produce less thyroid hormone), or surgery, which aims to remove part, or all of the thyroid so it is unable to produce thyroid hormone.    ...

Hypogonadism

Hypogonadism is an endocrine disorder in which the testes in men, and the ovaries in women, produce low quantities of testosterone and oestrogen respectively. The origins of this disorder can vary and may include hereditary factors, some types of surgery, autoimmune diseases, kidney or liver problems and infections. The most common symptoms of hypogonadism in women are the loss of menstruation and pubic hair, hot flushes, low libido. In men, the symptoms include loss of hair on beard and body, loss of muscle tone, breast enlargement and erection problems. The low production of testosterone in men is known as male hypogonadism. ...

Hypopituitarism

Hypopituitarism is the total or partial decrease of segregation of hormones by the pituitary gland. This will depend on the grade of damage and will cause changes in some organs. Furthermore, the lack of thyroid hormones or difficulty in their production can also affect blood pressure. In women, the most common symptoms of this disease include: changes in menstrual cycle, decreased libido and infertility. In men, hypopituitarism can cause decreased muscle strength, decreased libido and erectile dysfunction. In any case, hypopituitarism is a progressive disease, so symptoms are not too evident and usually occur gradually. Some of the most common causes of hypopituitarism are; head injuries, tumours, brain infections or radiation, genetic diseases and other disorders caused by the immune system. ...

Hypothalamus

The hypothalamus is a small hormonal gland, the size of a pea, located in the centre of the brain. Its task is to control and regulate each and every gland in the body and its functions, such as energy levels, sleep cycles, temperature, blood pressure, muscle function, immune system, among other functions. It changes and resets the functions of our body by sending orders to the body via the autonomous nervous system, through the spinal cord, the pituitary gland, and the endocrine system. ...

Infertility

Infertility is the inability to achieve pregnancy after a period of 12 months or more of unprotected sex. This term should be distinguished from sterility, which is the absolute inability to achieve pregnancy. According to the World Health Organization, infertility affects 15% of couples. In approximately 40% of cases, it is male infertility; in another 40%, the female is infertile, and in the remaining 20% either of the two sexes is infertile, or there are unspecified causes. The causes may be varied: genetics, immune, endocrine, toxic, infectious, etc. so both partners must undergo medical tests. Treatment may include techniques such as in vitro fertilisation, artificial insemination, transfer of zygotes to the fallopian tubes, and intracytoplasmic sperm injection. ...

Insulin resistance

What is insulin resistance? Insulin is a hormone made in the pancreas. It is released into the bloodstream when blood glucose levels rise after eating, as it aids the body’s cells in absorbing glucose from the blood and reduces glucose production in the liver, thus preventing blood sugar levels from becoming too high. If muscle, fat and liver cells develop insulin resistance, it means they do not respond properly to the presence of insulin, and as a result, their ability to absorb glucose from the blood is decreased. A greater concentration of insulin will be needed to achieve the desired effect.   Prognosis of insulin resistance Insulin resistance typically causes the body to produce more insulin to compensate – a condition known as hyperinsulinaemia. Moreover, it is a driving factor behind the development of type 2 diabetes, prediabetes and gestational diabetes.   Symptoms of insulin resistance There are usually no symptoms of insulin resistance when the condition first develops; symptoms manifest later as a knock-on effect of high blood glucose levels, including: Hunger Lethargy Difficulty concentrating High blood pressure High cholesterol levels Weight gain, particularly around the belly   Medical tests to diagnose insulin resistance Insulin resistance can be diagnosed by testing the blood for high insulin levels. However, doctors rarely test specifically for insulin resistance, as some of the most effective tests, such as the euglycemic clamp are too expensive and complicated to be carried out in a doctor’s surgery. It is most commonly diagnosed during blood tests for prediabetes, as prediabetes rarely occurs without insulin resistance.   What are the causes of insulin resistance? The causes of insulin resistance are not completely understood, but several risk factors that could contribute to its development have been identified: Being overweight/obese Little physical activity A diet that is high in calories, sugar and/or carbohydrates Chronic stress Long-term use of steroids taken in high doses Certain other conditions, such as polycystic ovary disease and Cushing’s disease   Treatments for insulin resistance There are several ways to reduce the effects of insulin resistance, and in some cases reverse it. These methods revolve around losing weight and increasing physical activity. Effective lifestyle changes could include: Adopting a low-carbohydrate, low-calorie or ketogenic diet Walking for 30 minutes a day Increasing weekly levels of exercise, e.g. going to the gym Weight loss surgery   Which type of specialist treats insulin resistance? Doctors specialising in endocrinology, diabetes and metabolism are usually able to diagnose and treat insulin resistance and prediabetes. ...

Ketogenic diet

What is the ketogenic diet? The ketogenic diet is a low carb diet where the body produces small fuel modules in the liver called ketones, which are used as energy. Ketones are an alternative fuel for the body, used when the blood sugar (glucose) is in short supply. Through eating very few carbohydrates, moderate amounts of protein and high levels of natural fats, ketones are produced. They are produced in the liver from fat and used throughout the body as fuel.   How does the ketogenic diet work? The entire body changes its fuel supply to run almost entirely on fat. The levels of insulin become very low, which enables fat burning to increase dramatically. The body is in a state of ketosis when it produces ketones.   What foods can be eaten on a ketogenic diet? It is important to track the number of carbohydrates that are being consumed daily. Some people will find that they can eat 50g of carbohydrates and lose weight, whilst others stick to 20g or less a day. Typical foods to be consumed on the ketogenic diet include: • Fish and seafood • Cheese • Natural fats such as avocado, grass-fed butter, coconut oil and olive oil • Meat • Eggs • Vegetables that grow above the ground.   What foods are to be avoided on a ketogenic diet? The main foods to avoid are those that contain a lot of sugar and starch. Foods high in carbohydrates such as bread, pasta, rice and potatoes should be avoided. Fruits should be avoided, although some fruits such as berries can be eaten in moderation. All processed foods should be cut out.   What are the benefits of the ketogenic diet? Weight loss – fat burning is vastly increased. Appetite control Constant energy and mental performance Control blood sugar and reverse type 2 diabetes – blood sugar levels are controlled, lowered and reduce the negative impact of high insulin levels. Improved health markers – improve cholesterol, blood sugar and insulin levels and blood pressure. Increased physical endurance – there is a constant access to all the energy of the fat stores. Top athletes follow the ketogenic diet for an increase in performance. Control epilepsy – the diet was originally intended as medical therapy for children with epilepsy since the 1920s. Reduce the risk of cancer - lowering carbohydrates reduces your levels of glucose, which is the fuel that feeds cancer cells. ...

Parathyroid gland

  The surgery of the parathyroid glands involves the partial or total removal of the glands near the thyroid. The minimally invasive surgery can be performed by standard surgery or through an incision in the neck. The procedure is as follows: the problem is identified through techniques that identify the hormone in the bloodstream and other tests that locate the hormone in the tissue, such as cervical ultrasound and scintigraphy. Through a small incision of about 10 or 15mm a camera of 5mm is inserted to help the surgeons perform the operation, displaying the procedure through a monitor connected to the camera. ...

Thyroid

The thyroid gland is an endocrine gland located in the front of the neck, below the Adam’s apple. The thyroid is shaped a little like a butterfly, and is responsible for producing hormones throughout your body. The hormones produced by the thyroid help to control such things as the burning of calories in your body, the speed of your body’s metabolism, and regulates the body’s development from birth to old age.   Diseases that can affect the thyroid   There are a number of diseases and disorders that can affect the thyroid, which usually cause either the production of too much or not enough hormones that the body needs, which can lead to other problems elsewhere. Problems that can affect the thyroid include:   Hyperthyroidism Otherwise known as overactive thyroid, this condition is when the thyroid gland produces too much of the thyroid hormone. An excess of the hormone can lead to many problems, such as changes in mood, anxiety, tiredness and heart palpitations amongst others. Hypothyroidism The opposite of hyperthyroidism, hypothyroidism is when not enough of the thyroid hormone is produced, leading to symptoms of constipation, feeling cold and tired, and difficulty concentrating. If a person is suffering with hypothyroidism at a young age, it can cause problems with growth, delayed puberty, and irregular periods. Goitre This is the term used for an enlarged thyroid, and is associated with a malfunctioning thyroid. It can cause symptoms of coughing, difficulty swallowing and even difficulty breathing in some cases. Thyroid cancer Along with other organs and glands in the body, the thyroid is also susceptible to cancer. It is more common in women aged between 25 and 65, and is more commonplace in Asian people, though it can affect anyone. Thyroiditis This is the general term for an inflamed thyroid. It can refer to a number of conditions such as Hashimoto’s thyroiditis, Postpartum thyroiditis, and Subacute thyroiditis. All of these conditions affect different age groups, and have different kinds of symptoms, though the common symptom is swelling of the thyroid gland.   How are thyroid problems treated?   Treatment for a thyroid disorder varies depending on the type of condition. Some may be treated with medication, where others may require surgery. Medication can be prescribed to correct the hormone levels produced by the thyroid gland, such as to help produce more hormone in the case of hypothyroidism, or to restrict the amount of hormone produced with hyperthyroidism. When surgery is required, it will usually involve removal of part of the gland, or to remove part of the swelling or goitre. The surgical treatment for patients with thyroid cancer is good, with many patients making a full recovery when the cancer is found early. ...

Thyroid nodules

What are thyroid nodules? Thyroid nodules are abnormal growths of thyroid cells and tissue which form a lump in the thyroid gland. The thyroid gland is located in the neck and releases thyroid hormone, which helps to control the body’s metabolism. Thyroid nodules are usually non-cancerous (benign), but some are cancerous, which means thyroid nodules must be evaluated in order to treat thyroid cancer in its early stages. What are the symptoms? Thyroid nodules usually do not cause symptoms, and most are found during routine examinations or through CT scans or other similar imaging tests. Most thyroid nodules are non-functioning, but some do produce an excess of thyroid hormone, which results in hyperthyroidism. Thyroid nodules may become noticeable if the nodule is large enough, as a lump may be seen on the neck, or the nodule may cause problems breathing and swallowing due to it restricting the windpipe. What causes thyroid nodules? Thyroid nodules do not always have a known or apparent cause. Some nodules are associated with iodine deficiency, but this is uncommon as iodine is often added to salt and other foods. Hashimoto’s thyroiditis, an autoimmune condition, is associated with an increased risk of developing thyroid nodules. Thyroid nodules can be caused by an excess of thyroid tissue, swelling of the thyroid (goitre), and thyroid cysts. However, it is not always clear why growths and swelling occur.   How can they be prevented? Thyroid nodules cannot be prevented. There are tests which can determine if an individual has a thyroid nodule, but these should always be discussed with a doctor. What is the treatment? Treatment for thyroid nodules depends on whether the nodule is benign or cancerous, and if it is functioning or not. If a thyroid nodule is cancerous, it must be removed surgically. Thyroid cancer, on the whole, is treatable and curable. Surgery may also be performed if the thyroid nodule is particularly large and causes the patient discomfort. The nodule also may be removed if it is actively secreting hormones. If a thyroid nodule is benign, then treatment may not be necessary, and the thyroid nodule will be monitored closely. Thyroid function tests and physical examinations will be performed regularly to make sure the nodule is still benign. If the thyroid nodule produces thyroid hormones, this can be treated using medication, radioactive iodine treatment, or in some cases, surgery.   ...

Thyroiditis

What is thyroiditis? The term thyroiditis refers to an infection of the thyroid gland, and is a general term – there are several types of thyroiditis causing inflammation in various ways, and treatment varies depending on the kind which the patient has. The thyroid gland produces hormones which help to control the body’s metabolism and growth. Types of thyroiditis include Hashimoto’s thyroiditis, De Quervain’s thyroiditis, postpartum thyroiditis, drug-induced thyroiditis, radiation-induced thyroiditis, infectious thyroiditis, and silent (or painless) thyroiditis.  What are the symptoms of thyroiditis? Symptoms vary depending on the type of thyroiditis contracted. De Quervain’s thyroiditis, for example, can cause fever, and pain to occur in the jaw, neck, and ear. The thyroid gland may, in addition, release too much thyroid hormone, causing symptoms of hyperthyroidism, e.g anxiety, heart palpitations, and inability to sleep (insomnia). Symptoms of an overactive thyroid gland are also experienced in postpartum thyroiditis, which affects a very small amount of women shortly after giving birth. These symptoms may be seen in silent thyroiditis, drug-induced thyroiditis, radiation-induced thyroiditis, and acute thyroiditis. Equally, these types of thyroiditis may display symptoms of an underactive thyroid gland. An overactive thyroid gland produces symptoms including: Anxiety Mood swings Trouble sleeping Feeling weak, or muscle weakness Lack of sexual interest Nervousness Irritability Hyperactivity Fatigue Diarrhoea An increased need to urinate An underactive thyroid gland produces symptoms including: Weight gain Being constipated Muscle cramps Dry skin Hair and nails breaking easily or feeling brittle Loss of sex drive Irregular periods Heavy periods Depression Feeling sensitive to the cold What causes thyroiditis? As thyroiditis comes in many forms, it can be caused in different ways. Hashimoto’s thyroiditis is caused by the immune system attacking the thyroid gland. De Quervain’s thyroiditis is caused by a viral infection such as the flu. Thyroiditis can also occur in women who have recently given birth, although this is more common in women with type 1 diabetes. Certain medications and radiation (e.g from radiotherapy) can also affect the thyroid gland, causing thyroiditis. Lastly, infectious thyroiditis (also called acute thyroiditis can be caused by an infection. How can thyroiditis be prevented? Most types of thyroiditis cannot be prevented, but lifestyle measures and looking after your body can help in the event of an infection. Get regular exercise, drink in moderation, and if you smoke, it is advisable that you give up. What is the treatment for thyroiditis? Treatment for thyroiditis depends on the kind which the patient has. Hashimoto’s thyroiditis is an autoimmune condition and it can take months or years to even detect. In Hashimoto’s thyroiditis, treatment focuses on relieving symptoms, as it is incurable. Other types of thyroiditis can be treated with medication, which attempts to restore normal thyroid function. Pain can be relieved with over-the-counter painkillers such as ibuprofen. In some cases, thyroiditis causes low thyroid hormone levels, meaning hormone replacement therapy may become necessary. This treatment is often lifelong. If the thyroiditis is infectious, it may be treated with antibiotics, and in children, surgery is usually necessary to remove the abnormal part of the thyroid.  ...

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