Focused Endocrine Health

Endocrine disorders rarely announce themselves through one isolated finding. Fatigue, weight change, nausea, anxiety, constipation, palpitations, and altered glucose can each have many causes. The useful assessment question is: Which findings travel together, and what hormone system could produce that pattern? A patient with tremor, heat intolerance, diarrhea, unintentional weight loss, and persistent tachycardia has a different pattern from a patient with cold intolerance, constipation, dry skin, bradycardia, and slowed thinking. Both may say, “I am exhausted,” but the associated findings point in opposite physiologic directions. Begin by deciding whether the patient is stable. Altered mental status, hypotension, respiratory distress, severe dehydration, seizure activity, marked temperature abnormality, or a rapidly changing heart rate can signal an endocrine emergency. Obtain vital signs, assess airway and circulation, check bedside glucose when hypoglycemia or hyperglycemia is plausible, and escalate urgent abnormalities without waiting for a complete endocrine history. A patient with diabetes who is confused and diaphoretic needs glucose assessment and immediate treatment for suspected hypoglycemia before a detailed discussion of diet, medication adherence, or long-term glucose control. Priorities change when brain function...