Choose and Books Services offered in Endocrinology

University Hospitals of Leicester NHS Trust
	Department of Diabetes & Endocrinology Leicester Royal Infirmary, Leicester, LE1 5WW

Official descriptions of our main Choose and Book Services in Endocrinology

Adult Endocrinology Service - Endocrinology - LRI - RWE General Endocrinology This service links to the main endocrinology clinics of all consultants in Diabetes and Endocrinology in UHL	The main clinical endocrinology services of University Hospitals of Leicester NHS Trust based at Leicester Royal Infirmary, Department of Diabetes and Endocrinology. We investigate and treat all forms of endocrine disease and manage all types of hormone replacement. Thyroid and parathyroid diseases including thyrotoxicosis, hypothyroidism and goitre and hyperparathyroidism. Adrenal disorders including Addison's disease. PCOS, hirsutism, disturbances of the menstrual cycle and the metabolic syndrome. We have extensive sub-specialist experience in pituitary diseases including hypopituitarism, prolactinomas and hyperprolactinaemia, acromegaly, non-functioning pituitary adenomas and Cushing's syndrome. Consultants within this service have a national and international reputation for excellence in clinical endocrinology services and research, and we also maintain close links with local and national patient support groups for endocrine disorders. Procedures: Basal and Dynamic endocrine function testing and imaging. Counselling and education in endocrine disorders (endocrine nurse specialists) Exclusions: Although we are happy to review endocrine disease in the adolescent transition, young children, particularly disorders of growth and development at a young age are better seen in the paediatric endocrine service
Gynaecological Endocrinology Service - Endocrinology - LRI – RWE Gynae-Endocrine Clinic This service links to the Thursday Gynae-Endocrine Clinic (Dr Howlett) Joint clinic with Fertility Gynaecologist on 2^nd Thursday of month	Part of the main clinical endocrinology services of University Hospitals of Leicester NHS Trust based at Leicester Royal Infirmary, Department of Diabetes and Endocrinology. This clinic is focused on Polycystic ovary syndrome and other causes of hirsutism, oligo and amenorrhoea - together with associated obesity, insulin resistance and metabolic syndrome. Anovulatory infertility related to endocrine causes is also assessed and initial treatment undertaken. Adult patients with Turner's syndrome, premature ovarian failure, and disorders of sexual differentiation and orientation are also reviewed here. Procedures: Basal and Dynamic endocrine function testing and imaging. Counselling and education in endocrine disorders (endocrine nurse specialists) Exclusions: Although we are happy to review endocrine disease in the adolescent transition, young children, particularly disorders of growth and development at a young age are better seen in the paediatric endocrine service
Thyrotoxicosis Shared-Care Service - Endocrinology - LRI - RWE Thyrotoxicosis Shared-Care Scheme Referral This service links to the Endocrinology Nurse Practitioner list in the Endocrine Clinics	The Thyrotoxicosis Share-Care Scheme is part of the main clinical endocrinology services of University Hospitals of Leicester NHS Trust based at Leicester Royal Infirmary, Department of Diabetes and Endocrinology. We are able to accept referrals for newly diagnosed patients with thyrotoxicosis and will advise on initiation and adjustment of medical treatment (typically carbimazole) from the point of referral even before first clinic attendance. After outpatient review, serial monitoring of thyroid function on - or subsequently off - treatment is undertaken on a shared-care computer-assisted basis minimising subsequent outpatient visits. Uncomplicated cases are seen on an endocrine nurse practitioner list, but reviewed by a consultant endocrinologist at first attendance and subsequently as required. Exclusions: GP practices who send thyroid function tests to laboratories other than the UHL service are rarely appropriate for shared-care (since we cannot search automatically for results). Although we are happy to review endocrine disease in the adolescent transition, young children, particularly disorders of growth and development at a young age are better seen in the paediatric endocrine service. Patients with hypothyroidism may be referred to the Leicestershire Thyroid Register.
Pituitary and Neuroendocrinology Service - Endocrinology - LRI - RWE Pituitary Disorders This service links to the relevant clinics of Drs Howlett, Levy and Gleeson rather than to the general endocrinology clinics	Part of the main clinical endocrinology services of University Hospitals of Leicester NHS Trust based at Leicester Royal Infirmary, Department of Diabetes and Endocrinology. We have extensive sub-specialist experience in pituitary diseases including hypopituitarism, prolactinomas and hyperprolactinaemia, acromegaly, non-functioning pituitary adenomas and Cushing's syndrome. Secondary male hypogonadism. Monthly joint clinics are also held with the regional pituitary neurosurgeon - and we will channel appropriate patients into this context. Procedures: Basal and Dynamic endocrine function testing and imaging. Counselling and education in endocrine disorders (endocrine nurse specialists) Exclusions: Although we are happy to review endocrine disease in the adolescent transition, young children, particularly disorders of growth and development at a young age are better seen in the paediatric endocrine service
Joint Surgical-Endocrine Service - Endocrinology - LRI - RWE Joint Surgical Endocrine Clinic Links to the endocrinologist list in the joint surgical-endocrine clinic (with Prof N London)	These slots allow booking onto the endocrinologist (physician) list of the monthly clinic which is a jointly run and manned clinic of the LRI Endocrinology Service (Drs Trevor Howlett and Miles Levy) and the Thyroid and Parathyroid Endocrine Surgeon within UHL (Prof Nick London). The clinic is focused on thyroid and parathyroid disease which may require surgical intervention including thyroid nodules and cysts, other goitres and hyperparathyroidism. We usually have immediate access to thyroid and parathyroid ultrasound in the clinic with ultrasound-guided FNA of suspicious thyroid lesions. Procedures: Fine needle aspiration cytology of thyroid lesions. Thyroid and parathyroid ultrasound Exclusions: If thyroid cancer is strongly suspected (rather than simply a possibility to be excluded) then referral via the 2-week-wait mechanism is more appropriate. Patients with disorders of thyroid function are better referred to the general endocrinology clinic, thyrotoxicosis shared-care service or Leicestershire thyroid register