When to See an Endocrinologist: Signs, Tips on Choosing One, & More

• An endocrinologist treats a wide range of conditions, including diabetes, thyroid disorders, endocrine cancers, and osteoporosis. 
• A primary care doctor may refer a patient to an endocrinologist after a diagnosis of one of these hormonal conditions. 
• Medicare, Medicaid, and many private insurance companies will cover endocrinology services when a primary care provider refers a patient. 

While it’s common to see an endocrinologist, what this medical specialist does is often a mystery. Simply, an endocrinologist specializes in the prevention, diagnosis, management, and treatment of endocrine diseases and hormonal disorders. The endocrine glands are organs that produce and regulate hormones in the body, including the pancreas, thyroid, parathyroids, ovaries, testes, pituitary, and adrenals. Because this system impacts many aspects of health and daily life, there are many reasons to see an endocrinologist.

Ahead, we’ll explore the most common reasons to see an endocrinologist, the hormone-related conditions they treat, and the role of an endocrinologist in your care. Plus, we’ll discuss if insurance covers endocrinology care and how to choose the right endocrinologist for your health and financial situation. 

An endocrinologist is a type of doctor who has specialized, advanced training in conditions that affect the endocrine system. They can diagnose and treat various conditions related to this system of organs and glands. The endocrine system has nine primary endocrine glands:

• Pituitary gland: This ​“master gland” controls many functions of the other glands in the endocrine system. 
• Thyroid gland: This butterfly-shaped gland in the front of your neck makes a hormone that helps control how your body makes and uses energy.
• Adrenal glands: These two small organs are near the kidney and make hormones that regulate blood pressure, metabolism, and blood sugar levels, alongside the pancreas. 
• Pancreas: Located in the abdomen, the pancreas helps with digestion and regulates blood sugar levels through its production of insulin. 
• Ovary: Found above the uterus, the ovaries are female sex glands that help regulate reproduction and sexual function.
• Testicles: A gland inside the scrotum that assists male reproduction by producing sperm. 
• Thymus gland: This tiny organ near the neck creates and houses T‑cells, important white blood cells that help ward off infections. 
• Pineal gland: This tiny gland regulates the circadian rhythm or our 24-hour sleep cycle.
• Parathyroid gland: This small gland that sits on the back of the thyroid gland regulates the levels of calcium, phosphorus, and magnesium in the blood and bones.

Together, these glands produce hormones that help the body function and grow. Hormones aid in many bodily functions, including mood, sexual function, and metabolism, as well as blood sugar levels or the process of getting energy from food. When the body produces too little or too much of certain hormones, it can lead to health problems and complex conditions that require specific treatments. 

The endocrine system impacts vital processes that keep the body alive and operating in a healthy way. As a result, an endocrinologist has quite a long list of conditions they can treat. Primary care doctors may also refer patients to an endocrinologist if they suspect that there is a hormonal imbalance or problem – not only can they diagnose the issue, but they can also help develop a tailored treatment plan that’s best for you. 

While endocrinologists diagnose many thyroid conditions, bone conditions, and other conditions that impact the endocrine organs, the most common include:

• Diabetes
• Osteoporosis
• Thyroid problems
• Pituitary and adrenal gland disorders
• Endocrine cancers

Diabetes

When working as intended, the human body breaks food down into many components, one of which is glucose (a sugar). Glucose is then released into the bloodstream, signaling to the pancreas that it’s time for insulin-producing cells to create insulin (a hormone that indicates to the body’s cells that it should use glucose to create energy). Insulin shuttles blood sugar to vital organs throughout the body.

When the pancreas doesn’t produce enough insulin, blood sugar remains in the blood, putting you at risk for developing diabetes (also called mellitus diabetes or diabetes mellitus). Often, a primary care physician can diagnose diabetes, but they won’t be the only healthcare provider involved in treatment. 

A diabetes care team often consists of:

• Registered dietitian
• Primary care provider
• Diabetes education specialist 
• Ophthalmologist
• Podiatrist
• Audiologist
• Dentist 
• Endocrinologist

Within that team, an endocrinologist treats problems related to insulin production. Because this role is so central to diabetes treatment, endocrinologists often become the go-to doctor when managing diabetes. They may also see pregnant people with gestational diabetes, a condition where an expectant mother develops high blood pressure during pregnancy. 

Many patients find it beneficial to work with a diabetes specialist (an endocrinologist with additional training in diabetes) as opposed to a more general endocrinologist. Any endocrinologist, however, can treat insulin resistance, help patients manage an insulin pump, and provide patient resources on diabetes management. 

Osteoporosis

Osteoporosis is a condition where bone mineral density decreases, and a patient has low bone mass, resulting in bone loss, putting them at an increased risk of pain and bone fractures. While it doesn’t seem like a condition related to the endocrine system, many causes of osteoporosis relate to hormones, specifically too few hormones in the body. Common reasons osteoporosis develops include:

• Low estrogen levels
• Low testosterone levels
• Hormone or endocrine conditions

An endocrinologist is well-positioned to diagnose osteoporosis and determine if the cause is hormone-related or not. When it is, an endocrinologist can help with treatment. 

Thyroid Problems

The thyroid gland is a major player in the endocrine system, and an over or underactive thyroid can have far-reaching impacts. Hyperthyroidism, when the thyroid is overactive and overproduces thyroid hormone, can lead to an irregular heartbeat, nervousness, tremors, heat intolerance, and weight loss, among other symptoms. It’s often caused by Graves’ disease, inflammation in the thyroid, or too much iodine, though there are other causes. 

Hypothyroidism is when a thyroid isn’t active enough and underproduces thyroid hormone. It often results in weight gain, fatigue, and low energy levels. It has many causes, ranging from Hashimoto’s disease to viral infection and inflammation in the thyroid to iodine deficiency. 

Examples of other thyroid conditions include:

• Thyroid nodules
• Goiter
• Thyroiditis

Managing thyroid problems requires specialized knowledge about how the thyroid works, and that’s where an endocrinologist comes in. For example, they can also treat an enlarged thyroid gland (also known as a goiter) even if it doesn’t cause hyper or hypothyroidism. 

Endocrinologists treat disorders related to the thyroid after they take the time to diagnose the underlying cause. Treatment can involve medication, lifestyle changes, and/​or surgery. 

Pituitary and Adrenal Gland Disorders

Another reason someone may see an endocrinologist is to treat a pituitary or adrenal disorder.

Common adrenal gland disorders include:

• Addison’s disease: when these glands produce too little cortisol.
• Aldosterone-producing adenoma: a non-cancerous tumor in the adrenal glands that can cause high blood pressure.
• Congenital Adrenal Hyperplasia (CAH): inherited diseases that stop the adrenal gland from producing enough cortisol.

Pituitary gland disorders occur when this gland is over or underactive. Some of the most prevalent pituitary disorders are:

• Pituitary tumors: Abnormal growths in the pituitary gland. Most pituitary tumors are benign.
• Acromegaly: When the pituitary gland produces too much growth hormone.
• Diabetes Insipidus (DI): A condition in which one experiences chronic and frequent urination and thirst, DI ocurs when water-retaining antidiuretic hormone (ADH) production is too high. This condition is not related to diabetes mellitus (what we commonly refer to as diabetes).
• Hypopituitarism: When the pituitary gland produces too few hormones, disrupting the signaling system that controls the production of hormones and the endocrine system as a whole.

Note: Cushing’s syndrome, a condition that elevates blood cortisol levels, is a pituitary and adrenal gland disorder. 

Endocrine Cancers

Cancer (when abnormal cells multiply in the body) can be present anywhere in the endocrine system. The most common type is thyroid cancer, which is the seventh most common cancer in women and the tenth most common in men. Pancreatic cancer is another prevalent type. Others include cancer in the adrenal glands, parathyroid gland, and pituitary gland.

Someone with cancer will see many specialists, including an endocrinologist when cancer is present in the endocrine system. 

Other Conditions

While the above conditions are the most common reasons to see an endocrinologist, they aren’t the only endocrine disorders. A primary care doctor may refer someone to an endocrinologist for:

• Fertility treatments or conditions
• Low testosterone 
• Metabolic conditions
• Autoimmune conditions
• Menopause
• Obesity 
• Polyendocrine Metabolic Ovarian Syndrome (previously called polycystic ovarian syndrome/​polycystic ovary syndrome)
• Endocrine-related heart disease 

A primary care doctor will decide when the referral is necessary, and an endocrinologist will begin by taking a medical history and assessing a patient’s symptoms before taking images and labs, forming an official diagnosis, and developing a management plan. 

Endocrinologists treat a wide range of conditions and assess a variety of symptoms related to the endocrine system. Because of how diverse their scope is, patients are typically only referred to an endocrinologist if their primary care provider suspects diabetes, osteoporosis, or another common condition is at play. 

Endocrinology plays a crucial role in various aspects of health, from bone health to blood sugar regulation. If a primary care doctor suspects an underlying hormonal imbalance or endocrine disorder, they may refer a patient to an endocrinologist for further evaluation and diagnosis.

Initially, it may be hard to tell if you have an endocrinological issue because many of the initial symptoms are subtle and nonspecific. If you have one or more of the following symptoms, you may want to talk about it with your primary care provider and potentially get a referral to an endocrinologist:

• Fatigue
• Unexplained weight gain or loss
• Excessive hair growth
• Hair loss
• Muscle weakness
• Menstrual irregularities or changes
• Hot flashes
• Feeling cold more often than usual
• Dry skin
• Insomnia
• Joint or muscle pain
• Lower sex drive
• Feeling shaky or jittery
• Excessive sweating
• Night sweats
• Overly frequent bowel movements
• Sleep disturbances
• Kidney stones

When a primary care doctor refers you to an endocrinologist, they may recommend specific endocrinology practices to reach out to. However, it’s essential to choose an endocrinologist who meets your individual needs.

Important factors to consider when choosing an endocrinologist include:

• If a provider is in-network for insurance
• Any specific specialists, such as pediatric endocrinology or diabetes care
• When the next available appointment is 
• The commute to the endocrinology practice
• Reviews from current or past patients
• Certification and training

An endocrinologist should be licensed by the state where a patient resides and be board-certified. Before endocrinologists can treat patients, they attend medical school and complete a residency in internal medicine, (the larger field of medicine that endocrinology belongs to). Afterward, they complete a fellowship in endocrinology.

To showcase their expertise, many endocrinologists earn board certification in internal medicine and endocrinology from the American Board of Internal Medicine (ABIM). This is on top of a medical license from the state or states in which they practice medicine. They may also specialize in a specific area of endocrinology, such as growth hormone deficiency or endocrinology for diabetes. To find licensed and certified endocrinologists, turn to search directories such as the one from the American Association of Clinical Endocrinology. Those covered by Medicare can also use Medicare’s search tool. 

For those who haven’t had an endocrinology appointment before, there are a few things to expect during a first visit:

• Initial assessment: like most doctors, an endocrinologist will start an appointment by conducting a physical exam.
• Review medical history: an endocrinologist will also review a patient’s medical history, with a specific focus on symptoms or conditions related to the endocrine system. They will also ask about family history, which can aid in early detection or prevention.
• Diagnostic tests: depending on a patient’s specific symptoms or concerns, an endocrinologist will conduct general laboratory tests, such as urine tests, and order imaging such as a X‑Ray, CT Scan or MRI on the specific body part in question.
• Additional tests: To further assess a patient’s condition, an endocrinologist may order additional blood tests to measure specific hormone levels and other biomarkers, such as thyroid function tests. These tests are typically performed in a laboratory.

Once test results are back, an endocrinologist will schedule a follow-up appointment with a patient, if necessary. In that appointment, the specialist will discuss treatment options and help a patient create an effective treatment plan. 

For insurance to cover endocrinology care, a patient often needs a referral from a primary care provider. This is true for most private insurance plans and ones through government-funded programs, including Medicare, Medicaid, and coverage through the Veterans Administration. 

The exact amount paid out-of-pocket for endocrinology services depends on the insurance policy’s deductible, copay, coinsurance, and the condition. Finding an endocrinologist who is in-network can help lower costs for those on a private insurance plan or those who have Medicare Advantage. Be sure to speak with your insurance provider prior to seeing an endocrinologist to ensure you are covered and to understand what costs are associated with the visit.