Clinical Investigation Unit

The Clinical Investigation Unit is situated in Cringleford Outpatients on Level 1 West Block. It consists of an administration office and a clinical area with two reclining couches. There is a radio to listen to or patients may bring their own personal entertainment with headphones.

A wide range of specialist blood and urine tests are performed to diagnose and monitor patients with endocrine or hormonal disorders. Highly skilled specialist nurses perform these tests in a relaxed and pleasant environment.

Education and Training

Staff are part of a multidisciplinary team and both medical and nursing student spend time with the Endocrine Specialist Nurses (ESN) in the CIU and in the Endocrine Clinics.

Many endocrine conditions are life long, and so it is vital that patients and their families understand their conditions in detail. The endocrine specialist nurses play a key role in this, and so provide individualised education sessions for some patients, and carry a wealth of printed education and information leaflets on the unit. These are available for patients, their families and staff and are free to access.

Support Groups

The unit is actively involved in patient support groups for many endocrine disorders such as The Pituitary Foundation, Turner Syndrome society, Addison’s Support and Cushing’s Support Group. For details of any of the endocrine support groups please contact CIU staff.

Endocrine conditions

This list is not exhaustive but these are the main endocrine conditions investigated in the Clinical Investigation Unit.

• Pituitary and hypothalamic disorders:

o Pituitary tumours
o Acromegaly
o Cushing’s Syndrome
o Prolactinoma
o Hypopituitarism
o Diabetes insipidus

• Reproductive disorders:

o Polycystic Ovary Syndrome
o Premature ovarian failure
o Disorders of low testosterone
o Congenital adrenal hyperplasia

• Adrenal disorders

o Addison’s disease
o Long term steroid treatment
o Congenital adrenal hyperplasia

Endocrine Dynamic Tests

Dynamic tests involve the measurements of hormone levels in special situations eg at specific times of the day, or before and after giving specific tablets, injections or infusions. These need to be done by highly trained and experienced staff and so are all performed on the CIU by specialist nurses. This list includes most of the common tests performed in the CIU. Please note: most of these test can only be requested by consultant endocrinologists, but those marked with an asterix* can be requested by other hospital specialists as well.

  • Short Synacthen Test*
    This is a test for Addison’s disease, or to see whether the adrenal glands can still make the hormone cortisol in people who have been taking steroids for a long time.
    A modified version of this test is also used to diagnose congenital adrenal hyperplasia.
  • Hydrocortisone Day Curve
    This is a test to monitor the levels throughout the day in patients who need steroid hormone replacement therapy.
  • Oral Glucose Tolerance Test
    This can be performed to confirm suspected diabetes, but a modified version can also be used to diagnose the pituitary disorder acromegaly.
  • Water Deprivation Test
    This prolonged test is to confirm the hypothalamic disorder Diabetes Insipidus as a cause of extreme thirst and urinary problems.
  • Insulin Stress Test
    This is a test for suspected hypopituitarism
  • GHRH-Arginine Test
    This is an alternative test for hypopituitarism and for diagnosing growth hormone deficiency
  • Glucagon Test
    This is an alternative test for hypopituitarism, and is used in people unable to have an insulin stress test.
  • Growth Hormone Profile
    This is a series of tests for monitoring the treatment of acromegaly.
  • Prolonged Glucose Tolerance Test
    This is a specially prolonged glucose test for diagnosing reactive hypoglycaemia.
  • Thyroxine Absorption Test
    This is a test to investigate unusual thyroid function tests, and to establish how well thyroxine is absorbed into the blood stream.
  • Ibandronic Acid Zoledronic Acid infusions
    These treatments are given on the CIU to treat osteoporosis, Paget’s Disease and hypercalcaemia.
  • Autonomic Function Test
    This is a series of measurements to test for damage to the autonomic nervous system.
  • Venous sampling
    This highly specialised test is coordinated through Interventional Radiography and is used to help localise very small tumours of the endocrine system.

Staff Members

Administrator – Chris Jermy
Endocrine Specialist Nurses – Sondra Gorick and Katherine Powell

The endocrine nurses also support and have their own outpatient clinics as follows:

Monday morning – Katherine Powell supports Dr Sword’s thyroid assessment clinic.

Monday morning – Neetha Jose supports Dr Myint’s weight management clinic.

Monday afternoon – Katherine Powell provides a thyroid tele clinic. Referrals can only be made by doctors within endocrinology.

Wednesday morning – Sondra Gorick has an endocrine clinic where she starts and monitors treatments for patients with growth hormone deficiency; she also sees patients for education and monitoring of their endocrine disease.

Contact Details

Main Telephone Number: 01603 286360 direct dial