Synopsis
Convert non-specific symptoms into an anatomical endocrine hypothesis, interpret paired hormones through feedback physiology, and recognise results or presentations that need immediate treatment or specialist escalation.
- Endocrine symptoms such as fatigue, weight change, thirst, menstrual disturbance and palpitations are common; specificity comes from tempo, associated signs, medicines and a coherent physiological pattern.
- Interpret a target-gland hormone with its controlling hormone whenever the axis permits: an isolated number often cannot distinguish primary gland disease from hypothalamic or pituitary disease.
- In primary target-gland failure the end hormone is low and the trophic hormone usually rises; in central failure the trophic hormone is low or inappropriately normal for the low end hormone.
Key red flags
A low end hormone with a low or merely normal trophic hormone is discordant and can indicate hypothalamic or pituitary disease, particularly when several axes or visual symptoms coexist.
Investigation priorities
Assess the thyroid axis and distinguish primary thyroid dysfunction from a potentially central pattern.
Management branches
Non-specific symptoms raise the possibility of endocrine disease.
- Define tempo, episodic triggers, weight and fluid balance, reproductive symptoms, family syndromes and every prescribed, injected, inhaled, topical and non-prescription hormone-active product.
- Examine physiology and targeted signs, separating an acutely unstable presentation from a stable outpatient question before ordering broad tests.