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As specialist Endocrinologists and Obstetric Physicians, Dr Sheila Cook and Dr Julian Pavey received their medical training at the University of Queensland and fellowships from the Royal Australasian College of Physicians. This fellowship recognizes their extensive training and understanding of endocrinology, diabetes and medical disorders in pregnancy.
Queensland is huge and there is no need to spend hours in the car to receive expert specialist help.
Toowoomba Endocrinology and Diabetes are expert Telehealth providers and our COVIU platform allows for convenient and easy to use consultations, wherever you are. We have now successfully completed telehealth appointments to some of Australia’s most remote areas, including the Tiwi Islands. We regularly undertake these appointments with remote patients, some from their Utes or tractors in the back paddocks! We have a Telehealth Specialist Endocrinologist in Dr Ramessh Ranjan who is available to help you, and all of our doctors are able to use this technology to provide expert care.
Telehealth can be done to your phone, your tablet, your laptop or your desktop PC or Mac. Scripts and Pathology forms can be sent electronically, and we are also able to partner with your local pharmacy or GP practice to ensure you have a good user experience at your end.
The price for a telehealth is the same as for regular in person appointments. Medicare recognises the benefit of Telehealth and a Medicare rebate for these services is available for eligible patients.
To find out more, or book a Telehealth appointment, please call on (07) 4588 6615 or email us at admin@twba-ed.com.au.
The thyroid gland produces hormones that regulate your metabolism.
Hypothyroidism
The commonest thyroid condition is an underactive thyroid, due to the immune system (Hashimoto’s thyroiditis), following a virus (thyroiditis) or insufficient iodine in your diet. If the thyroid hormone levels are very low, you can feel very lethargic, feel cold and experience constipation. These symptoms are common in people without a thyroid problem, so it is important to get a blood test to confirm whether underactive thyroid (hypothyroidism) is actually the cause.
Hyperthyroidism
An overactive thyroid (hyperthyroidism or thyrotoxicosis) is less common but can also make you feel fatigued. It can also cause palpitations, insomnia, tremor and agitation. Several conditions cause an overactive thyroid, so investigations – blood tests and thyroid scan – are important to work out the diagnosis and the best treatment.
Thyroid cancer
Thyroid cancer is a slow growing cancer that can occur at any age and is readily treated with surgery and sometimes a dose of radioactive iodine. It may present with a neck lump, difficulties swallowing or a change in the voice. It is diagnosed on ultrasound, with a needle biopsy of the lump. After surgery to remove the thyroid cancer, an endocrinologist will provide care to manage the thyroid hormone treatment and to check if the cancer returns.
We provide care to diagnose and manage thyroid disorders and work closely with thyroid surgeons as needed.
Calcium levels in the blood stream are regulated by hormones that work on the bones, kidneys and your gut. If the calcium levels are high, you are at risk for bone thinning (osteoporosis), kidney stones or muscle aches and pains. There are several causes for high calcium levels, so investigations are required to work out which treatment will work best. Eating more dairy foods and taking Vitamin D supplements are a good start.
We provide care to diagnose and manage calcium disorders, in partnership with a specialist endocrine surgeon where appropriate.
Breaking a bone with a minor bump or fall is a clue to osteoporosis, which is when bones are thin and brittle. Other clues include a hunched posture or reducing height. It is different to osteoarthritis, which is when the joins are painful due to wear and tear. Osteoporosis can run in families and is more likely if you didn’t eat protein foods or dairy when you were young, if you smoke or drink more than the recommended amount of alcohol. Treatment includes increasing your intake of cheese or yoghurt, exercise, Vitamin D supplements and medications that protect the bones from further loss of mineral.
We provide care to manage osteoporosis – both lifestyle and medications – to prevent fractures.
The pituitary gland is a small part of the brain that sits behind the bridge of your nose and produces several hormones that talk to other glands in the body. Problems in the pituitary gland can cause low testosterone in men, irregular periods in women, affect fertility and headaches. Blood tests and brain scans will diagnose disorders in the pituitary, and hormone treatments will improve symptoms and quality of life.
We provide care to diagnose and manage pituitary disorders, using hormone therapies. Where appropriate, we work closely with neurosurgeons to manage pituitary tumours.
The adrenal glands sit on top of the kidneys in the abdomen and produce hormones that control blood pressure and your response to stress. Disorders that affect your adrenal glands can cause high blood pressure, low blood pressure, craving for salt, skin changes or fatigue. Investigations include blood tests, and scans of the adrenal glands.
We provide care to diagnose and manage adrenal disorders including Addison’s disease, Cushing’s Syndrome, primary hyperaldosteronism, and adrenal nodules.
Testosterone is produced by the testes in men and leads to beard growth, sex drive and muscle strength. In women, testosterone is produced by the ovaries and adrenal glands at much lower levels and improves sex drive. Low testosterone in men causes fatigue, low sex drive and problems with erections. To diagnose the cause for low testosterone, investigations include blood tests and sometimes a brain scan or ultrasound of the testes.
We provide care to diagnose and manage low testosterone. An endocrinologist or urologist is required to prescribe testosterone treatment for men with a PBS prescription.
Overweight and obesity often runs in families, and develops when the hormones that respond to food we eat causes fat to accumulate as energy storage. If fat builds up in the abdomen, it can lead to health problems like a fatty liver, diabetes and certain cancers. Understanding which foods trigger the weight gain hormones will help you to manage weight and feel better. Newer treatments are available to help with weight loss, including weekly injections and bariatric surgery.
We provide care to manage overweight and to support weight loss. Where appropriate, we work closely with bariatric surgeons.
National Association of Clinical Obesity Services (NACOS) link →
PCOS affects up to 12% of Australian women and can explain irregular periods, infertility, dark facial or acne and weight gain. It can run in families and increases your chances of developing gestational diabetes and Type 2 Diabetes later in life. It is treated with changes to your diet, especially reducing soft drink, sugar and processed food. Symptoms improve with the oral contraceptive pill and tablets used to treat Type 2 Diabetes.
We provide care to improve PCOS symptoms and weight management.
If you are thinking about becoming pregnant, and you have a preexisting medical condition that requires specialist care, we can help to manage this so that your health is optimal, and your medications are safe and ready for pregnancy. We will continue to provide care throughout the pregnancy and after delivery, and work closely with your obstetrician and GP.
When oestrogen levels decrease around the time of menopause, women can develop a range of symptoms including brain fog, insomnia, increased hunger, hot flushes and feeling more emotional than usual. Symptoms can improve with treatment using oestrogen patches or gels rubbed onto the skin. HRT is considered safe and can reduce the risk of osteoporosis and heart disease.
We provide care to manage the symptoms of menopause.
Australasian Menopause Society link→
Jean Hailes for Women’s Health link→
Type 1 Diabetes occurs when the immune system switches off the cells in your pancreas that produce insulin. Without insulin, the glucose levels in the bloodstream rise and can make you feel very unwell, causing the following symptoms:
Type 1 Diabetes is a lifelong condition and is treated with insulin given as regular injections using insulin pens or an insulin pump. Insulin treatment aims to replace the insulin that is missing from the body to control the glucose levels. Blood glucose levels are monitored using a glucose meter or a continuous glucose monitor that is stuck on the skin and gives moment-to-moment information about glucose levels.
We provide care to improve glucose control, manage complications, annual screening, drivers license certification, insulin pump – start up and ongoing management.
Type 2 Diabetes is more common than Type 1 Diabetes and often runs in families. It develops when the hormone insulin doesn’t work properly in your body to control the glucose levels. When the glucose in your bloodstream rises, you are at risk for infection and blood vessel disease later in life. Type 2 Diabetes is treated with changes to your diet and exercise, tablets and injections that make your insulin work better in your body to control the blood glucose levels.
We provide care to improve glucose control, manage complications, annual screening, driver’s license certification, insulin treatment and weight management.
If you have diabetes, we can provide a medical authority for your driver’s license, as required by Queensland Transport. If this is required urgently, please contact our reception staff so that we can prioritize your appointment. Please bring to the appointment:
For more information about medical conditions and driving, please visit their website or call 13 23 80.
Diabetes educators provide education and day-to-day practical support for diabetes and:
We partner with the Diabetes Educators in Toowoomba at AH Diabetes, Healthy Lifestyles Australia, St Vincent’s Hospital and St Andrew’s Hospital.
We partner with Dietitians in Toowoomba to provide personalized and structured approach to healthy eating and matched to your individual preferences and your health needs.
Some long-term medical problems can affect fertility and pregnancy health, including thyroid disease, diabetes, high blood pressure and obesity. Other medical problems arise in pregnancy – including gestational diabetes, high blood pressure and preeclampsia – and require specialist medical care to make sure mother and baby are healthy, and the delivery goes well. An obstetric physician provides specialist medical care with your GP and obstetrician to help manage these conditions before, during and after pregnancy.
We provide care to manage women before, during and after pregnancy, and work closely with your obstetrician, general practitioner, and midwife. We visit St Vincent’s Private Hospital to provide medical care at the time of delivery.
About 10% of women will develop high blood glucose levels because of hormones coming from the placenta. It is diagnosed with a glucose tolerance test and treated by making changes to your diet and doing more exercise, and in some cases, with Metformin tablets and/or insulin. Having Gestational Diabetes in pregnancy can increase your chances of developing Type 2 Diabetes later in life.
We provide care to improve glucose control, including starting and managing insulin and care during and after delivery.
