Diagnostic & Therapeutic Protocols
This handbook is designed for efficient clinical diagnosis, treatment, and prognosis of most endocrine conditions. For background information about these procedures and their scientific research basis, consult the corresponding section in “Basics of Naturopathic Endocrinology” and the relevant papers in “Clinical Studies and Literature Reviews.”
Diagnosing Endocrine Disorders
Diagnosis of endocrine conditions includes physical examination, medical history, and laboratory diagnostics. A physical exam would review not only the physical symptoms of the patient, such as pain, but also physical characteristics, such as obesity. The medical history would include questions about any physical symptoms or signs that they might have had in the past. Laboratory testing will help further define the endocrine diagnoses. The information provided below is to be used as a basic reference tool in pointing to the suspected endocrine condition.
Physical Examination
Pain
On a physical exam, finding the character and location of pain originating from endocrine condition can be helpful in diagnosing further lab work follow-up.
Lower Quadrant Pain
[Sari: Let’s use the check box bullet in these places so that practitioners could check off symptoms.]
- Ureter calculi. Kidney stones are usually caused by high levels of blood calcium from unknown reasons. About 5% is caused by hyperparathyroidism.
- Endometriosis or polycystic ovary syndrome. Patients who have these conditions usually have significant menstrual pain.
- Diabetic keto acidosis. Nausea with diffuse abdominal pain along with acetone breath are key signs of this condition.
Epigastric Pain
- Zollinger-Ellison syndrome. This condition is primarily found in the pancreas, resulting in high gastric juice formation causing burning epigastric pain.
- Adrenal insufficiency. Patients will have vague digestive complaints, including nausea associated with severe fatigue.
Chest Pain
- Osteoporosis. Bone pain due to bone loss commonly found in postmenopausal women.
- Osteomalacia. Bone pain due to bone loss due to abnormal vitamin D metabolism or phosphate deficiency.
Physical Signs
Cardiomegaly
- Carcinoid syndrome
- Hyperthyroidism. Increased thyroid hormone levels continually stimulate the heart to pump faster and harder.
- Diabetic atherosclerosis. This eventually causes high blood pressure.
- Hypothyroidism. This is associated as well with hypertension.
- Adrenal tumors. Secrete high levels of aldosterone, which results in hypertension.
Bleeding Under the Skin (Purpura)
- Cushing’s syndrome
- Waterhouse-Friderichsen syndrome
Epistaxis
- Menopause
- Menstruation
Hematemesis and Melena
Zollinger Ellison syndrome
Vaginal Bleeding
Menopause (from the uterus)
Dysfunctional bleeding (from the uterus)
Hypopituitarism (from the ovaries)
Hypothyroidism (from the ovaries)
Stein Leventhal (from the ovaries)
Constricted Pupils
Hypoparathyroidism
Convulsions
- Hypoglycemia (due to effects on the brain)
- Hypocalcemia (due to effects on the brain)
- Addison’s disease (due to effects on supporting tissue)
- Hyperthyroidism (due to effects on the heart)
Cough
- Substernal thyroid
Diarrhea
- Zollinger-Ellison syndrome (due to effects on stomach and small intestine)
- Pancreatic cholera
- Hypoparathyroidism (due to effects on small intestine)
- Hyperthyroidism (due to effects on small intestine)
- Addison’s disease (due to effects on small intestine)
Dilated Pupils
- Pheochromocytoma
- Pituitary tumors (advanced)
- Cataracts (due to diabetes)
- Exophthalmos (due to hyperthyroidism)
Dyspnea
- Hyperthyroidism (due to increased oxygen demand)
- Diabetic acidosis (due to inability to excrete carbon dioxide)
Fevers
- Pituitary tumors
- Diabetes mellitus
- Calculi
- Pregnancy
Jaundice
- Hyperthyroidism
Paresthesias, Dyschezias, and Numbness
- Tetany of hypoparathyroidism
- Diabetic neuropathy
- Pituitary tumors
- Acromegaly
Syncope
- Insulinomas
- Addison’s disease
- Hypopituitarism
Tachycardia
- Fat emboli
- Hyperthyroidism
- Hyperthyroidism
- Pheochromocytomas
Tinnitus and Deafness
- Myxedema
- Diabetic neuropathy
