Endocrinology is a branch of medicine that concerns the study of hormones and its disorders. The endocrine system consists of several glands located in different parts of the body that secrete hormones.

Endocrinologists are doctors who specialize in study of hormonal diseases like diabetes, thyroid disorders, obesity, growth disorders, etc.

The principal endocrine glands in our body are Pituitary, Thyroid, Pancreas, Adrenal, Parathyroid, and Gonads – ovary and testis. Besides hormones are secreted by various other organs like brain (hypothalamus), heart, kidney, gut, placenta, breasts, etc. The pituitary is considered as a master gland and governs the function of other endocrine glands in the body.

These are products of various endocrine glands, which are released into the bloodstream, which then acts on various cells and tissues of body.

The endocrine disorders are a varied group of diseases resulting from deficiency or excess of various hormones.

Diabetes
Thyroid disorders
Obesity
Sexual disorders, erectile dysfunction, hypogonadism & reproductive endocrinology
Male infertility
Hirsutism (Excessive facial or body hair in females)
Polycystic ovary syndrome (PCOS) and other female endocrine disorders
Disorders of growth – Short Stature, Growth hormone deficiency & Growth hormone excess
Delayed & premature puberty
Osteoporosis (low bone density)
Metabolic bone diseases - Vitamin D deficiency, Rickets, Osteomalacia, Hyperparathyroidism
Pituitary disorders - pituitary tumors, raised pituitary hormone levels, deficiency of pituitary hormones, diabetes insipidus
Adrenal disorders - Adrenal tumors, Cushing's syndrome, Pheochromocytoma, adrenal failure
Disorder of Sexual Development - Small penis, hidden testis, genital ambiguity, gynecomastia, Turner's syndrome, Klinefelter's syndrome

1. Type 1 Diabetes: Type 1 Diabetes develops if the body is unable to produce any insulin. This type of diabetes usually develops before the age of 30 years. Type 1 Diabetes is treated with daily insulin injections, a healthy diet and regular physical activity.

2. Type 2 Diabetes: Type 2 Diabetes develops when the body can still make some insulin, but not enough or when the insulin that is produced does not work properly (known as insulin resistance). Type 2 diabetes is treated with a healthy diet and increased physical activity. In addition to this, medications and/or insulin are often required.

3. Gestational Diabetes: Gestational diabetes develops in 5% to 10% of all pregnancies but usually disappears when the pregnancy is over. Women who have had gestational diabetes are at an increased risk (up to 50%) of developing type 2 diabetes later.

Indians in general are more predisposed for developing Diabetes. In addition, other risk factors are:

If any of your close family member has diabetes (parent, brother or sister)
Overweight or obese (Body mass index more than 23)
Habitual physical inactivity
Women who delivered a baby weighing >3.5 kg or were diagnosed with diabetes during pregnancy
High blood pressure
Those with high blood cholesterol
Women with Polycystic ovary syndrome (PCOS)
Heart disease patients

When a child is diagnosed with type 1 diabetes it not only affects the child's life but the family as a whole. Type 1 diabetes is not caused by wrong eating habits or lifestyle nor is it a sin or punishment. The question still remains unanswered as to why some children get it. The answer to this question is not as important as is the fact that with the help of regular insulin injections, proper monitoring and incorporation of nutritious foods and physical activity into each day, one can enjoy a relatively normal, healthy life. Every day technology for taking insulin is changing. Now we have finer thin and small needles, which are almost painless. We have smart glucose monitoring devices and somewhere research to find a cure is making progress.

Frequent urination
Increased thirst
Sudden weight loss
Increased hunger
Always tired
Wounds that won't heal
Blurring of vision
Sexual problems
Vaginal infection
Tingling or numbness in hands or feet

Majority of diabetics in fact do not have any symptoms. After the age of 45 years all people should get their blood sugar checked routinely even in the absence of symptoms and risk factors. If your blood sugar is normal you should get it checked every 3 yearly.

You need to get your blood sugar checked in fasting as well as 2 hours after taking 75gms of glucose. You should consult your doctor for all precautions & information prior to testing.

Poorly managed diabetes can lead to various complications like blindness, kidney failure, neuropathy, heart attack, paralysis, sexual and urologic problems. Although diabetes cannot yet be cured, it can be successfully managed. In order to stay away from complications, it is important that your blood glucose is adequately controlled. Eating a balanced diet, managing your weight and following a healthy lifestyle together with taking your prescribed treatment and regular monitoring is important.

Every visit - blood glucose, blood pressure, foot examination
3 monthly - HbA1C (Glycated hemoglobin) - This test gives estimate for average blood sugar control over past 3 months
Yearly - Kidney function test (KFT), lipid profile, fundus for diabetic retinopathy, urine for micro albumin

Pre meal blood sugar - 70–130 mg/dL
Post meal blood sugar - <180 mg/dL
HbA1C (Glycated hemoglobin) - <7.0%
Blood pressure - <130/80 mmHg
LDL cholesterol - <100 mg/dL

A thyroid gland is an endocrine gland; which manufactures thyroid hormone that is essential for the function of every tissue in the body.

The thyroid gland is located in the lower part of the neck.

The thyroid gland produces thyroid hormones which it secretes into the bloodstream, which then act to affect cells and tissues in other parts of the body. Thyroid hormones regulate the speed at which your body cells work. Thyroid hormones also help children grow and develop.

Hypothyroidism (underactive thyroid gland)
Hyperthyroidism (overactive thyroid gland)
Goiter (enlargement of thyroid gland, visible as neck swelling)
Thyroid malignancy (cancer of thyroid gland)

Hypothyroidism means that the thyroid gland can't make enough thyroid hormone to keep the body running normally.

Most cases of hypothyroidism are caused by a condition called Hashimoto's thyroiditis, in which a patient's immune system attacks and destroys the thyroid. Iodine deficiency used to be a common cause in India but after iodized salt became widely available has now become rare. It can also be caused by treatment of hyperthyroidism or by certain medications, and it may be present from birth.

Common complaints include fatigue and lethargy, cold sensitivity, dry skin and lifeless hair, impaired concentration and memory, increased weight, puffiness and constipation. Patients may also fairly often experience a hoarse voice, tingling of the hands, heavy or delayed menstrual periods, deafness and joint aches. In childhood there may be delayed development and puberty. Some patients have a swelling in the front of the neck due to thyroid enlargement (a goiter).

Yes. Many patients have relatively few of the classical signs or symptoms. In fact, nowadays most patients often are diagnosed at an early stage of disease, due to increased awareness and improved testing.

Your doctor will be able to get a good assessment of your thyroid gland activity by taking a history of your symptoms and by a physical examination. However to confirm the diagnosis, it is necessary to get laboratory tests that measure thyroid function test (TFT; serum T4 and TSH levels).

With synthetic thyroxine (T4). Thyroxine (T4) is the major hormone produced by the thyroid gland and pure synthetic T4, taken once daily by mouth, successfully treats the symptoms of hypothyroidism in most patients. The current branded forms of synthetic T4 are Eltroxin, Thyronorm, Thyrox, Thyroup, Thyrofit, Thyobuild, Lethyrox, Thyrocheck etc. Because of variations in the potency of T4 made by different manufacturers, including generic preparations, it is best to stay on T4 from a single manufacturer whenever possible.

It depends on diagnosis. It can be a few months as in case of viral thyroiditis. However, in most cases, you may have to take treatment lifelong so as to keep your hormone levels in normal range.

If you are not taking enough T4, some of the symptoms of hypothyroidism may continue. If you take too much, you may have symptoms of an overactive thyroid, including nervousness, a racing heart, trouble sleeping, and shaking. You should get repeated your thyroid function test as per advice of your doctor.

If too much of the thyroid hormones are secreted, the body cells work faster than normal, and you have thyroid overactivity or 'hyperthyroidism' (also referred to as "thyrotoxicosis").

Common complaints include fatigue, heat intolerance, sweating, weight loss despite good appetite, shakiness, inappropriate anxiety, palpitations of the heart, shortness of breath, tetchiness and agitation, poor sleep, thirst, nausea and increased frequency of defecation, enlarged thyroid gland and prominent or bulging eyes. Children tend to have hyperactivity, with a short attention span.

Goitre is an enlargement of the thyroid Gland, which is situated in front of the neck. In many cases it is related to abnormal thyroid hormone levels.

Yes, it is possible.

Obesity is a medical condition that occurs when a person weighs considerably more than is considered healthy. This extra weight can put extra strain on the body and serious health complications can arise if treatment is not sought and the weight is not lost.

The most common way to measure obesity is Body Mass Index (BMI). BMI is calculated by dividing your weight in kilograms by the square of your height in meters. For Asian Indians, a BMI of 23 or more is considered overweight, and a BMI of 25 or more is considered obese. Waist circumference is also an important measure – a waist circumference of more than 90 cm in men and 80 cm in women indicates abdominal obesity.

Type 2 Diabetes
High blood pressure
Heart disease and stroke
Sleep apnea
Fatty liver disease
Osteoarthritis
Certain types of cancer
PCOS and infertility
Psychological issues like depression

Obesity is caused by a combination of factors including excessive calorie intake, sedentary lifestyle, genetic predisposition, hormonal imbalances (such as hypothyroidism, Cushing's syndrome), certain medications, and psychological factors. In many cases, multiple factors contribute together.

You should consult an endocrinologist if your BMI is above 25, if you have tried diet and exercise without success, if you have associated conditions like diabetes, PCOS, or thyroid problems, or if you suspect a hormonal cause for your weight gain.

Treatment ranges from lifestyle modifications (diet and exercise), behavioral therapy, medications approved for weight loss, to bariatric surgery in selected cases. An endocrinologist can evaluate for hormonal causes and recommend an appropriate personalized treatment plan.

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age. It is characterized by irregular or absent periods, excess androgen (male hormone) levels, and polycystic appearance of ovaries on ultrasound. It is one of the most common causes of female infertility.

Irregular or absent menstrual periods
Excessive hair growth on face, chest, abdomen (hirsutism)
Acne
Weight gain or difficulty losing weight
Darkening of skin in creases (acanthosis nigricans)
Thinning hair or hair loss
Difficulty getting pregnant

PCOS is diagnosed based on the Rotterdam criteria – presence of at least 2 out of 3 features: (1) Oligo/anovulation (irregular periods), (2) Clinical or biochemical signs of hyperandrogenism (excess male hormones), (3) Polycystic ovaries on ultrasound. Other conditions mimicking PCOS must be ruled out through blood tests.

PCOS cannot be completely cured, but its symptoms can be effectively managed. Lifestyle modifications (healthy diet, regular exercise, weight management) are the cornerstone of treatment. Medications can regulate periods, reduce hair growth, treat acne, and improve fertility. With proper management, most women with PCOS lead healthy, normal lives.

PCOS is one of the leading causes of female infertility due to irregular ovulation. However, many women with PCOS do conceive, either naturally or with the help of fertility treatments. It is important to manage PCOS before and during pregnancy, as women with PCOS have a higher risk of gestational diabetes, preeclampsia, and preterm delivery.

ED can be caused by both physical and psychological factors. Common physical causes include diabetes, high blood pressure, heart disease, low testosterone, thyroid disorders, and certain medications. Psychological causes include stress, anxiety, depression, and relationship issues. An endocrinologist can evaluate hormonal causes like low testosterone, thyroid problems, and prolactin excess.

Hypogonadism in males refers to low testosterone levels. Symptoms include reduced libido, erectile dysfunction, fatigue, decreased muscle mass, increased body fat, mood changes, and decreased bone density. It can be caused by testicular problems (primary) or pituitary/hypothalamic problems (secondary). Blood tests can diagnose it and treatment involves testosterone replacement therapy when appropriate.

A male should see an endocrinologist for evaluation of low testosterone symptoms, infertility, erectile dysfunction not responding to standard treatment, gynecomastia (breast enlargement), delayed or absent puberty, or if other hormonal disorders are suspected.

Yes. Diabetes is one of the most common causes of erectile dysfunction. High blood sugar over time can damage blood vessels and nerves that are essential for normal erectile function. Diabetes can also cause reduced testosterone levels (hypogonadism), retrograde ejaculation, and decreased libido. Good diabetes control can help prevent or delay these complications.

Short stature can be caused by genetic/familial factors, constitutional growth delay, growth hormone deficiency, hypothyroidism, chronic illnesses, nutritional deficiencies, chromosomal abnormalities (like Turner syndrome), and certain bone disorders. A pediatric endocrinologist can evaluate the cause through detailed history, examination, growth charts, and specific blood tests.

Growth hormone deficiency (GHD) is a condition where the pituitary gland does not produce enough growth hormone. It can be present from birth (congenital) or develop later (acquired) due to tumors, radiation, trauma, or infections. Children with GHD have slow growth, short stature, and may appear younger than their age. Treatment involves daily growth hormone injections.

You should consult a doctor if your child is significantly shorter than classmates, if growth velocity has slowed down, if your child is growing less than 5 cm per year after age 3, or if there is a significant difference between your child's height and the expected height based on parental height. Early evaluation allows for timely intervention.

Precocious puberty is the onset of signs of puberty before age 8 in girls and before age 9 in boys. This includes breast development in girls, testicular enlargement in boys, pubic hair, growth spurt, or advanced bone age. It can cause the child to stop growing earlier than expected, leading to short adult height. An endocrinologist should evaluate this to determine the cause and plan treatment.

Osteoporosis is a condition characterized by low bone mass and deterioration of bone tissue, leading to increased bone fragility and risk of fractures. It is often called a "silent disease" because it progresses without symptoms until a fracture occurs. Common fracture sites include the hip, spine, and wrist.

Female gender, especially postmenopausal
Advanced age
Low body weight
Vitamin D deficiency
Long-term steroid use
Thyroid overactivity
Family history of osteoporosis
Smoking and excessive alcohol
Sedentary lifestyle
Early menopause

Osteoporosis is diagnosed by a DEXA scan (Dual-energy X-ray Absorptiometry), which measures bone mineral density (BMD). The result is expressed as a T-score. A T-score of -2.5 or lower indicates osteoporosis, while a T-score between -1.0 and -2.5 indicates osteopenia (low bone mass). Blood tests for vitamin D, calcium, thyroid, and parathyroid hormone may also be done.

Adequate calcium intake (1000-1200 mg/day)
Maintain sufficient vitamin D levels
Regular weight-bearing exercises
Avoid smoking and excessive alcohol
Prevent falls
Get bone density testing if at risk
Take prescribed medications if needed

While a referral from a primary care physician is helpful, it is not always necessary. You can directly book an appointment with Dr. Alka Bishnoi for any endocrine concern including diabetes, thyroid disorders, PCOS, obesity, or other hormonal issues.

Previous blood test reports and investigations
List of current medications with dosages
Previous imaging reports (ultrasound, CT, MRI, etc.)
Medical records from other doctors
Insurance cards (if applicable)
A list of questions you want to ask

An initial consultation typically lasts 20-30 minutes, which includes a detailed history, physical examination, review of previous reports, and discussion of the treatment plan. Follow-up visits are usually shorter, around 10-15 minutes.

Dr. Alka Bishnoi is available for consultations Monday through Saturday, 10 AM to 6 PM. It is recommended to book an appointment in advance to avoid waiting. You can book through phone, WhatsApp, or the online booking form.

Yes, online/video consultations are available for follow-up visits and for patients who are unable to visit in person. However, for initial consultations, an in-person visit is preferred for a thorough physical examination. Please contact the clinic to schedule an online consultation.

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