Dr Helen Spoudeas areas of expertise:

Professional statement

Dr Helen Spoudeas is a highly-experienced, leading endocrinologist based in London. She is a paediatric endocrine subspecialist consultant, with 20 years' experience at both Great Ormond Street Hospital, the leading children's hospital in the UK, and at University College Hospitals.

Dr Helen Spoudeas is an international expert on the neuroendocrine effects of brain and pituitary tumours, particularly abnormalities of growth and development, hormone excess and deficiency.

Dr Spoudeas has published original research and articles in peer-reviewed literature, and has appeared as a guest speaker at national and international conferences on the topics of hormone secretion, growth, pubertal and fertility status after cancer therapies. Dr Spoudeas is a member of a multitude of reputable professional bodies.

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Credentials

GMC: ‍2716903

Professional experience

• More than 35 years of experience
• Consultant in endocrine service to survivors of childhood cancer, especially brain tumours, at the London Centre of Paediatric Endocrinology between Great Ormond Street and University College Hospitals
• Part of the general endocrine services, University College London Hospitals (UCLH) (present)
• Part of the general endocrine services, Great Ormond Street Hospital (GOSH) (present)
• Visiting paediatric endocrinology appointments, Watford General Hospital (1998 - 2003)
• Visiting paediatric endocrinology appointments, Barnet Hospital, London (1997 - 2003)
• Senior Registrar Paediatric Endocrinology (UCLH & GOSH) (1993 - 1999)
• Visiting paediatric endocrinology appointments, Royal Marsden Hospital, Sutton, Surrey (1988 - 1998)
• Qualified from Barts Hospital, London (1981)

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Sub-specialties

• Long-term-follow-up (LTFU): Late effects of Cancer
• Children and young people's endocrinology
• Children and young people's services

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Teaching posts

• Honorary senior lecturer in Paediatric Endocrinology at University College London and the Institute of Child Heath, where her main NHS practice continues (1999 - present)
• She has provided expert advice to the NICE guidance on child and adolescent cancer (2005) and in 2012 to the national specialist commissioning (NCG) paediatric neurosurgery ‘safe and sustainable’ initiatives for service improvement in children with complex brain tumours.
• Accredited educational supervisor of postgraduate paediatric trainees with 10 years experience mentoring and leading paediatric training programmes at the London Deanery and Royal College of Paediatrics and Child Health (RCPCH ) and currently supervising MsC and PhD students.
• Honorary Lecturer in Paediatric Endocrinology in University College London Hospital (UCLH) (1988 - 1993)

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Education

• Paediatric specialisation (1985)
• Attained her postgraduate doctorate (MD) (1995)
• Member of the multidisciplinary working party on fertility preservation before childhood cancer therapy (2003)
• MBBS (London) (1981)
• ECFMG and VQE (1981)
• DRCOG (1983)
• MRCP (London) (1985)
• MD (London) (1995)
• MRCPCH (1996)
• CCST (Paediatrics and Endocrinology) (1996)
• FRCPCH (1999)
• FRCP (2000)

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Publications and conferences

• Hoong-Wei Gan, Kim Phipps, Kristian Aquilina, Mark Nicholas Gaze, Richard Hayward, Helen Alexandra Spoudeas. Neuroendocrine morbidity after paediatric optic gliomas: a longitudinal analysis of 166 children over 30 years. J Clin Endocrinol Metab (2015)
• Spoudeas HA. The evolution of growth hormone neurosecretory disturbance during high dose cranial irradiation and chemotherapy for childhood brain tumours. MD thesis, University of London (1995)
• Spoudeas HA. Paediatric Endocrine Tumours. A Multidisciplinary Consensus Statement of Best Practice from a Working Group convened under the auspices of the British Society for Paediatric Endocrinology and Diabetes (BSPED and the United Kingdom Children’s Cancer Study Group (UKCCSG) (October, 2005)
• Author and editor of the joint BSPED-CCLG commissioned guidance on paediatric endocrine tumours (2005)
• She has published over 40 articles and chapterson the neuroendocrine effects of childhood brain tumours and related aspects of quality of survival and continues to be active in collaborative clinical research locally and internationally in this area.
• She is a recognised international speaker in her specialist field, invited to give over 10 lectures annually to a wide variety of interdisciplinary professionals.

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Professional membership

• Member of the European Society of Paediatric Endocrinology (ESPE) (1990 - present)
• Member of the Children's Cancer and Leukaemia Group (CCLG) (1999 - present)
• Member of the European Children’s NeuroOncology Society (SIOP-E)
• Member of the "brain tumour" and "quality of survival" committees (2000 - present)
• Executive member of the British Society of Paediatric Endocrinology (BSPED) (2000)
• Nominated endocrine society (paediatric and adult) stakeholder and endocrine expert to N.I.C.E. guidelines on child and adolescent cancer (2003 - 2005)
• Fellow of the Royal College of Physicians (FRCP) (1999 - present)
• Fellow of the Child Health (FRCPCH) (1999 - present)
• Deputy Regional Adviser and Member of Specialty Training Committee North Central Thames (RCPCH) (2003 - present)

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Languages spoken

English
Greek

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Diseases, Medical Tests and Treatments

Adrenal glands disorders

What are adrenal gland disorders? Adrenal gland disorders are a group of conditions affecting the adrenal glands, which are endocrine glands lo ...

Childhood obesity

What is it? Obesity can be described as the accumulation of fat in the body. This means a higher body weight in relation to sex, height, and ...

Growth disorders

What are growth disorders? Growth disorders are anomalies or irregularities during a child’s growth and development. This means that a child can ei ...

Hypopituitarism

What is hypopituitarism? Hypopituitarism is a condition in which the pituitary gland is not producing normal quantities of certain hormones. The pi ...

Independent medical examination

Independent medical examinations are carried out to determine the severity of an injury.

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. ...

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

What are eating disorders? An eating disorder is when someone has a very unhealthy attitude to food, body weight or shape. Eating disorders are serious illnesses that can prove fatal if not treated. The most common types of eating disorders are: Anorexia nervosa: when an individual tries to keep their body weight as low as possible by not eating enough or exercising excessively, or both. Bulimia: characterised by periods of binging and then purging by either use of laxatives or by being deliberately sick. Binge eating disorder (BED: loss of control over eating, consuming large portions all at once until you feel ill and consumed by feelings of guilt. Women are more likely to suffer from these types of disorders. They tend to occur in adolescence and are often accompanied by depression and anxiety disorders. What symptoms do they present? The common symptoms of eating disorders are: Excessive exercise Worrying a lot about your weight and body shape Eating very little Inducing vomiting after eating Taking laxatives Depression Mood swings Having strict routines around food Avoiding social settings that could involve food Additional physical signs include: A weight that is very low Amenorrhoea (absence of menstruation) Digestion problems Fatigue Feeling cold and dizzy What causes eating disorders? The exact causes of eating disorders are not known, however, some risk factors include: Having a family history of depression, substance abuse and eating disorders. You have been criticised in the past for your weight or body shape. You are overly concerned about your weight, for example, because of the nature of your work (e.g. being a model). You suffer from anxiety and have low self-esteem. You have been sexually abused. Can eating disorders be prevented? Prevention of eating disorders refers to any programs or interventions that reduce the risk factors of developing such a disorder. This includes primary and secondary prevention. Primary prevention aims to prevent the onset of an eating disorder, whilst secondary prevention tries to reduce the severity and duration of an eating disorder in someone who has already been diagnosed. What is the treatment for eating disorders? Treatment may differ slightly between each case and each type of eating disorder. Recovering from an eating disorder is entirely possible, but recovery can take a while and it will be a different experience for each person. Physically, treatment will aim to increase your nutritional intake, stop purging and reduce excessive exercise. Together, these will allow the individual to reach a healthier weight. Further to this, treatment will involve individual, group and family psychotherapy sessions (e.g. CBT), nutritional counselling, medical monitoring and medication. Medications that may be given include anti-depressants, but medication must not be the only form of treatment for eating disorders, and may not be given to patients under the age of 18. ...

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....

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. ...

Hypothyroidism

What is hypothyroidism? Hypothyroidism, otherwise known as underactive thyroid, is a condition affecting the thyroid gland, causing it to underproduce thyroid hormone. Thyroid hormone plays an important role in the body, affecting the metabolism. In those with hypothyroidism, the metabolic system runs more slowly, resulting in various problems. Hypothyroidism most commonly affects women, affecting ten times more women than men. The condition can also occur in children. What are the symptoms of hypothyroidism? As hypothyroidism develops, symptoms may not be noticeable, as they are often a natural result of ageing e.g weight gain, fatigue. However, as the condition progresses, further signs and symptoms of hypothyroidism may develop, including: Dry skin Sensitivity to cold Thinning hair/brittle hair Pain in the joints Stiffness or swelling in the joints Irregular or heavy periods Weakness/aching in the muscles General fatigue Constipation Depression A doctor usually performs a thyroid function test to determine if these symptoms indicate hypothyroidism. In this test, a sample of blood is taken to measure hormone levels. What causes hypothyroidism? The thyroid gland can fail to produce enough thyroid hormone for a number of reasons, including: Hashimoto’s thyroiditis, which is an autoimmune disorder in which the body attacks its own tissues. Hyperthyroidism treatment. In those who produce too much thyroid hormone, treatment seeks to reduce thyroid function. However, the treatment can cause permanent hypothyroidism. Radiation. Radiation therapy in cancer treatment of the head and neck can affect the thyroid gland and increase the risk of developing a thyroid disorder. Certain medication. Particular types of medication can cause hypothyroidism, such as lithium (often used in the treatment of psychiatric disorders). How can it be prevented? Anyone can develop hypothyroidism, and it cannot be prevented. However, there are certain risk factors, and being aware of the signs can help with a swift diagnosis. Women over the age of 60 are more likely to develop hypothyroidism, along with women six months after having been pregnant or having had a baby. Family history of autoimmune disease or thyroid disease can also increase the chances of developing the condition. Those who have undergone radiation therapy in the upper chest or neck area are also at an increased risk, along with those who have undergone thyroid surgery to remove or partially remove the thyroid gland. What is the treatment for hypothyroidism? Treatment for hypothyroidism seeks to raise thyroid hormone levels. This is normally achieved through hormone replacement, which is generally taken lifelong. However, with hormone replacement, patients are able to live normal, and healthy lives. It is important to make sure hypothyroidism is treated correctly. If the condition goes untreated, it can cause medical complications such as heart disease, and goitre (enlarged thyroid). ...

Neuroendocrinology

What is neuroendocrinology? Neuroendocrinology refers to the study of the neuroendocrine system, which is the interaction between the nervous system and the endocrine system and how they communicate together. Areas of the brain control the secretion of various hormones throughout the body, which in turn helps to regulate reproduction, blood pressure, metabolism, how our body uses energy, and other bodily functions. What kind of conditions are related to the neuroendocrine system? Hormones regulate a number of functions, including the way we behave, and our emotions. The neuroendocrine system encompasses a wide range of systems including how we cope and respond to stress, growth and metabolism, reproduction, our body clocks and sleep habits, giving birth, eating and drinking, and milk production. Therefore there are a great many conditions directly related to the neuroendocrine system, such as pituitary disorders, growth disorders, and stress-related disorders, to name but a few. The neuroendocrine system is connected to libido, food intake, our internal body clock, and even the way we behave. What is the difference between endocrinology and neuroendocrinology? Neuroendocrinology, rather than being substantially different from the field of endocrinology, which is the study of hormones, studies the interaction between hormones and the brain. Therefore the two fields are closely connected. Hormones affect a great number of functions in the body, and referral to a neuroendocrinologist may come from a wide range of specialties, including obstetrics and gynaecology, neurology, psychiatry, and endocrinology itself, seeking a further examination of potential hormonal causes of a condition. ...

Precocious puberty

What is precocious puberty? Precocious puberty when a child’s body begins changing into that of an adult before the age of eight, in the case of girls, or nine in the case of boys. It’s not always clear what causes precocious puberty, but sometimes diagnosis can reveal an underlying cause, such as a genetic disorder or tumour. Precocious puberty is a rare condition, but is more common in girls than boys. How can precocious puberty affect my child? Normally, a slight variation in when a child starts puberty is to be expected. However, precocious puberty is a serious condition, because it causes the child’s bones to stop growing at an earlier age. This can stop them from ever reaching their full adult height potential. Going through puberty early on relative to other kids can also be a difficult experience for your child, making them feel self-conscious and socially isolated. It’s therefore important that precocious puberty is recognised and treated early on. Symptoms of precocious puberty Precocious puberty can be identified by the common signs of puberty: in boys, this can include a lower voice, facial hair, or enlarged genitals in girls, this can include breast growth or menstruation In both boys and girls, symptoms can include pubic hair, acne, body odour or spurt in growth. Medical tests to diagnose precocious puberty It important to go to the doctor with full medical records and family history. Diagnosis can involve asking about the height of relatives. The doctor will also run some blood tests to measure the hormone levels in your child. Precocious puberty generally causes the bones to grow more quickly, so the doctor will take some X-rays of your child’s hand and wrist to determine their bone age and check if there is any abnormality. Treatments for precocious puberty Treatment will depend on the cause of precocious puberty. Treating an underlying condition, such as a tumour, may resolve the issue by itself. Sometimes, however, the doctor will recommend taking medication to pause puberty for a few years until your child is of the right age to begin puberty again. Which type of specialist treats precocious puberty? Unless it is suspected that there is an underlying cause that needs to be investigated, your child may only need to see a GP. However, they may need to see a radiologist for an X-ray or MRI scan if a tumour is suspected. ...

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Clinics

London Medical

Other information about Helen Spoudeas

http://www.drhelenspoudeas.co.uk/

Publications in the National Institute of Health

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