Endocrinology & Metabolism

Hormones influence many essential functions in the body, including blood sugar, metabolism, growth, energy levels, reproduction, bone health and the body’s response to stress. When hormone levels become too high, too low or the body does not respond to hormones normally, a person may develop an endocrine disorder.

For patients searching for an Endocrinology Hospital in Nepal, Nagarik Community Teaching Hospital provides specialist consultation through its Endocrinology & Metabolism Department in Gatthaghar, Bhaktapur. The department evaluates and manages conditions involving diabetes, thyroid disorders, pituitary and adrenal conditions, parathyroid disorders, PCOS and other hormonal or metabolic problems.

If you have been diagnosed with an endocrine condition or are experiencing symptoms that may be related to a hormonal imbalance, an endocrinology consultation can help determine the appropriate next step.

Book an Endocrinology Consultation at Nagarik Hospital.

What Is Endocrinology?

Endocrinology is the branch of medicine concerned with the endocrine system, which consists of glands that produce hormones and release them into the bloodstream.

Important endocrine glands and organs include the:

• Thyroid gland
• Pituitary gland
• Adrenal glands
• Parathyroid glands
• Pancreas
• Ovaries
• Testes

Hormones produced by these glands help regulate metabolism, blood glucose, growth and development, reproduction, blood pressure, bone health and many other body functions. Endocrine diseases can develop when hormone levels are abnormal or when the body does not respond properly to a hormone.

An endocrinologist is a doctor trained to evaluate and manage disorders involving hormones, glands and metabolism.

When Should You See an Endocrinologist?

You may be referred to an endocrinologist after an abnormal blood test, a diagnosis such as diabetes or thyroid disease, or symptoms that suggest a possible hormonal problem.

Consider discussing an endocrinology consultation with your doctor if you experience persistent or unexplained:

• Weight gain or weight loss
• Excessive thirst
• Frequent urination
• Unusual fatigue or weakness
• Increased hunger
• Heat or cold intolerance
• Excessive sweating
• Tremors or palpitations
• Changes in menstrual periods
• Difficulty becoming pregnant associated with hormonal problems
• Excess facial or body hair in women
• Changes in growth or puberty
• Neck swelling
• Muscle weakness
• Unexplained changes in blood pressure
• Recurrent low or high blood sugar
• Reduced sexual function
• Symptoms associated with abnormal thyroid or hormone test results

These symptoms can occur for many different reasons and do not necessarily mean that you have an endocrine disease. Proper assessment is important before determining the cause.

Endocrine Conditions We Evaluate and Manage

The Endocrinology & Metabolism specialty covers a wide range of conditions affecting hormonal and metabolic health.

Diabetes Mellitus

Diabetes develops when blood glucose levels remain too high because the body does not produce enough insulin, does not use insulin effectively, or both.

An endocrinologist may be involved in the assessment and management of:

• Type 1 diabetes
• Type 2 diabetes
• Difficult-to-control diabetes
• Insulin resistance
• Recurrent high blood sugar
• Recurrent low blood sugar
• Diabetes-related metabolic problems
• Complications requiring coordinated specialist care

Diabetes management usually involves more than controlling a single blood glucose reading. Depending on the patient, care may include evaluation of HbA1c, blood glucose patterns, medicines, nutrition, physical activity and risk factors for complications.

Nagarik Hospital lists fasting glucose and HbA1c testing among several of its screening and laboratory services.

Thyroid Disorders

The thyroid gland is located in the neck and produces hormones that influence metabolism and many body functions.

Two common thyroid conditions are:

Hypothyroidism – when the thyroid does not produce enough thyroid hormone.

Hyperthyroidism – when the thyroid produces too much thyroid hormone.

Hypothyroidism can be associated with symptoms such as fatigue, weight gain, dry skin, hair changes, menstrual changes and increased sensitivity to cold. However, these symptoms are not specific to thyroid disease and require proper evaluation.

Hyperthyroidism may be associated with weight loss, rapid heartbeat, tremors, sweating, heat intolerance, anxiety or increased bowel movements. The condition can have different causes and treatment depends on the diagnosis.

Thyroid evaluation may involve:

• Clinical examination
• TSH
• T3 and T4 when indicated
• Other thyroid-related blood tests
• Imaging when clinically appropriate
• Referral to another specialist when necessary

Nagarik Hospital includes thyroid function testing in several of its published screening packages.

Parathyroid Disorders

The parathyroid glands help regulate calcium levels in the body.

Conditions affecting these glands may cause abnormal calcium levels and can influence:

• Bones
• Kidneys
• Muscles
• Nerves

Evaluation can include calcium-related blood tests, hormone assessment and other investigations depending on the suspected disorder.

Pituitary Disorders

The pituitary is a small gland at the base of the brain that helps control several other endocrine glands.

Pituitary disorders can affect hormones involved in:

• Growth
• Reproduction
• Thyroid function
• Adrenal function
• Prolactin production

Examples of endocrine conditions associated with pituitary dysfunction include:

• Hyperprolactinemia
• Growth hormone deficiency
• Acromegaly
• Panhypopituitarism
• Hypogonadism

Dr. Subi Kharel's published specialist profile at Nagarik Hospital lists pituitary disorders among her clinical areas of expertise.

Adrenal Gland Disorders

The adrenal glands sit above the kidneys and produce hormones including cortisol and aldosterone.

Adrenal disorders may result in excessive or insufficient hormone production.

Examples include:

• Cushing syndrome
• Adrenal insufficiency
• Endocrine causes of hypertension

Adrenal insufficiency can cause symptoms such as prolonged fatigue, weakness, loss of appetite, weight loss, dizziness and low blood pressure, although these symptoms can also occur in many other conditions.

Depending on the clinical situation, evaluation may involve cortisol measurements, other hormone testing and imaging when appropriate.

Polycystic Ovary Syndrome — PCOS

PCOS is a hormonal and metabolic condition that can affect menstrual cycles, ovulation, androgen levels and metabolic health.

Women with PCOS may experience:

• Irregular periods
• Difficulty with ovulation
• Excess facial or body hair
• Acne
• Weight-related concerns
• Insulin resistance

Not every woman with irregular menstruation has PCOS. Diagnosis usually considers the clinical history, examination and appropriate testing while excluding other possible hormonal causes.

Growth and Puberty Disorders

Hormones play an important role in childhood and adolescent development.

Endocrine evaluation may be considered when there are concerns about:

• Short stature
• Growth hormone deficiency
• Excess growth hormone
• Precocious puberty
• Delayed puberty

Growth patterns and puberty vary between individuals, so specialist assessment is necessary before deciding whether a hormonal disorder is present.

Symptoms and the Appropriate Next Step

Symptom or Situation	Possible Next Step
Persistent excessive thirst and frequent urination	Blood glucose evaluation and medical consultation
Repeated high blood sugar	Diabetes assessment
Unexplained fatigue with weight changes	Medical evaluation; thyroid or other tests may be considered
Palpitations, tremor and heat intolerance	Thyroid and general medical assessment
Persistent cold intolerance and unexplained weight gain	Thyroid evaluation may be appropriate
Irregular menstruation with excess facial hair	Hormonal assessment, including evaluation for PCOS where appropriate
Abnormal TSH or thyroid test	Endocrinology consultation may be recommended
Abnormal cortisol or pituitary hormone result	Specialist endocrinology evaluation
Unusual growth or puberty changes	Endocrine evaluation may be considered
Recurrent low blood glucose	Prompt medical assessment is important

Symptoms alone cannot confirm an endocrine disorder. Diagnosis generally requires a combination of medical history, clinical examination and appropriate investigations.

How Does an Endocrinology Consultation Work?

An endocrinology consultation begins by understanding the patient's symptoms, medical history and previous test results.

1. Medical History

The endocrinologist may ask about:

• Current symptoms
• When symptoms began
• Previous endocrine conditions
• Diabetes or thyroid history
• Current medicines
• Previous surgery
• Pregnancy history when relevant
• Menstrual history when relevant
• Growth and puberty history
• Family history of endocrine diseases

Bringing previous laboratory reports, imaging reports and a list of current medicines can help the doctor understand your condition.

2. Clinical Examination

The examination depends on the reason for consultation.

The doctor may evaluate factors such as:

• Weight and body mass index
• Blood pressure
• Pulse
• Neck and thyroid gland
• Skin and hair changes
• Signs of abnormal hormone activity
• Growth or developmental features
• Diabetes-related findings

3. Diagnostic Testing

Not every patient requires the same tests.

Based on the suspected condition, the endocrinologist may consider tests such as:

• Fasting blood glucose
• HbA1c
• Thyroid function test
• TSH
• T3 and T4
• Cortisol
• Prolactin
• Calcium
• Electrolytes
• Lipid profile
• Growth-related hormones
• Reproductive hormone tests
• Other specialized endocrine tests

Nagarik Hospital's published health packages include tests such as fasting glucose, HbA1c, thyroid function tests, prolactin and cortisol in selected packages.

Additional testing or imaging may be recommended depending on the initial findings.

Endocrine and Hormone Testing

Hormone testing is useful only when interpreted in the correct clinical context.

Hormone levels may change according to:

• Time of day
• Age
• Menstrual cycle
• Pregnancy
• Medicines
• Acute illness
• Fasting status
• Other medical conditions

For this reason, an abnormal laboratory value should not usually be interpreted in isolation.

For example, evaluation of suspected adrenal insufficiency may involve cortisol testing and, in selected situations, stimulation testing or imaging to determine the underlying cause.

Your doctor will determine which tests are appropriate based on your symptoms and clinical findings.

How Are Endocrine Disorders Treated?

Treatment depends on the specific condition, its cause, severity, test results and the patient's overall health.

Endocrinology treatment may involve one or more of the following approaches.

Medicines

Some endocrine disorders are managed with medicines that:

• Replace a hormone the body does not produce adequately
• Reduce excessive hormone production
• Improve blood glucose control
• Improve the body's response to insulin
• Address associated metabolic problems

The choice of medicine must be individualized after clinical evaluation.

Lifestyle and Nutrition Support

Lifestyle changes can be an important part of managing several metabolic conditions, particularly diabetes and insulin resistance.

Depending on the condition, a care plan may include:

• Individualized nutrition advice
• Appropriate physical activity
• Weight management
• Sleep and stress management
• Smoking cessation
• Monitoring blood glucose where necessary

Nagarik Hospital's published obesity screening package includes both dietitian and endocrinologist consultation.

Hormone Replacement

When the body cannot produce enough of a particular hormone, replacement therapy may be considered.

The type, dose and monitoring depend on the specific hormone deficiency and individual patient factors.

Patients should not start, stop or change hormone medicines without medical guidance.

Referral for Additional Treatment

Some endocrine conditions require input from other specialties.

Depending on the diagnosis, an endocrinologist may coordinate care with:

• Internal medicine
• Cardiology
• Nephrology
• Gynaecology
• Surgery
• Radiology
• Nutrition services
• Other relevant departments

For example, a structural thyroid problem may require imaging or surgical assessment, while diabetes-related kidney disease may require coordinated endocrinology and nephrology care.

What Are the Benefits and Limitations of Endocrinology Care?

Specialist endocrinology evaluation can help identify whether symptoms are related to a hormonal or metabolic disorder and guide appropriate treatment.

Potential benefits include:

• More focused evaluation of endocrine conditions
• Appropriate hormone testing
• Interpretation of abnormal endocrine laboratory results
• Long-term management of chronic disorders
• Treatment adjustment based on clinical response
• Coordination with other specialists when needed
• Monitoring for complications associated with chronic endocrine disease

However, endocrinology assessment also has limitations.

Symptoms such as fatigue, weight changes, hair loss, weakness and menstrual irregularity can have causes unrelated to hormones. A hormonal test alone may not explain the patient's symptoms, and some conditions require evaluation by another medical specialty.

Treatment response also varies depending on the condition, severity, underlying cause and individual patient factors.

Your Endocrinology Patient Journey

Step 1: Recognize a Concern

You may have symptoms, an existing diagnosis or an abnormal laboratory result.

Step 2: Book a Consultation

Schedule an appointment with the Endocrinology & Metabolism Department.

Step 3: Clinical Assessment

The endocrinologist reviews your symptoms, medical history, medicines and previous test results.

Step 4: Appropriate Testing

Laboratory tests or imaging may be recommended according to the suspected condition.

Step 5: Diagnosis and Treatment Planning

Your doctor discusses the findings and recommends treatment or further assessment.

Step 6: Follow-Up

Many endocrine disorders are chronic and require ongoing monitoring.

Follow-up may include:

• Repeat laboratory tests
• Medicine adjustment
• Monitoring symptoms
• Blood glucose monitoring
• Thyroid monitoring
• Assessment for complications
• Lifestyle and nutrition support

Managing Diabetes With Specialist Care

Diabetes is one of the most common conditions managed within endocrinology.

Effective diabetes management is individualized. A patient's treatment can depend on:

• Type of diabetes
• Duration of disease
• HbA1c
• Blood glucose patterns
• Age
• Kidney function
• Heart health
• Other medical conditions
• Current medication
• Risk of low blood sugar
• Lifestyle

Regular monitoring can help the medical team determine whether the current treatment plan remains appropriate.

Patients with diabetes may also need coordinated evaluation of their kidneys, eyes, heart and other organs depending on their risk profile.

Thyroid Treatment and Long-Term Monitoring

Many thyroid conditions require follow-up rather than one-time treatment.

For hypothyroidism, doctors may monitor thyroid hormone levels and clinical symptoms to determine whether treatment remains appropriate.

For hyperthyroidism, treatment depends on the underlying cause and can require ongoing monitoring.

Patients should avoid changing thyroid medicine or using hormone supplements based solely on symptoms or internet advice. Too much or too little thyroid hormone can both cause health problems.

Hormonal Imbalance: Why Proper Diagnosis Matters

The phrase “hormonal imbalance” can refer to many different conditions.

Hormones include:

• Thyroid hormones
• Insulin
• Cortisol
• Growth hormone
• Prolactin
• Reproductive hormones
• Parathyroid hormone

Because different hormones perform different functions, there is no single universal “hormone imbalance test.”

The correct evaluation depends on the patient's symptoms, examination and medical history.

Instead of testing every hormone without a clear reason, an endocrinologist can identify which investigations are clinically appropriate.

When Is an Endocrine Problem an Emergency?

Most endocrine conditions are managed through scheduled outpatient care. However, some situations require urgent assessment.

Seek emergency medical attention for symptoms such as:

• Severe confusion or loss of consciousness
• Seizures
• Severe dehydration
• Persistent vomiting with weakness or altered consciousness
• Very low blood glucose causing confusion or unconsciousness
• Severe high blood glucose with vomiting, breathing difficulty or altered consciousness
• Severe weakness with fainting or very low blood pressure
• Sudden serious deterioration in a person with a known adrenal disorder

These symptoms can have many causes and should not be self-diagnosed.

Nagarik Hospital publishes 24-hour emergency and ambulance services.

Endocrinology Specialists at Nagarik Hospital

Nagarik Community Teaching Hospital's Endocrinology & Metabolism Department currently lists:

Dr. Amrit Rijal

Endocrinologist — Endocrinology & Metabolism

Dr. Amrit Rijal is listed by Nagarik Hospital as an endocrinologist within the Endocrinology & Metabolism Department.

Dr. Subi Kharel

Consultant, Endocrinology & Metabolism

Dr. Subi Kharel holds an MBBS from Nepal Medical College and an MD in Endocrinology and Metabolism from Bangabandhu Sheikh Mujib Medical University, Bangladesh.

Her published areas of expertise include:

• Diabetes mellitus
• Hypothyroidism
• Hyperthyroidism
• Parathyroid disorders
• Pituitary disorders
• Adrenal disorders
• Cushing syndrome
• Adrenal insufficiency
• Growth hormone disorders
• Hyperprolactinemia
• Hypogonadism
• Pubertal disorders
• PCOS

Why Consider Nagarik Hospital for Endocrinology Care?

Endocrine disorders frequently require a combination of specialist consultation, laboratory evaluation, ongoing monitoring and coordination with other medical departments.

Nagarik Community Teaching Hospital provides an established Endocrinology & Metabolism Department with endocrinology specialists and access to supporting hospital services. The hospital's published screening services include several endocrine-related investigations such as fasting glucose, HbA1c, thyroid function testing, prolactin and cortisol in appropriate packages.

The hospital is located at:

Nagarik Community Teaching Hospital
Gatthaghar, Bhaktapur, Nepal

Patients from Bhaktapur, Kathmandu and other areas of Kathmandu Valley can contact the hospital to confirm the current endocrinology OPD schedule before visiting.

Questions to Ask Your Endocrinologist

Before or during your consultation, you may want to ask:

• What may be causing my symptoms?
• Which tests do I actually need?
• What does my hormone test result mean?
• Do I need treatment now or monitoring?
• How often should my blood tests be repeated?
• What changes should I make to my diet or lifestyle?
• Could another medicine be affecting my hormone levels?
• What side effects should I watch for?
• How often should I return for follow-up?
• Do I need consultation with another specialist?

Understanding your diagnosis and treatment plan can help you participate more actively in your care.

Frequently Asked Questions

What does an endocrinologist treat?

An endocrinologist diagnoses and manages disorders involving hormones, endocrine glands and metabolism. These can include diabetes, thyroid disorders, pituitary conditions, adrenal disorders, parathyroid problems, PCOS and growth or puberty-related endocrine conditions.

When should I see an endocrinologist?

You may need an endocrinologist if you have an established endocrine condition, abnormal hormone tests, difficult-to-control diabetes, thyroid problems or symptoms that your doctor believes may be caused by a hormonal disorder.

Which doctor should I see for thyroid problems?

An endocrinologist commonly evaluates and manages hormonal thyroid disorders such as hypothyroidism and hyperthyroidism. Some structural thyroid conditions may also require evaluation by radiology or a thyroid surgeon depending on the findings.

Does an endocrinologist treat diabetes?

Yes. Diabetes is one of the major conditions managed by endocrinologists. Specialist care may be particularly useful when diabetes is difficult to control, treatment needs adjustment or other endocrine and metabolic conditions are present.

What is a thyroid function test?

A thyroid function test is a blood test used to assess thyroid activity. TSH is commonly measured, while T3, T4 or other tests may be recommended depending on the clinical situation.

What are common symptoms of hormonal imbalance?

Symptoms depend on which hormone is affected. Possible symptoms include unexplained weight changes, fatigue, menstrual changes, changes in growth, excessive thirst, frequent urination, changes in body hair, heat or cold intolerance and muscle weakness. These symptoms can also occur in non-endocrine conditions.

Can an endocrinologist treat PCOS?

Endocrinologists may be involved in managing hormonal and metabolic aspects of PCOS, particularly when insulin resistance or other endocrine abnormalities are present. Care may also involve a gynaecologist depending on the patient's symptoms and goals.

What tests does an endocrinologist recommend?

Testing depends on the suspected condition. Examples may include fasting glucose, HbA1c, thyroid tests, cortisol, prolactin, calcium, electrolytes, lipid profile and other targeted hormone tests. Not every patient needs all of these investigations.

Do hormone problems always require lifelong treatment?

No. Some endocrine conditions require long-term treatment and monitoring, while others may be temporary or require treatment for a limited period. The duration depends on the diagnosis and response to treatment.

Can weight gain be caused by hormones?

Certain endocrine disorders can contribute to weight changes, but weight gain has many possible causes. An endocrinologist may investigate hormonal causes when the medical history, symptoms or examination indicate that such testing is appropriate.

Can thyroid disorders be controlled?

Many thyroid disorders can be managed effectively with appropriate diagnosis, treatment and follow-up. The treatment approach and monitoring requirements depend on the specific thyroid condition.

Where is Nagarik Hospital's Endocrinology Department located?

Nagarik Community Teaching Hospital is located in Gatthaghar, Bhaktapur, Nepal and provides Endocrinology & Metabolism consultations through its specialist department.

Book an Endocrinology Consultation at Nagarik Hospital

If you have diabetes, thyroid problems, abnormal hormone test results, menstrual or metabolic concerns, or symptoms that may be related to an endocrine disorder, specialist assessment can help determine the cause and appropriate next step.

Consult the Endocrinology & Metabolism Department at Nagarik Community Teaching Hospital for evaluation, diagnosis, treatment planning and follow-up of endocrine and metabolic conditions.

Location: Gatthaghar, Bhaktapur, Nepal
Hospital Contact: +977-1-6637700
Department: Endocrinology & Metabolism

Book an Appointment | Consult an Endocrinologist

This information is intended for general patient education and does not replace consultation, diagnosis or treatment from a qualified healthcare professional. Treatment and testing should be individualized after medical assessment.

Content updated: August 2026