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Endocrinology Clinics
Endocrinology Clinics at Royal North Shore Hospital
This page is for referring General Practitioners and other Health Professionals only.
Scope of Service:
The Department of Endocrinology at Royal North Shore Hospital is a busy tertiary referral centre and there is a high demand for our outpatient services. As such, the following conditions are considered appropriate for GP care alone:
  • Pre-diabetes (impaired fasting glucose and impaired glucose tolerance)
  • Primary hypothyroidism (including subclinical hypothyroidism)
    Please note women of child bearing age who are pregnant or considering pregnancy should have thyroxine replaced aiming for a TSH of ≤2.5. Women who are currently pregnant and planning to deliver at RNSH should be referred to the Specialist Obstetric Clinic (Tel: 02 9463 2377, Fax: 02 9926 4061) for ongoing care during their pregnancy. Urgent review of complicated thyroid issues in pregnancy can be reviewed in the Endocrine Clinic and phone advice can be sought by contacting the Endocrine Registrar/Fellow on 02 9926 7111.
  • Positive thyroglobulin and thyroid peroxidase antibodies with normal thyroid function
  • Osteopenia

Patients with well-controlled (HbA1c ≤7.0% or 53mmol/mol) type 2 diabetes mellitus who are on diet-control only do not necessarily require specialist review and may be appropriate for our Diabetes Education services or Sydney Diabetes Health Assessment Unit instead (click here).

Referral Forms:

Please click here to download our the referral form
and fax to 02 9463 1045.
or submit online by clicking here.

Please ensure all details of the patient and referring clinician are completed on the form or they may be sent back for appropriate completion.

All received referrals will be triaged by a clinician based on the information you have provided and the patient will be contacted with an appointment date and time. Urgent appointments sent through the online system should also be discussed with the Endocrine Registrar/Fellow (02 9926 7111) to facilitate interim treatment and arrange an earlier appointment if necessary.

 
Guidelines for Referrals:
The following are considered desirable investigations to be included with the referral, or at least performed prior to the appointment:
  • Any relevant imaging studies, eg thyroid ultrasound – please provide reports and instruct patients to bring copies of the films/CD with them
  • Diabetes: HbA1c, TSH, UEC, fasting chol/HDL/LDL/triglycerides, glucose, FBC, LFTs, B12, red cell folate, iron studies, 25OH vitamin D, uric acid and morning spot urine albumin:Cr ratio
  • Thyrotoxicosis: TSH, free T3, free T4, TSH receptor antibodies (rather than anti-thyroid antibodies), FBC, LFTs
  • Hypercalcaemia: corrected (+/- ionised) calcium, phosphate, PTH, 25OH Vitamin D, TFTs, 24hr urinary calcium excretion (Note: they should not be on a thiazide diuretic for at least 2 weeks prior to collection)
  • Pituitary problem: early morning (08:00) cortisol, ACTH, prolactin, FSH, LH, estradiol (for females), testosterone (for males), SHBG, growth hormone, IGF-1, UEC
  • Osteoporosis: 25OH vitamin D, PTH, corrected calcium and phosphate, TSH, serum protein electrophoresis, ESR, coeliac serology and IgA level, LFTs, UEC, FBE, bone mineral density and any previous vertebral xrays or xrays of minimal trauma fractures. For males with osteoporosis, please also see investigations for hypogonadism
  • Suspected Cortisol insufficiency: If you are concerned about cortisol insufficiency, please contact the Endocrine Registrar/Fellow (02 9926 7111) to discuss patient details and arrange a short synacthen test if appropriate prior to an appointment.
  • Suspected Cushing’s syndrome: 24hr urinary free cortisol, 1mg overnight dexamethasone suppression test (1mg dexamethasone orally at 11pm-midnight followed by 08:00 cortisol the next morning).
  • Suspected pheochromocytoma: plasma metanephrines X 2 (or 24 hour urine catecholamines and metanephrines)
  • Hypogonadism: Men will require an early morning (08:00) testosterone, LH, FSH, SHBG and prolactin. Women will require an estradiol, progesterone, LH, FSH and prolactin (and please make note of the stage of the menstrual cycle at the time of investigations)
  • PCOS/hirsutism: TSH, prolactin, LH, FSH, estradiol, progesterone, testosterone, SHBG, androstenedione, DHEA-sulphate, early morning (08:00) 17OH progesterone (bHCG if amenorrhoea)
  • Health Weight Clinic: height, weight and BMI must be included in referral to ensure they fit the criteria for this clinic (see below). UEC, LFTs, FBC, HbA1c (if diabetic), fasting chol/LDL/HDL/triglycerides, TSH, 25OH vit D

    Patients must fulfil the following criteria: 1) BMI ≥35 with type 2 diabetes mellitus and ≥ 1 comorbidities * or 2) BMI ≥40 with ≥1 comorbidities. (*Comorbidities include ischaemic heart disease, obstructive sleep apnoea, osteoarthirits, fatty liver disease, hypertension and dyslipidaemia.)

Cumulative results are always appreciated and the more details that are provided for a patient (including current medications and comorbidities), the better we are able to allocate them to an appropriate and timely clinic.