Endocrinology

Endocrinology is dealing with diagnosis, prevention, and treatment of diseases of the endocrine glands that secrete hormones into the body. There are many endocrine diseases and in most cases no obvious symptoms develop. Therefore, it is important to recognize the problem quickly and contact a specialist in Germany in time.

Please take a look at the list of the best endocrine clinics in Germany which have earned a good reputation both in Europe and worldwide. For more information please visit our website or contact our medical experts directly and get an individual medical consultation.

Metabolism and hormones

The metabolism in the human body includes all chemical reactions that serve to maintain life, such as building and maintaining body substance and functions, generating energy and breaking down and excreting metabolic end products. Hormones, important signal and messenger substances, which are released by hormone-producing cells in the body and transported via the blood, are often switched on.

Lipid metabolism disorders

Different lipid metabolism disorders can lead to increased blood lipid levels. These so-called hyperlipoproteinemias are among the most common metabolic disorders in industrialized countries. They often occur in combination with obesity and other diseases of civilization.

Elevated blood lipids: diagnosis

Elevated blood lipids do not cause any symptoms and are therefore usually discovered by chance. The existence of a lipid metabolism disorder can never be concluded from individually measured laboratory values. Slight deviations from the reference range also occur in healthy people. Due to the distinction between LDL and HDL cholesterol, an assessment of the total cholesterol level is only of limited significance. The distribution in LDL and HDL cholesterol is more interesting.

How is the diagnosis made?

A blood test is used to diagnose elevated blood lipid levels. To do this, it is important that the patient is fasted for at least twelve hours. Total, HDL cholesterol and triglyceride levels are determined in the blood. LDL cholesterol is usually not measured directly but calculated using a formula (Friedewald formula).

If elevated blood lipid levels can be seen in the blood, the doctor tries to determine the causes and connections. In the anamnesis interview, it is therefore asked whether an elevated cholesterol level is known in direct relatives (parents, siblings). It is also relevant whether your family has had cases of (early) heart disease. The doctor will measure the blood pressure, conduct a clinical examination if necessary, and check the body for cholesterol deposits, especially in the eyes and (Achilles) tendons.

Further examinations may be required, e.g .:

• TSH level (indication of thyroid disease),
• Blood sugar (indication of diabetes),
• Urinalysis.

For the doctor, the pattern of blood lipid values in relation to one another and the level of the values can already be informative. In the case of extremely high triglyceride and / or extremely high LDL levels, a genetic defect (primary lipid metabolism disorder) can be assumed. An ultrasound examination of the carotid arteries can reveal early changes in the sense of arteriosclerosis.

When are the values increased?

Specifying a normal value for total cholesterol is considered less useful. Instead, the doctor orients himself to the cardiovascular risk of a person: the higher the risk, the lower the value for bad (LDL) cholesterol should be.

Total cholesterol / HDL quotient

Due to the distinction between LDL and HDL cholesterol, an assessment of the total cholesterol level is only of limited significance. If the total cholesterol is increased, the ratio of LDL to HDL cholesterol must be determined. Further information can be found in the laboratory section under What is normal? and lipid metabolism.

The diagnosis of endocrine diseases

Endocrinology in Germany involves a wide range of methods to detect endocrine disorders:

• laboratory hormone testing
• functional diagnostic tests
• ultrasound
• evaluation of metabolic disorders
• paracentesis
• scintigraphy (radiography, computed tomography (CT), nuclear magnetic resonance imaging (NMRI).

What kind of endocrine diseases are treated in Germany?

• Thyroid diseases
• Parathyroid gland diseases
• Acromegaly (excessive and disproportionate growth of extremities)
• Cushing’s syndrome (also called hypercorticism) – excess cortisol secretion
• Endocrine-inactive pituitary tumors
• Craniopharyngioma – inherited benign brain tumor derived from pituitary gland embryonic tissue
• Endocrine system disorder: inherited or acquired disorders after a surgical procedure or as a result of inflammation
• Prolactinoma is an endocrine active tumor of the anterior pituitary which secretes high levels of the hormone prolactin
• Diabetes insipidus
• Hyperaldosteronism (Conn’s syndrome) – excess secretion of aldosterone
• Addison’s disease is a chronic adrenal insufficiency
• Congenital adrenal hyperplasia – excess cortisol and cholesterol secretion
• Hypoglycemia, e.g. in case of insulinoma (insulin-producing tumor of the pancreas)
• Pheochromocytoma (adrenaline-producing adrenal tumor)
• Excess or deficient sex hormone production (e.g. gynecomastia – breast development in men or hirsutism – excess facial and body hair in women)
• Inherited metabolic disorders like porphyria
• Hypolipemia
• Adiposity (obesity)

Scientific researches in the centres for endocrine surgery in Germany

Grave’s disease

Diagnosis and treatment of thyroid disorders has been one of the main fields of endocrinology and endocrine surgery in German clinics so far. The treatment of the patients with Grave’s disease and thyroid eye disease includes a special medical consultation as well as an examination by an ophthalmologist.

Medullary thyroid cancer

German endocrine clinics treat patients with thyroid cancer in cooperation with health care facilities in the field of nuclear medicine and general surgery. Medical centres conduct researches on new chemotherapy methods to treat well and poorly differentiated thyroid cancer.

In recent years medical centres for endocrinology in collaboration with research institutes for the endocrine disorders have developed advanced molecular genetic characteristics of inherited forms of diseases. A close cooperation with medical facilities specializing in gastroenterology and nuclear medicine has enabled to perform such new diagnostic procedures as endoscopic ultrasound and positron emission tomography.

Endocrine surgery in Germany – minimally invasive methods

For patients with endocrine diseases German surgeons offer minimally invasive surgeries. Due to a very small incision there is only a little scar after a surgery. After such surgeries the patient recovers fast and quickly goes back to the usual way of life.

Radioactive iodine therapy

Radioactive iodine therapy, a widely used method in the German endocrinology clinics, deserves special attention. This type of treatment is recommended to diagnose a lesion or thyroid nodules. The level of radiation during the therapy is similar to the electromagnetic radiation during the radiography. It means the patient gets only a low dose of radiation.

Endocrine disorders that cause ovarian diseases form a special field of endocrinology. Due to therapeutic intervention in the pituitary gland and thyroid gland German physicians can treat infertility and regulate the hormone level.

In case of endocrine diseases it is important to bear in mind that if you postpone the treatment for a long time, the disease can lead to significant disorders. So, if you suffer from a thyroid or other endocrine disorder, we are ready to assist you with a diagnosis, treatment or a medical consultation in a German clinic.